server/staging/scholarships/index.html

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   9         <title> Scholarships &mdash; LibrePlanet 2014</title>
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  41                           <div class="lp-head">
  42                                 <h1><a href="/2014/"> LibrePlanet <small>2014</small></a></h1>
  43                                 <p><strong>March 22nd-23rd 2014 in Cambridge, MA</strong></p>
  44                                 <p class="text-muted">Free software, free society</p>
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  49                                  href="https://libreplanet.org/2014/register">
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  51                                 Register now
  52                           </a>
  53                           <p class="text-muted text-center">
  54                                 gratis for members and students!
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  89                         <p class="text-muted text-center">and attend the conference gratis!</p>
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  93                         <h2> Scholarship <small>application</small> </h2>
  94
  95                         <p>We are offering a limited number of travel scholarships to assist with expenses related to attending LibrePlanet 2014. While we cannot offer stipends to everyone who applies, we will do our best to bring as many people as possible from as many communities as possible. We are generally unable to cover 100% of your travel and hotel costs, applicants should be prepared to cover some portion of travel expenses. <strong>The application deadline for travel stipends is Friday, January 10, 2014 at 22:00 UTC (17:00 EST).</strong></p>
  96
  97                         <form action="https://crm.fsf.org/civicrm/profile/create?gid=250&amp;reset=1"
  98                                   class="form-horizontal margin-top" method="post" name="Edit" id="Edit" role="form">
  99
 100                           <div>
 101                                 <input name="postURL" type="hidden"
 102                                            value="https://www.libreplanet.org/2014/scholarships/confirmation.html" />
 103                                 <input name="cancelURL" type="hidden"
 104                                            value="https://www.libreplanet.org/2014" />
 105                                 <input name="add_to_group" type="hidden" value="572" />
 106                                 <input name="_qf_default" type="hidden" value="Edit:cancel" />
 107                           </div>
 108
 109                           <div id="crm-container" class="crm-container crm-public" lang="en"
 110                                    xml:lang="en">
 111
 112
 113                                 <div id="editrow-email-Primary" class="form-group">
 114                                   <label for="email-Primary" class="col-sm-3 control-label">
 115                                         Email
 116                                         <span class="field-required">*</span>
 117                                   </label>
 118
 119                                   <div class="col-sm-5">
 120                                         <input name="email-Primary"
 121                                                    class="form-control"
 122                                                    type="email" id="email-Primary"
 123                                                    placeholder="Your email address" required>
 124                                   </div>
 125                                 </div>
 126
 127                                 <div id="editrow-first_name"
 128                                          class="form-group">
 129                                   <label class="col-sm-3 control-label" for="first_name">
 130                                         First Name
 131                                         <span class="field-required">*</span>
 132                                   </label>
 133                                   <div class="col-sm-5">
 134                                         <input class="form-control"
 135                                                    name="first_name"
 136                                                    type="text" id="first_name" required>
 137                                   </div>
 138                                 </div>
 139
 140                                 <div id="editrow-last_name" class="form-group">
 141                                   <label class="col-sm-3 control-label"
 142                                                  for="last_name">
 143                                         Last Name
 144                                         <span class="field-required">*</span>
 145                                   </label>
 146                                   <div class="col-sm-5">
 147                                         <input
 148                                            name="last_name"
 149                                            type="text"
 150                                            id="last_name"
 151                                            class="form-control" required>
 152                                   </div>
 153                                 </div>
 154
 155                                 <div class="form-group"
 156                                          id="helprow-street_address-Primary">
 157                                   <div class="col-sm-offset-3 col-sm-5">
 158                                         <p class="help-block scholarship-input-annotation">
 159                                           <small>Please tell us where you're coming from.</small>
 160                                         </p>
 161                                   </div>
 162                                 </div>
 163
 164                                 <div id="editrow-street_address-Primary" class="form-group">
 165                                   <label class="col-sm-3 control-label"
 166                                                  for="street_address-Primary">
 167                                         Street Address
 168                                   </label>
 169                                   <div class="col-sm-7">
 170                                         <input name="street_address-Primary" type="text"
 171                                                    id="street_address-Primary" class="form-control">
 172                                   </div>
 173                                 </div>
 174
 175                                 <div id="editrow-city-Primary"
 176                                          class="form-group">
 177                                   <label class="col-sm-3 control-label" for="city-Primary">
 178                                         City
 179                                   </label>
 180                                   <div
 181                                          class="col-sm-5">
 182                                         <input name="city-Primary" type="text" id="city-Primary" class="form-control"
 183                                                    />
 184                                   </div>
 185                                 </div>
 186
 187                                 <div id="editrow-postal_code-Primary" class="form-group">
 188                                   <label class="col-sm-3 control-label"
 189                                                  for="postal_code-Primary">
 190                                         Postal Code
 191                                   </label>
 192                                   <div class="col-sm-5">
 193                                         <input
 194                                            name="postal_code-Primary" type="text" id="postal_code-Primary"
 195                                            class="form-control" />
 196                                   </div>
 197                                 </div>
 198
 199                                 <div id="editrow-country-Primary" class="form-group">
 200                                   <label class="col-sm-3 control-label" for="country-Primary">
 201                                         Country
 202                                         <span class="field-required">*</span>
 203                                   </label>
 204                                   <div class="col-sm-5">
 205                                         <select
 206                                            name="country-Primary" id="country-Primary" class="form-control"
 207                                            required>
 208                                           <option value="">- select -</option>
 209                                           <option value="1228" selected="selected">United States</option>
 210                                           <option value="1001">Afghanistan</option>
 211                                           <option value="1241">Åland Islands</option>
 212                                           <option value="1002">Albania</option>
 213                                           <option value="1003">Algeria</option>
 214                                           <option value="1004">American Samoa</option>
 215                                           <option value="1005">Andorra</option>
 216                                           <option value="1006">Angola</option>
 217                                           <option value="1007">Anguilla</option>
 218                                           <option value="1008">Antarctica</option>
 219                                           <option value="1009">Antigua and Barbuda</option>
 220                                           <option value="1010">Argentina</option>
 221                                           <option value="1011">Armenia</option>
 222                                           <option value="1012">Aruba</option>
 223                                           <option value="1013">Australia</option>
 224                                           <option value="1014">Austria</option>
 225                                           <option value="1015">Azerbaijan</option>
 226                                           <option value="1212">Bahamas</option>
 227                                           <option value="1016">Bahrain</option>
 228                                           <option value="1017">Bangladesh</option>
 229                                           <option value="1018">Barbados</option>
 230                                           <option value="1019">Belarus</option>
 231                                           <option value="1020">Belgium</option>
 232                                           <option value="1021">Belize</option>
 233                                           <option value="1022">Benin</option>
 234                                           <option value="1023">Bermuda</option>
 235                                           <option value="1024">Bhutan</option>
 236                                           <option value="1025">Bolivia</option>
 237                                           <option value="1250">Bonaire, Saint Eustatius and Saba</option>
 238                                           <option value="1026">Bosnia and Herzegovina</option>
 239                                           <option value="1027">Botswana</option>
 240                                           <option value="1028">Bouvet Island</option>
 241                                           <option value="1029">Brazil</option>
 242                                           <option value="1030">British Indian Ocean Territory</option>
 243                                           <option value="1032">Brunei Darussalam</option>
 244                                           <option value="1033">Bulgaria</option>
 245                                           <option value="1034">Burkina Faso</option>
 246                                           <option value="1036">Burundi</option>
 247                                           <option value="1037">Cambodia</option>
 248                                           <option value="1038">Cameroon</option>
 249                                           <option value="1039">Canada</option>
 250                                           <option value="1040">Cape Verde</option>
 251                                           <option value="1041">Cayman Islands</option>
 252                                           <option value="1042">Central African Republic</option>
 253                                           <option value="1043">Chad</option>
 254                                           <option value="1044">Chile</option>
 255                                           <option value="1045">China</option>
 256                                           <option value="1046">Christmas Island</option>
 257                                           <option value="1047">Cocos (Keeling) Islands</option>
 258                                           <option value="1048">Colombia</option>
 259                                           <option value="1049">Comoros</option>
 260                                           <option value="1051">Congo, Republic of the</option>
 261                                           <option value="1050">Congo, The Democratic Republic of the</option>
 262                                           <option value="1052">Cook Islands</option>
 263                                           <option value="1053">Costa Rica</option>
 264                                           <option value="1054">Côte d'Ivoire</option>
 265                                           <option value="1055">Croatia</option>
 266                                           <option value="1056">Cuba</option>
 267                                           <option value="1248">CuraÃ§ao</option>
 268                                           <option value="1057">Cyprus</option>
 269                                           <option value="1058">Czech Republic</option>
 270                                           <option value="1059">Denmark</option>
 271                                           <option value="1060">Djibouti</option>
 272                                           <option value="1061">Dominica</option>
 273                                           <option value="1062">Dominican Republic</option>
 274                                           <option value="1064">Ecuador</option>
 275                                           <option value="1065">Egypt</option>
 276                                           <option value="1066">El Salvador</option>
 277                                           <option value="1067">Equatorial Guinea</option>
 278                                           <option value="1068">Eritrea</option>
 279                                           <option value="1069">Estonia</option>
 280                                           <option value="1070">Ethiopia</option>
 281                                           <option value="1072">Falkland Islands (Malvinas)</option>
 282                                           <option value="1073">Faroe Islands</option>
 283                                           <option value="1074">Fiji</option>
 284                                           <option value="1075">Finland</option>
 285                                           <option value="1076">France</option>
 286                                           <option value="1077">French Guiana</option>
 287                                           <option value="1078">French Polynesia</option>
 288                                           <option value="1079">French Southern Territories</option>
 289                                           <option value="1080">Gabon</option>
 290                                           <option value="1213">Gambia</option>
 291                                           <option value="1081">Georgia</option>
 292                                           <option value="1082">Germany</option>
 293                                           <option value="1083">Ghana</option>
 294                                           <option value="1084">Gibraltar</option>
 295                                           <option value="1085">Greece</option>
 296                                           <option value="1086">Greenland</option>
 297                                           <option value="1087">Grenada</option>
 298                                           <option value="1088">Guadeloupe</option>
 299                                           <option value="1089">Guam</option>
 300                                           <option value="1090">Guatemala</option>
 301                                           <option value="1245">Guernsey</option>
 302                                           <option value="1091">Guinea</option>
 303                                           <option value="1092">Guinea-Bissau</option>
 304                                           <option value="1093">Guyana</option>
 305                                           <option value="1094">Haiti</option>
 306                                           <option value="1095">Heard Island and McDonald Islands</option>
 307                                           <option value="1096">Holy See (Vatican City State)</option>
 308                                           <option value="1097">Honduras</option>
 309                                           <option value="1098">Hong Kong</option>
 310                                           <option value="1099">Hungary</option>
 311                                           <option value="1100">Iceland</option>
 312                                           <option value="1101">India</option>
 313                                           <option value="1102">Indonesia</option>
 314                                           <option value="1103">Iran, Islamic Republic of</option>
 315                                           <option value="1104">Iraq</option>
 316                                           <option value="1105">Ireland</option>
 317                                           <option value="1246">Isle of Man</option>
 318                                           <option value="1106">Israel</option>
 319                                           <option value="1107">Italy</option>
 320                                           <option value="1108">Jamaica</option>
 321                                           <option value="1109">Japan</option>
 322                                           <option value="1244">Jersey</option>
 323                                           <option value="1110">Jordan</option>
 324                                           <option value="1111">Kazakhstan</option>
 325                                           <option value="1112">Kenya</option>
 326                                           <option value="1113">Kiribati</option>
 327                                           <option value="1114">Korea, Democratic People's Republic of</option>
 328                                           <option value="1115">Korea, Republic of</option>
 329                                           <option value="1251">Kosovo</option>
 330                                           <option value="1116">Kuwait</option>
 331                                           <option value="1117">Kyrgyzstan</option>
 332                                           <option value="1118">Lao People's Democratic Republic</option>
 333                                           <option value="1119">Latvia</option>
 334                                           <option value="1120">Lebanon</option>
 335                                           <option value="1121">Lesotho</option>
 336                                           <option value="1122">Liberia</option>
 337                                           <option value="1123">Libya</option>
 338                                           <option value="1124">Liechtenstein</option>
 339                                           <option value="1125">Lithuania</option>
 340                                           <option value="1126">Luxembourg</option>
 341                                           <option value="1127">Macao</option>
 342                                           <option value="1128">Macedonia, Republic of</option>
 343                                           <option value="1129">Madagascar</option>
 344                                           <option value="1130">Malawi</option>
 345                                           <option value="1131">Malaysia</option>
 346                                           <option value="1132">Maldives</option>
 347                                           <option value="1133">Mali</option>
 348                                           <option value="1134">Malta</option>
 349                                           <option value="1135">Marshall Islands</option>
 350                                           <option value="1136">Martinique</option>
 351                                           <option value="1137">Mauritania</option>
 352                                           <option value="1138">Mauritius</option>
 353                                           <option value="1139">Mayotte</option>
 354                                           <option value="1140">Mexico</option>
 355                                           <option value="1141">Micronesia, Federated States of</option>
 356                                           <option value="1142">Moldova</option>
 357                                           <option value="1143">Monaco</option>
 358                                           <option value="1144">Mongolia</option>
 359                                           <option value="1243">Montenegro</option>
 360                                           <option value="1145">Montserrat</option>
 361                                           <option value="1146">Morocco</option>
 362                                           <option value="1147">Mozambique</option>
 363                                           <option value="1035">Myanmar</option>
 364                                           <option value="1148">Namibia</option>
 365                                           <option value="1149">Nauru</option>
 366                                           <option value="1150">Nepal</option>
 367                                           <option value="1152">Netherlands</option>
 368                                           <option value="1153">New Caledonia</option>
 369                                           <option value="1154">New Zealand</option>
 370                                           <option value="1155">Nicaragua</option>
 371                                           <option value="1156">Niger</option>
 372                                           <option value="1157">Nigeria</option>
 373                                           <option value="1158">Niue</option>
 374                                           <option value="1159">Norfolk Island</option>
 375                                           <option value="1160">Northern Mariana Islands</option>
 376                                           <option value="1161">Norway</option>
 377                                           <option value="1162">Oman</option>
 378                                           <option value="1163">Pakistan</option>
 379                                           <option value="1164">Palau</option>
 380                                           <option value="1165">Palestinian Territory, Occupied</option>
 381                                           <option value="1166">Panama</option>
 382                                           <option value="1167">Papua New Guinea</option>
 383                                           <option value="1168">Paraguay</option>
 384                                           <option value="1169">Peru</option>
 385                                           <option value="1170">Philippines</option>
 386                                           <option value="1171">Pitcairn</option>
 387                                           <option value="1172">Poland</option>
 388                                           <option value="1173">Portugal</option>
 389                                           <option value="1174">Puerto Rico</option>
 390                                           <option value="1175">Qatar</option>
 391                                           <option value="1179">Reunion</option>
 392                                           <option value="1176">Romania</option>
 393                                           <option value="1177">Russian Federation</option>
 394                                           <option value="1178">Rwanda</option>
 395                                           <option value="1180">Saint Helena</option>
 396                                           <option value="1181">Saint Kitts and Nevis</option>
 397                                           <option value="1182">Saint Lucia</option>
 398                                           <option value="1183">Saint Pierre and Miquelon</option>
 399                                           <option value="1184">Saint Vincent and the Grenadines</option>
 400                                           <option value="1185">Samoa</option>
 401                                           <option value="1186">San Marino</option>
 402                                           <option value="1207">Sao Tome and Principe</option>
 403                                           <option value="1187">Saudi Arabia</option>
 404                                           <option value="1188">Senegal</option>
 405                                           <option value="1242">Serbia</option>
 406                                           <option value="1238">Serbia and Montenegro</option>
 407                                           <option value="1189">Seychelles</option>
 408                                           <option value="1190">Sierra Leone</option>
 409                                           <option value="1191">Singapore</option>
 410                                           <option value="1249">Sint Maarten (Dutch Part)</option>
 411                                           <option value="1192">Slovakia</option>
 412                                           <option value="1193">Slovenia</option>
 413                                           <option value="1194">Solomon Islands</option>
 414                                           <option value="1195">Somalia</option>
 415                                           <option value="1196">South Africa</option>
 416                                           <option value="1197">South Georgia and the South Sandwich Islands</option>
 417                                           <option value="1247">South Sudan</option>
 418                                           <option value="1198">Spain</option>
 419                                           <option value="1199">Sri Lanka</option>
 420                                           <option value="1200">Sudan</option>
 421                                           <option value="1201">Suriname</option>
 422                                           <option value="1202">Svalbard and Jan Mayen</option>
 423                                           <option value="1203">Swaziland</option>
 424                                           <option value="1204">Sweden</option>
 425                                           <option value="1205">Switzerland</option>
 426                                           <option value="1206">Syrian Arab Republic</option>
 427                                           <option value="1208">Taiwan</option>
 428                                           <option value="1209">Tajikistan</option>
 429                                           <option value="1210">Tanzania, United Republic of</option>
 430                                           <option value="1211">Thailand</option>
 431                                           <option value="1063">Timor-Leste</option>
 432                                           <option value="1214">Togo</option>
 433                                           <option value="1215">Tokelau</option>
 434                                           <option value="1216">Tonga</option>
 435                                           <option value="1217">Trinidad and Tobago</option>
 436                                           <option value="1218">Tunisia</option>
 437                                           <option value="1219">Turkey</option>
 438                                           <option value="1220">Turkmenistan</option>
 439                                           <option value="1221">Turks and Caicos Islands</option>
 440                                           <option value="1222">Tuvalu</option>
 441                                           <option value="1223">Uganda</option>
 442                                           <option value="1224">Ukraine</option>
 443                                           <option value="1225">United Arab Emirates</option>
 444                                           <option value="1226">United Kingdom</option>
 445                                           <option value="1227">United States Minor Outlying Islands</option>
 446                                           <option value="1229">Uruguay</option>
 447                                           <option value="1230">Uzbekistan</option>
 448                                           <option value="1231">Vanuatu</option>
 449                                           <option value="1232">Venezuela</option>
 450                                           <option value="1233">Viet Nam</option>
 451                                           <option value="1031">Virgin Islands, British</option>
 452                                           <option value="1234">Virgin Islands, U.S.</option>
 453                                           <option value="1235">Wallis and Futuna</option>
 454                                           <option value="1236">Western Sahara</option>
 455                                           <option value="1237">Yemen</option>
 456                                           <option value="1239">Zambia</option>
 457                                           <option value="1240">Zimbabwe</option>
 458                                         </select>
 459                                   </div>
 460                                 </div>
 461
 462                                 <div id="editrow-state_province-Primary" class="form-group">
 463                                   <label class="col-sm-3 control-label" for="state_province-Primary">
 464                                         State or Province
 465                                   </label>
 466                                   <div class="col-sm-5">
 467                                         <select name="state_province-Primary" id="state_province-Primary"
 468                                                         class="form-control">
 469                                           <option value="">- select -</option>
 470                                           <option value="1000">Alabama</option>
 471                                           <option value="1001">Alaska</option>
 472                                           <option value="1052">American Samoa</option>
 473                                           <option value="1002">Arizona</option>
 474                                           <option value="1003">Arkansas</option>
 475                                           <option value="1060">Armed Forces Americas</option>
 476                                           <option value="1059">Armed Forces Europe</option>
 477                                           <option value="1061">Armed Forces Pacific</option>
 478                                           <option value="1004">California</option>
 479                                           <option value="1005">Colorado</option>
 480                                           <option value="1006">Connecticut</option>
 481                                           <option value="1007">Delaware</option>
 482                                           <option value="1050">District of Columbia</option>
 483                                           <option value="1008">Florida</option>
 484                                           <option value="1009">Georgia</option>
 485                                           <option value="1053">Guam</option>
 486                                           <option value="1010">Hawaii</option>
 487                                           <option value="1011">Idaho</option>
 488                                           <option value="1012">Illinois</option>
 489                                           <option value="1013">Indiana</option>
 490                                           <option value="1014">Iowa</option>
 491                                           <option value="1015">Kansas</option>
 492                                           <option value="1016">Kentucky</option>
 493                                           <option value="1017">Louisiana</option>
 494                                           <option value="1018">Maine</option>
 495                                           <option value="1019">Maryland</option>
 496                                           <option value="1020">Massachusetts</option>
 497                                           <option value="1021">Michigan</option>
 498                                           <option value="1022">Minnesota</option>
 499                                           <option value="1023">Mississippi</option>
 500                                           <option value="1024">Missouri</option>
 501                                           <option value="1025">Montana</option>
 502                                           <option value="1026">Nebraska</option>
 503                                           <option value="1027">Nevada</option>
 504                                           <option value="1028">New Hampshire</option>
 505                                           <option value="1029">New Jersey</option>
 506                                           <option value="1030">New Mexico</option>
 507                                           <option value="1031">New York</option>
 508                                           <option value="1032">North Carolina</option>
 509                                           <option value="1033">North Dakota</option>
 510                                           <option value="1055">Northern Mariana Islands</option>
 511                                           <option value="1034">Ohio</option>
 512                                           <option value="1035">Oklahoma</option>
 513                                           <option value="1036">Oregon</option>
 514                                           <option value="1037">Pennsylvania</option>
 515                                           <option value="1056">Puerto Rico</option>
 516                                           <option value="1038">Rhode Island</option>
 517                                           <option value="1039">South Carolina</option>
 518                                           <option value="1040">South Dakota</option>
 519                                           <option value="1041">Tennessee</option>
 520                                           <option value="1042">Texas</option>
 521                                           <option value="1058">United States Minor Outlying Islands</option>
 522                                           <option value="1043">Utah</option>
 523                                           <option value="1044">Vermont</option>
 524                                           <option value="1057">Virgin Islands</option>
 525                                           <option value="1045">Virginia</option>
 526                                           <option value="1046">Washington</option>
 527                                           <option value="1047">West Virginia</option>
 528                                           <option value="1048">Wisconsin</option>
 529                                           <option value="1049">Wyoming</option>
 530                                         </select>
 531                                   </div>
 532                                 </div>
 533
 534                                 <hr/>
 535
 536                                 <div id="editrow-custom_107" class="form-group">
 537                                   <label class="col-sm-3 control-label">
 538                                         Would you be willing to volunteer at the event?
 539                                         <span class="field-required">*</span>
 540                                   </label>
 541
 542                                   <div class="col-sm-5">
 543                                         <label class="radio-inline" for="CIVICRM_QFID_1_2">
 544                                           <input value="1"
 545                                                          type="radio" id="CIVICRM_QFID_1_2" name="custom_107"
 546                                                          />Yes</label>&nbsp;
 547
 548                                         <label class="radio-inline" for="CIVICRM_QFID_0_4">
 549                                         <input value="0"
 550                                                    type="radio" id="CIVICRM_QFID_0_4" name="custom_107"
 551                                                    />No</label>
 552                                   </div>
 553                                 </div>
 554
 555                                 <div class="form-group"
 556                                          id="helprow-custom_122">
 557                                   <div class="col-sm-offset-3 col-sm-5">
 558                                         <p class="help-block scholarship-input-annotation">
 559                                           <small>Check all that apply</small>
 560                                         </p>
 561                                   </div>
 562                                 </div>
 563
 564                                 <div id="editrow-custom_122" class="form-group">
 565                                   <label class="col-sm-3 control-label">
 566                                         Race/Ethnicity
 567                                   </label>
 568
 569                                   <div class="col-sm-9">
 570
 571                                         <input type="hidden" name="custom_122[African]" value="" />
 572                                         <label class="checkbox-inline"
 573                                                    for="custom_122_African">
 574                                           <input id="custom_122_African" name="custom_122[African]"
 575                                                          type="checkbox" value="1"/>
 576                                           African
 577                                         </label>&nbsp;
 578
 579                                         <input type="hidden" name="custom_122[African American]" value="" />
 580                                         <label class="checkbox-inline" for="custom_122_African_American">
 581                                           <input id="custom_122_African_American"
 582                                                          name="custom_122[African American]"
 583                                                          type="checkbox" value="1"/>
 584                                           African American
 585                                         </label>&nbsp;
 586
 587                                         <input type="hidden" name="custom_122[Arab American]" value="" />
 588                                         <label class="checkbox-inline"
 589                                                    for="custom_122_Arab_American">
 590                                           <input id="custom_122_Arab_American" name="custom_122[Arab American]"
 591                                                          type="checkbox" value="1"/>
 592                                           Arab American
 593                                         </label>&nbsp;
 594
 595                                         <input type="hidden" name="custom_122[Asian]" value="" />
 596                                         <label class="checkbox-inline"
 597                                                    for="custom_122_Asian">
 598                                           <input id="custom_122_Asian" name="custom_122[Asian]"
 599                                                          type="checkbox" value="1"/>
 600                                           Asian
 601                                         </label>&nbsp;
 602
 603                                         <input type="hidden" name="custom_122[Asian American]" value="" />
 604                                         <label class="checkbox-inline" for="custom_122_Asian_American">
 605                                           <input id="custom_122_Asian_American" name="custom_122[Asian American]"
 606                                                          type="checkbox" value="1"/>
 607                                           Asian American</label>&nbsp;
 608
 609                                         <input type="hidden" name="custom_122[Black]"
 610                                                    value="" />
 611                                         <label class="checkbox-inline"
 612                                                    for="custom_122_Black">
 613                                           <input id="custom_122_Black" name="custom_122[Black]"
 614                                                          type="checkbox" value="1"/>
 615                                           Black</label>&nbsp;
 616
 617                                         <input type="hidden" name="custom_122[Caribbean]" value="" />
 618                                         <label class="checkbox-inline"
 619                                                    for="custom_122_Caribbean">
 620                                           <input id="custom_122_Caribbean" name="custom_122[Caribbean]"
 621                                                          type="checkbox" value="1"/>Caribbean</label>&nbsp;
 622
 623                                         <input type="hidden" name="custom_122[Caucasian]" value="" />
 624                                         <label class="checkbox-inline"
 625                                                    for="custom_122_Caucasian">
 626                                           <input id="custom_122_Caucasian" name="custom_122[Caucasian]"
 627                                                          type="checkbox" value="1" />Caucasian</label>&nbsp;
 628
 629                                         <input type="hidden" name="custom_122[Indigenous]" value="" />
 630                                         <label class="checkbox-inline"
 631                                                    for="custom_122_Indigenous">
 632                                           <input id="custom_122_Indigenous" name="custom_122[Indigenous]" type="checkbox"
 633                                                          value="1"/>Indigenous</label>&nbsp;
 634
 635                                         <input type="hidden" name="custom_122[Latina/Latino]" value="" />
 636                                         <label class="checkbox-inline"
 637                                                    for="custom_122_Latina/Latino">
 638                                           <input id="custom_122_Latina/Latino" name="custom_122[Latina/Latino]"
 639                                                          type="checkbox" value="1"/>Latina/Latino</label>&nbsp;
 640
 641                                         <input type="hidden" name="custom_122[Middle Eastern]" value="" />
 642                                         <label class="checkbox-inline"
 643                                                    for="custom_122_Middle_Eastern">
 644                                           <input id="custom_122_Middle_Eastern" name="custom_122[Middle Eastern]"
 645                                                          type="checkbox" value="1"/>Middle Eastern</label>&nbsp;
 646
 647                                         <input type="hidden" name="custom_122[Pacific Islander]" value="" />
 648                                         <label class="checkbox-inline"
 649                                                    for="custom_122_Pacific_Islander">
 650                                           <input id="custom_122_Pacific_Islander" name="custom_122[Pacific Islander]"
 651                                                          type="checkbox" value="1"/>Pacific Islander</label>&nbsp;
 652
 653                                         <input type="hidden" name="custom_122[South Asian]" value="" />
 654                                         <label class="checkbox-inline"
 655                                                    for="custom_122_South_Asian">
 656                                           <input id="custom_122_South_Asian" name="custom_122[South Asian]"
 657                                                          type="checkbox" value="1"/>South Asian</label>&nbsp;
 658
 659                                         <input type="hidden" name="custom_122[White]" value="" />
 660                                         <label class="checkbox-inline"
 661                                                    for="custom_122_White">
 662                                           <input id="custom_122_White" name="custom_122[White]"
 663                                                          type="checkbox" value="1"
 664                                                          />White</label>&nbsp;
 665
 666                                         <input type="hidden" name="custom_122[None of these are accurate for me]" value="" />
 667                                         <label class="checkbox-inline" for="custom_122_None_of_these_are_accurate_for_me">
 668                                           <input id="custom_122_None_of_these_are_accurate_for_me"
 669                                                          name="custom_122[None of these are accurate for me]" type="checkbox" value="1"/>
 670                                           None of these are accurate for me</label>
 671                                   </div>
 672                                 </div>
 673
 674                                 <div id="editrow-gender" class="form-group">
 675                                   <label class="col-sm-3 control-label">
 676                                         Gender
 677                                   </label>
 678
 679                                   <div class="col-sm-9">
 680
 681                                         <label class="radio-inline"
 682                                                    for="CIVICRM_QFID_3_6">
 683                                           <input value="3" type="radio" id="CIVICRM_QFID_3_6"
 684                                                          name="gender" />
 685                                           Transgender</label>&nbsp;
 686
 687                                         <label class="radio-inline"  for="CIVICRM_QFID_4_8">
 688                                           <input value="4" type="radio" id="CIVICRM_QFID_4_8" name="gender"/>
 689                                           Cisgender</label>&nbsp;
 690
 691                                         <label class="radio-inline" for="CIVICRM_QFID_5_10">
 692                                           <input value="5" type="radio" id="CIVICRM_QFID_5_10" name="gender" />
 693                                           Genderqueer / Non-Conforming / Variant</label>&nbsp;
 694
 695                                         <label class="radio-inline"
 696                                                    for="CIVICRM_QFID_1_12">
 697                                           <input value="1" type="radio"
 698                                                          id="CIVICRM_QFID_1_12" name="gender"/>
 699                                           Woman
 700                                         </label>&nbsp;
 701
 702                                         <label class="radio-inline"
 703                                                    for="CIVICRM_QFID_2_14">
 704                                           <input value="2" type="radio"
 705                                                          id="CIVICRM_QFID_2_14" name="gender"/>
 706                                           Man</label>&nbsp;
 707
 708                                         <label class="radio-inline" for="CIVICRM_QFID_6_16">
 709                                           <input value="6" type="radio" id="CIVICRM_QFID_6_16" name="gender" />
 710                                           None of these are accurate for
 711                                           me</label>&nbsp;
 712
 713                                         <span class="radio-clear-link">
 714                                           (<a href="#"
 715                                                   title="unselect"
 716                                                   onclick="unselectRadio('gender', 'Edit'); return false;">clear</a>)
 717                                         </span>
 718
 719                                   </div>
 720                                 </div>
 721
 722                                 <div class="form-group" id="helprow-custom_104">
 723                                   <div class="col-sm-offset-3 col-sm-5">
 724                                         <p class="help-block scholarship-input-annotation">
 725                                           <small>Please limit each of your answers to 150 words.</small>
 726                                         </p>
 727                                   </div>
 728                                 </div>
 729
 730                                 <div id="editrow-custom_104" class="form-group">
 731                                   <label class="col-sm-3 control-label" for="custom_104">
 732                                         GNU Project affiliation, if any
 733                                   </label>
 734                                   <div class="col-sm-9">
 735                                         <textarea rows="4" name="custom_104" id="custom_104"
 736                                                           class="form-control"></textarea>
 737                                   </div>
 738                                 </div>
 739
 740                                 <div id="editrow-custom_105" class="form-group">
 741                                   <label class="col-sm-3 control-label" for="custom_105">
 742                                         Why do you want to attend LibrePlanet 2014?</label>
 743                                   <div class="col-sm-9">
 744                                         <textarea
 745                                            rows="4" name="custom_105" id="custom_105"
 746                                            class="form-control"></textarea>
 747                                   </div>
 748                                 </div>
 749
 750                                 <div id="editrow-custom_106" class="form-group">
 751                                   <label class="col-sm-3 control-label" for="custom_106">
 752                                         How do you plan to bring your
 753                                         experience back to your community?
 754                                   </label>
 755                                   <div class="col-sm-9">
 756                                         <textarea rows="4" name="custom_106" id="custom_106"
 757                                                           class="form-control"></textarea>
 758                                   </div>
 759                                 </div>
 760
 761                                 <div id="editrow-custom_103" class="form-group">
 762                                   <label class="col-sm-3" for="custom_103">
 763                                         Estimated travel and hotel expenses
 764                                   </label>
 765                                   <div class="col-sm-9">
 766                                         <textarea rows="4" name="custom_103" id="custom_103"
 767                                                           class="form-control"></textarea>
 768                                   </div>
 769                                 </div>
 770                           </div>
 771
 772                           <!-- end form-layout-compressed for last profile -->
 773
 774                           <div class="form-group">
 775                                 <p>
 776                                   We will not publish or share
 777                                   your information with any party outside the FSF. See our
 778                                   <a href="https://my.fsf.org/donate/privacypolicy.html">
 779                                         privacy policy</a> for more information.
 780                                 </p>
 781                           </div>
 782
 783                           <div class="form-group">
 784
 785                                 <input class="btn btn-default"
 786                                            accesskey="S" name="_qf_Edit_next"
 787                                            value="Save" type="submit"
 788                                            id="_qf_Edit_next" />
 789                           </div>
 790
 791                   </form>
 792
 793
 794                   </div> <!-- end of Scholarships LP14 main text -->
 795                 </div>
 796           </div> <!-- end of container -->
 797
 798         </div> <!-- end of wrapper -->
 799
 800         <div id="footer">
 801           <div class="container">
 802                 <p class="text-muted text-center">
 803                   The <a href="http://www.fsf.org/">Free Software
 804                   Foundation</a> is a nonprofit with a worldwide mission to
 805                   advance software freedom.
 806                   <a href="https://my.fsf.org/associate/support_freedom">
 807                         Donate</a>.
 808                 </p>
 809
 810                 <p class="text-muted text-center">
 811                   <a rel="license"
 812                          href="http://creativecommons.org/licenses/by-sa/3.0/us/">
 813                         <img alt="[ Creative Commons License ]" style="border-width:0"
 814                                  src="//i.creativecommons.org/l/by-sa/3.0/80x15.png" />
 815                   </a>
 816                   This page and its images, logos and videos are licensed under a <br />
 817                   <a rel="license"
 818                          href="http://creativecommons.org/licenses/by-sa/3.0/us/">
 819                         Creative Commons Attribution-ShareAlike 3.0 US
 820                   </a>.
 821                   Copyright &copy; 2013 Free Software Foundation.
 822                 </p>
 823
 824                 <p class="text-muted text-center">
 825                   <a href="http://weblabels.fsf.org/libreplanet.org/CURRENT/" rel="jslicense">
 826                         JavaScript license information
 827                   </a>
 828                 </p>
 829
 830                 <p class="text-muted text-center">
 831                   This site, including fonts, CSS, and JavaScript, was built using
 832                   <a href="http://getbootstrap.com">Bootstrap</a>,
 833                   which is licensed under the
 834                   <a href="https://directory.fsf.org/wiki/License:Apache2.0">
 835                         Apache 2.0 license</a>.
 836                 </p>
 837           </div>
 838         </div>
 839
 840         <script type="text/javascript"
 841                         src="/2014/assets/js/jquery-1.8.3.min.js">
 842         </script>
 843
 844         <script type="text/javascript"
 845                         src="/2014/assets/js/jquery.chainedSelects.js">
 846         </script>
 847
 848         <script type="text/javascript"
 849                         src="/2014/assets/js/jquery.form.js">
 850         </script>
 851
 852         <script type="text/javascript"
 853                         src="/2014/assets/js/Common.js">
 854         </script>
 855
 856         <script type="text/javascript">
 857           // @license magnet:?xt=urn:btih:8e4f440f4c65981c5bf93c76d35135ba5064d8b7&dn=apache-2.0.txt
 858
 859           var cj = jQuery.noConflict(); $ = cj;
 860
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 862                   countryID = "#country-Primary"
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