{"id":2669,"date":"2021-08-03T19:35:26","date_gmt":"2021-08-03T19:35:26","guid":{"rendered":"https:\/\/education.delaware.gov\/diaa\/digital-assets\/diaa-committee-application-form\/"},"modified":"2024-10-28T17:31:16","modified_gmt":"2024-10-28T21:31:16","slug":"diaa-committee-application-form","status":"publish","type":"page","link":"https:\/\/education.delaware.gov\/diaa\/governance\/committees\/diaa-committee-application-form\/","title":{"rendered":"Committee Application Form"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 100% + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form fusion-form-builder fusion-form-form-wrapper fusion-form-2662\" style=\"--awb-tooltip-text-color:#ffffff;--awb-tooltip-background-color:#333333;\" data-form-id=\"2662\" data-config=\"{&quot;form_id&quot;:&quot;2662&quot;,&quot;form_post_id&quot;:&quot;2662&quot;,&quot;post_id&quot;:2669,&quot;form_type&quot;:&quot;ajax&quot;,&quot;confirmation_type&quot;:&quot;message&quot;,&quot;redirect_url&quot;:&quot;&quot;,&quot;redirect_timeout&quot;:&quot;0&quot;,&quot;field_labels&quot;:{&quot;first_name&quot;:&quot;First Name&quot;,&quot;middle_initial&quot;:&quot;Middle Initial&quot;,&quot;last_name&quot;:&quot;Last Name&quot;,&quot;suffix_ie_jr_phd&quot;:&quot;Suffix (i.e. Jr, Ph.D)&quot;,&quot;street&quot;:&quot;Street&quot;,&quot;city&quot;:&quot;City&quot;,&quot;state&quot;:&quot;State&quot;,&quot;zip&quot;:&quot;Zip&quot;,&quot;schoolcompanyemployer_name&quot;:&quot;School\\\/Company\\\/Employer Name&quot;,&quot;cell&quot;:&quot;Cell&quot;,&quot;home&quot;:&quot;Home&quot;,&quot;Race&quot;:&quot;Race&quot;,&quot;work&quot;:&quot;Work&quot;,&quot;email&quot;:&quot;Email&quot;,&quot;gender&quot;:&quot;Gender&quot;,&quot;employercompany&quot;:&quot;Employer\\\/Company&quot;,&quot;positiontitle&quot;:&quot;Position\\\/Title&quot;,&quot;start_date&quot;:&quot;Start Date&quot;,&quot;end_date&quot;:&quot;End Date&quot;,&quot;retired_educator&quot;:&quot;Retired Educator?&quot;,&quot;retiring_agency&quot;:&quot;If yes, retiring agency&quot;,&quot;license_date_issued_date_expires&quot;:&quot;License, Date Issued, Date Expires&quot;,&quot;school_name&quot;:&quot;School Name&quot;,&quot;city_state&quot;:&quot;City, State&quot;,&quot;certificatediploma_or_degree&quot;:&quot;Certificate\\\/Diploma or Degree&quot;,&quot;years_attended&quot;:&quot;Years Attended&quot;,&quot;college_name&quot;:&quot;College Name&quot;,&quot;other_name&quot;:&quot;Other Name&quot;,&quot;qualifications&quot;:&quot;Qualifications&quot;,&quot;previousother_dssaa_or_diaa_service&quot;:&quot;Previous\\\/Other DSSAA or DIAA Service&quot;,&quot;former_student_athlete&quot;:&quot;Former Student Athlete&quot;,&quot;sport_1&quot;:&quot;Sport 1&quot;,&quot;sport_2&quot;:&quot;Sport 2&quot;,&quot;sport_3&quot;:&quot;Sport 3&quot;,&quot;whereyearssport&quot;:&quot;Where\\\/Years\\\/Sport&quot;,&quot;college&quot;:&quot;College&quot;,&quot;high_school&quot;:&quot;High School&quot;,&quot;club&quot;:&quot;Club&quot;,&quot;middle_school&quot;:&quot;Middle School&quot;,&quot;youth&quot;:&quot;Youth&quot;,&quot;sport_coaching_experience&quot;:&quot;&quot;,&quot;diaa_committees_interested_in_joining&quot;:&quot;DIAA Committees Interested in Joining&quot;,&quot;please_explain_why_you_wish_to_serve_in_this_position&quot;:&quot;Please explain why you wish to serve in this position&quot;},&quot;field_logics&quot;:{&quot;first_name&quot;:&quot;&quot;,&quot;middle_initial&quot;:&quot;&quot;,&quot;last_name&quot;:&quot;&quot;,&quot;suffix_ie_jr_phd&quot;:&quot;&quot;,&quot;street&quot;:&quot;&quot;,&quot;city&quot;:&quot;&quot;,&quot;state&quot;:&quot;&quot;,&quot;zip&quot;:&quot;&quot;,&quot;schoolcompanyemployer_name&quot;:&quot;&quot;,&quot;cell&quot;:&quot;&quot;,&quot;home&quot;:&quot;&quot;,&quot;Race&quot;:&quot;&quot;,&quot;work&quot;:&quot;&quot;,&quot;email&quot;:&quot;&quot;,&quot;gender&quot;:&quot;&quot;,&quot;employercompany&quot;:&quot;&quot;,&quot;positiontitle&quot;:&quot;&quot;,&quot;start_date&quot;:&quot;&quot;,&quot;end_date&quot;:&quot;&quot;,&quot;retired_educator&quot;:&quot;&quot;,&quot;retiring_agency&quot;:&quot;&quot;,&quot;license_date_issued_date_expires&quot;:&quot;&quot;,&quot;school_name&quot;:&quot;&quot;,&quot;city_state&quot;:&quot;&quot;,&quot;certificatediploma_or_degree&quot;:&quot;&quot;,&quot;years_attended&quot;:&quot;&quot;,&quot;college_name&quot;:&quot;&quot;,&quot;other_name&quot;:&quot;&quot;,&quot;qualifications&quot;:&quot;&quot;,&quot;previousother_dssaa_or_diaa_service&quot;:&quot;&quot;,&quot;former_student_athlete&quot;:&quot;&quot;,&quot;sport_1&quot;:&quot;&quot;,&quot;sport_2&quot;:&quot;&quot;,&quot;sport_3&quot;:&quot;&quot;,&quot;whereyearssport&quot;:&quot;&quot;,&quot;college&quot;:&quot;&quot;,&quot;high_school&quot;:&quot;&quot;,&quot;club&quot;:&quot;&quot;,&quot;middle_school&quot;:&quot;&quot;,&quot;youth&quot;:&quot;&quot;,&quot;sport_coaching_experience&quot;:&quot;&quot;,&quot;diaa_committees_interested_in_joining&quot;:&quot;&quot;,&quot;please_explain_why_you_wish_to_serve_in_this_position&quot;:&quot;&quot;,&quot;submit_1&quot;:&quot;&quot;,&quot;notice_1&quot;:&quot;&quot;},&quot;field_types&quot;:{&quot;first_name&quot;:&quot;text&quot;,&quot;middle_initial&quot;:&quot;text&quot;,&quot;last_name&quot;:&quot;text&quot;,&quot;suffix_ie_jr_phd&quot;:&quot;text&quot;,&quot;street&quot;:&quot;text&quot;,&quot;city&quot;:&quot;text&quot;,&quot;state&quot;:&quot;text&quot;,&quot;zip&quot;:&quot;text&quot;,&quot;schoolcompanyemployer_name&quot;:&quot;text&quot;,&quot;cell&quot;:&quot;phone_number&quot;,&quot;home&quot;:&quot;phone_number&quot;,&quot;Race&quot;:&quot;checkbox&quot;,&quot;work&quot;:&quot;phone_number&quot;,&quot;email&quot;:&quot;email&quot;,&quot;gender&quot;:&quot;radio&quot;,&quot;employercompany&quot;:&quot;text&quot;,&quot;positiontitle&quot;:&quot;text&quot;,&quot;start_date&quot;:&quot;date&quot;,&quot;end_date&quot;:&quot;date&quot;,&quot;retired_educator&quot;:&quot;radio&quot;,&quot;retiring_agency&quot;:&quot;text&quot;,&quot;license_date_issued_date_expires&quot;:&quot;text&quot;,&quot;school_name&quot;:&quot;text&quot;,&quot;city_state&quot;:&quot;text&quot;,&quot;certificatediploma_or_degree&quot;:&quot;text&quot;,&quot;years_attended&quot;:&quot;number&quot;,&quot;college_name&quot;:&quot;text&quot;,&quot;other_name&quot;:&quot;text&quot;,&quot;qualifications&quot;:&quot;textarea&quot;,&quot;previousother_dssaa_or_diaa_service&quot;:&quot;text&quot;,&quot;former_student_athlete&quot;:&quot;radio&quot;,&quot;sport_1&quot;:&quot;text&quot;,&quot;sport_2&quot;:&quot;text&quot;,&quot;sport_3&quot;:&quot;text&quot;,&quot;whereyearssport&quot;:&quot;text&quot;,&quot;college&quot;:&quot;text&quot;,&quot;high_school&quot;:&quot;text&quot;,&quot;club&quot;:&quot;text&quot;,&quot;middle_school&quot;:&quot;text&quot;,&quot;youth&quot;:&quot;text&quot;,&quot;sport_coaching_experience&quot;:&quot;textarea&quot;,&quot;diaa_committees_interested_in_joining&quot;:&quot;checkbox&quot;,&quot;please_explain_why_you_wish_to_serve_in_this_position&quot;:&quot;textarea&quot;,&quot;submit_1&quot;:&quot;submit&quot;,&quot;notice_1&quot;:&quot;notice&quot;},&quot;nonce_method&quot;:&quot;ajax&quot;,&quot;form_views&quot;:&quot;ajax&quot;,&quot;form_views_counting&quot;:&quot;all&quot;}\"><form action=\"https:\/\/education.delaware.gov\/diaa\/governance\/committees\/diaa-committee-application-form\/\" method=\"post\" class=\"fusion-form fusion-form-2662\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><h1>DIAA Committee Application Form<\/h1>\n<p>Thank you for expressing interest in being a part of a DIAA Committee. Please complete all required information.<\/p>\n<\/div><div class=\"fusion-text fusion-text-2\"><hr \/>\n<h2>Information of person completing report<\/h2>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.3333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:33.3333333333%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Name<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"first_name\">First Name <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"first_name\" id=\"first_name\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"middle_initial\">Middle Initial <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"middle_initial\" id=\"middle_initial\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"last_name\">Last Name <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"last_name\" id=\"last_name\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"suffix_ie_jr_phd\">Suffix (i.e. Jr, Ph.D)<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"suffix_ie_jr_phd\" id=\"suffix_ie_jr_phd\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.3333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:33.3333333333%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Home Address<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"street\">Street <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"street\" id=\"street\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"city\">City <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"city\" id=\"city\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"state\">State <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"state\" id=\"state\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"zip\">Zip <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"zip\" id=\"zip\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-2 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.3333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:33.3333333333%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>School\/Employer Address<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"schoolcompanyemployer_name\">School\/Company\/Employer Name <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"schoolcompanyemployer_name\" id=\"schoolcompanyemployer_name\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"street\">Street <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"street\" id=\"street\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"city\">City <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"city\" id=\"city\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"state\">State <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"state\" id=\"state\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"zip\">Zip <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"zip\" id=\"zip\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><\/div><div class=\"fusion-text fusion-text-3\"><hr \/>\n<h3>Contact Information<\/h3>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-3 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-phone-number-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"cell\">Cell <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><div class=\"fusion-form-input-with-icon\"><i class=\"awb-form-icon fa-phone-square-alt fas\"><\/i><input type=\"tel\" autocomplete=\"off\" name=\"cell\" id=\"cell\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><\/div><\/div><div class=\"fusion-form-field fusion-form-phone-number-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"home\">Home <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><div class=\"fusion-form-input-with-icon\"><i class=\"awb-form-icon fa-phone-square-alt fas\"><\/i><input type=\"tel\" autocomplete=\"off\" name=\"home\" id=\"home\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><\/div><\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><fieldset data-awb-fieldset-min-required=\"1\" data-awb-fieldset-max-required=\"0\" data-awb-fieldset-error=\"Please select at least 1 checkbox from this field.\"><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Race <abbr class=\"fusion-form-element-required\" title=\"Please select at least 1 checkbox from this field.\">*<\/abbr><\/span><\/legend><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-0\" type=\"checkbox\" value=\"American Indian or Alaska Native\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-0\">American Indian or Alaska Native<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-1\" type=\"checkbox\" value=\"Asian\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-1\">Asian<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-2\" type=\"checkbox\" value=\"Black or African American\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-2\">Black or African American<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-3\" type=\"checkbox\" value=\"Native Hawaiian or Other Pacific Islander\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-3\">Native Hawaiian or Other Pacific Islander<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-4\" type=\"checkbox\" value=\"White\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-4\">White<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-5\" type=\"checkbox\" value=\"Hispanic\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-5\">Hispanic<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-race-1-6\" type=\"checkbox\" value=\"Other\" name=\"Race[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-race-1-6\">Other<\/label><\/div><\/fieldset><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-4 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-phone-number-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"work\">Work <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><div class=\"fusion-form-input-with-icon\"><i class=\"awb-form-icon fa-phone-square-alt fas\"><\/i><input type=\"tel\" autocomplete=\"off\" name=\"work\" id=\"work\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><\/div><\/div><div class=\"fusion-form-field fusion-form-email-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"email\">Email <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><div class=\"fusion-form-tooltip\"><i class=\"awb-icon-question-circle\"><\/i><span class=\"fusion-form-tooltip-content\">Best contact email to reach you<\/span><\/div><\/div><input type=\"email\" autocomplete=\"off\" name=\"email\" id=\"email\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Gender <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/span><\/legend><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-gender-1-0\" type=\"radio\" value=\"Male\" name=\"gender\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-gender-1-0\">Male<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-gender-1-1\" type=\"radio\" value=\"Female\" name=\"gender\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-gender-1-1\">Female<\/label><\/div><\/fieldset><\/div><\/div><\/div><\/div><div class=\"fusion-text fusion-text-4\"><hr \/>\n<h2>Employment History<\/h2>\n<p>Please list most recent\/current employer first.<\/p>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-5 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Employer<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"employercompany\">Employer\/Company <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"employercompany\" id=\"employercompany\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"positiontitle\">Position\/Title <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"positiontitle\" id=\"positiontitle\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"start_date\">Start Date <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"start_date\" name=\"start_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"end_date\">End Date <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"end_date\" name=\"end_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\"\/><\/div><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Employer<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"employercompany\">Employer\/Company<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"employercompany\" id=\"employercompany\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"positiontitle\">Position\/Title<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"positiontitle\" id=\"positiontitle\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"start_date\">Start Date<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"start_date\" name=\"start_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"end_date\">End Date<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"end_date\" name=\"end_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"\/><\/div><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Retiree?<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Retired Educator? <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/span><\/legend><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-retired_educator-2-0\" type=\"radio\" value=\"Yes\" name=\"retired_educator\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-retired_educator-2-0\">Yes<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-retired_educator-2-1\" type=\"radio\" value=\"No\" name=\"retired_educator\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-retired_educator-2-1\">No<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"retiring_agency\">If yes, retiring agency<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"retiring_agency\" id=\"retiring_agency\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-6 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Employer<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"employercompany\">Employer\/Company<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"employercompany\" id=\"employercompany\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"positiontitle\">Position\/Title<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"positiontitle\" id=\"positiontitle\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"start_date\">Start Date<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"start_date\" name=\"start_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"end_date\">End Date<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"end_date\" name=\"end_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"\/><\/div><div class=\"fusion-title title fusion-title-8 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Employer<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"employercompany\">Employer\/Company<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"employercompany\" id=\"employercompany\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"positiontitle\">Position\/Title<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"positiontitle\" id=\"positiontitle\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"start_date\">Start Date<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"start_date\" name=\"start_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"\/><\/div><div class=\"fusion-form-field fusion-form-date-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"end_date\">End Date<\/label><input autocomplete=\"off\" type=\"date\" data-first-day=\"1\"  data-format=\"\" tabindex=\"\" id=\"end_date\" name=\"end_date\" data-type=\"custom\" value=\"\" data-holds-private-data=\"false\" class=\"fusion-form-input\"\/><\/div><\/div><\/div><\/div><div class=\"fusion-text fusion-text-5\"><hr \/>\n<h2>Education and Qualifications<\/h2>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-7 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-9 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3><label for=\"QID1830\">Professional Licenses and Certificates<\/label><\/h3><\/h1><\/div><div class=\"fusion-text fusion-text-6\"><p><span class=\"InlineHelpSpanStyle\">License, Date Issued, Date Expires Use each entry line to input any professional licenses\/certificates received. If you do not have any, input \"N\/A\"<\/span><\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"license_date_issued_date_expires\">License, Date Issued, Date Expires <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"license_date_issued_date_expires\" id=\"license_date_issued_date_expires\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"license_date_issued_date_expires\">License, Date Issued, Date Expires <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"license_date_issued_date_expires\" id=\"license_date_issued_date_expires\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"license_date_issued_date_expires\">License, Date Issued, Date Expires <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"license_date_issued_date_expires\" id=\"license_date_issued_date_expires\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-title title fusion-title-10 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>High School<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"school_name\">School Name <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"school_name\" id=\"school_name\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"city_state\">City, State <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"city_state\" id=\"city_state\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"certificatediploma_or_degree\">Certificate\/Diploma or Degree <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"certificatediploma_or_degree\" id=\"certificatediploma_or_degree\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-number-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"years_attended\">Years Attended <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"number\" autocomplete=\"off\" name=\"years_attended\" id=\"years_attended\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" min=\"0\" max=\"100\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-8 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-11 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>College<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"college_name\">College Name <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"college_name\" id=\"college_name\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"city_state\">City, State<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"city_state\" id=\"city_state\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"certificatediploma_or_degree\">Certificate\/Diploma or Degree <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"certificatediploma_or_degree\" id=\"certificatediploma_or_degree\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-number-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"years_attended\">Years Attended <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"number\" autocomplete=\"off\" name=\"years_attended\" id=\"years_attended\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" min=\"0\" max=\"100\"\/><\/div><div class=\"fusion-title title fusion-title-12 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>Other<\/h3><\/h1><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"other_name\">Other Name<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"other_name\" id=\"other_name\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"city_state\">City, State<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"city_state\" id=\"city_state\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"certificatediploma_or_degree\">Certificate\/Diploma or Degree<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"certificatediploma_or_degree\" id=\"certificatediploma_or_degree\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-number-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"years_attended\">Years Attended<\/label><\/div><input type=\"number\" autocomplete=\"off\" name=\"years_attended\" id=\"years_attended\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" min=\"0\" max=\"100\"\/><\/div><\/div><\/div><\/div><div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"qualifications\">Qualifications <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><textarea cols=\"40\" autocomplete=\"off\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"qualifications\" name=\"qualifications\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" placeholder=\"Please explain what qualifies you for this appointment *\" data-holds-private-data=\"false\"><\/textarea><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"previousother_dssaa_or_diaa_service\">Previous\/Other DSSAA or DIAA Service <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"previousother_dssaa_or_diaa_service\" id=\"previousother_dssaa_or_diaa_service\" value=\"\"  class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-text fusion-text-7\"><hr \/>\n<h2>Sport Background<\/h2>\n<\/div><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">Former Student Athlete <abbr class=\"fusion-form-element-required\" title=\"required\">*<\/abbr><\/span><\/legend><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-former_student_athlete-3-0\" type=\"radio\" value=\"Yes\" name=\"former_student_athlete\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-former_student_athlete-3-0\">Yes<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-former_student_athlete-3-1\" type=\"radio\" value=\"No\" name=\"former_student_athlete\" class=\"fusion-form-input\" required=\"true\" aria-required=\"true\" data-holds-private-data=\"false\"\/><label for=\"radio-former_student_athlete-3-1\">No<\/label><\/div><\/fieldset><\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-9 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-13 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>High School Sports Played<\/h3><\/h1><\/div><div class=\"fusion-text fusion-text-8\"><p><span class=\"InlineHelpSpanStyle\">Please specify up to 3 sports<\/span><\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"sport_1\">Sport 1<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sport_1\" id=\"sport_1\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"sport_2\">Sport 2<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sport_2\" id=\"sport_2\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"sport_3\">Sport 3<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sport_3\" id=\"sport_3\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-10 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-14 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3>College Sports Played<\/h3><\/h1><\/div><div class=\"fusion-text fusion-text-9\"><p><span class=\"InlineHelpSpanStyle\">Specify up to 3 sports played in college<\/span><\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"sport_1\">Sport 1<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sport_1\" id=\"sport_1\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"sport_2\">Sport 2<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sport_2\" id=\"sport_2\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"sport_3\">Sport 3<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"sport_3\" id=\"sport_3\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><\/div><div class=\"fusion-text fusion-text-10\"><hr \/>\n<h2>Former\/Current Coaching Experience<\/h2>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"--awb-flex-grow:0;--awb-flex-grow-medium:0;--awb-flex-grow-small:0;--awb-flex-shrink:0;--awb-flex-shrink-medium:0;--awb-flex-shrink-small:0;width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-11 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-15 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3><label for=\"QID1845\">High School Coaching Experience<\/label><\/h3><\/h1><\/div><div class=\"fusion-text fusion-text-11\"><p><span class=\"InlineHelpSpanStyle\">Specify up to 3 sports<\/span><\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"whereyearssport\">Where\/Years\/Sport<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"whereyearssport\" id=\"whereyearssport\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"whereyearssport\">Where\/Years\/Sport<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"whereyearssport\" id=\"whereyearssport\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"whereyearssport\">Where\/Years\/Sport<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"whereyearssport\" id=\"whereyearssport\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-12 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-16 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><h3><label for=\"QID1845\">College Coaching Experience<\/label><\/h3><\/h1><\/div><div class=\"fusion-text fusion-text-12\"><p><span class=\"InlineHelpSpanStyle\">Specify up to 3 sports<\/span><\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"whereyearssport\">Where\/Years\/Sport<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"whereyearssport\" id=\"whereyearssport\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"whereyearssport\">Where\/Years\/Sport<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"whereyearssport\" id=\"whereyearssport\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"whereyearssport\">Where\/Years\/Sport<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"whereyearssport\" id=\"whereyearssport\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><\/div><div class=\"fusion-text fusion-text-13\"><hr>\n<h2><label for=\"QID1841\">Officiating Experience: <\/label><label for=\"QID1841\">Sport &amp; Level<\/label><\/h2>\n<p><span class=\"InlineHelpSpanStyle\">List sport officiating experience. Separate different sports coached at that level with a comma (,) Example - High School: girls lacrosse, field hockey<\/span><\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"college\">College<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"college\" id=\"college\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"high_school\">High School<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"high_school\" id=\"high_school\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"club\">Club<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"club\" id=\"club\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"middle_school\">Middle School<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"middle_school\" id=\"middle_school\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div class=\"fusion-form-label-wrapper\"><label for=\"youth\">Youth<\/label><\/div><input type=\"text\" autocomplete=\"off\" name=\"youth\" id=\"youth\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><div class=\"fusion-text fusion-text-14\"><hr \/>\n<\/div><div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"sport_coaching_experience\">Sport coaching experience<\/label><textarea cols=\"40\" autocomplete=\"off\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"sport_coaching_experience\" name=\"sport_coaching_experience\" class=\"fusion-form-input\" placeholder=\"Share what sport coaching experience you have. List each experience with where you coached and when. \" data-holds-private-data=\"false\"><\/textarea><\/div><div class=\"fusion-text fusion-text-15\"><p>&nbsp;<\/p>\n<hr>\n<p>&nbsp;<\/p>\n<h2><label for=\"QID1841\">Educator and\/or Student Development Experience:&nbsp;<\/label><\/h2>\n<p><strong data-start=\"68\" data-end=\"159\">Please describe your experience in education, youth development, or student leadership.<\/strong><br data-start=\"159\" data-end=\"162\">Share any relevant roles, programs, or initiatives you\u2019ve been involved with that reflect your work in supporting, mentoring, or developing students.<\/p>\n<\/div>\n<div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><textarea cols=\"40\" autocomplete=\"off\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"sport_coaching_experience\" name=\"sport_coaching_experience\" class=\"fusion-form-input\" placeholder=\"Share your experience here: \" data-holds-private-data=\"false\"><\/textarea><\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><fieldset><legend class=\"fusion-form-label-wrapper\"><span class=\"label\">DIAA Committees Interested in Joining<\/span><div class=\"fusion-form-tooltip\"><i class=\"awb-icon-question-circle\"><\/i><span class=\"fusion-form-tooltip-content\">Select at least 1.<\/span><\/div><\/legend><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-0\" type=\"checkbox\" value=\"Baseball (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-0\">Baseball (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-1\" type=\"checkbox\" value=\"Basketball, Boys (Winter)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-1\">Basketball, Boys (Winter)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-2\" type=\"checkbox\" value=\"Basketball, Girls (Winter)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-2\">Basketball, Girls (Winter)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-3\" type=\"checkbox\" value=\"Cross Country (Fall)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-3\">Cross Country (Fall)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-4\" type=\"checkbox\" value=\"Field Hockey (Fall)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-4\">Field Hockey (Fall)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-5\" type=\"checkbox\" value=\"Football (Fall)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-5\">Football (Fall)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-6\" type=\"checkbox\" value=\"Golf (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-6\">Golf (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-7\" type=\"checkbox\" value=\"Lacrosse, Boys (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-7\">Lacrosse, Boys (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-8\" type=\"checkbox\" value=\"Lacrosse, Girls (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-8\">Lacrosse, Girls (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-9\" type=\"checkbox\" value=\"Soccer, Boys (Fall)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-9\">Soccer, Boys (Fall)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-10\" type=\"checkbox\" value=\"Soccer, Girls (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-10\">Soccer, Girls (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-11\" type=\"checkbox\" value=\"Softball (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-11\">Softball (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-12\" type=\"checkbox\" value=\"Swimming & Diving (Winter)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-12\">Swimming & Diving (Winter)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-13\" type=\"checkbox\" value=\"Tennis (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-13\">Tennis (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-14\" type=\"checkbox\" value=\"Track & Field (Winter\/Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-14\">Track & Field (Winter\/Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-15\" type=\"checkbox\" value=\"Unified Sports (Fall\/Winter\/Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-15\">Unified Sports (Fall\/Winter\/Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-16\" type=\"checkbox\" value=\"Volleyball, Boys (Spring)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-16\">Volleyball, Boys (Spring)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-17\" type=\"checkbox\" value=\"Volleyball, Girls (Fall)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-17\">Volleyball, Girls (Fall)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-18\" type=\"checkbox\" value=\"Wrestling, Boys (Winter)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-18\">Wrestling, Boys (Winter)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-19\" type=\"checkbox\" value=\"Wrestling, Girls (Winter)\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-19\">Wrestling, Girls (Winter)<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-20\" type=\"checkbox\" value=\"Competition Committee\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-20\">Competition Committee<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-21\" type=\"checkbox\" value=\"Officials Committee\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-21\">Officials Committee<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-22\" type=\"checkbox\" value=\"Rules & Regulations Committee\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-22\">Rules & Regulations Committee<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-23\" type=\"checkbox\" value=\"Sports Medicine Committee\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-23\">Sports Medicine Committee<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-24\" type=\"checkbox\" value=\"Sportsmanship Committee\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-24\">Sportsmanship Committee<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox-diaa_committees_interested_in_joining-2-25\" type=\"checkbox\" value=\"Student Athlete Development Committee\" name=\"diaa_committees_interested_in_joining[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox-diaa_committees_interested_in_joining-2-25\">Student Athlete Development Committee<\/label><\/div><\/fieldset><\/div><div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><label for=\"please_explain_why_you_wish_to_serve_in_this_position\">Please explain why you wish to serve in this position<\/label><textarea cols=\"40\" autocomplete=\"off\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"please_explain_why_you_wish_to_serve_in_this_position\" name=\"please_explain_why_you_wish_to_serve_in_this_position\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><\/textarea><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:calc( 100% + 0px ) !important;max-width:calc( 100% + 0px ) !important;margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:20px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-submit-field fusion-form-label-above\" style=\"\" data-form-id=\"2662\"><div ><button type=\"submit\" class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-default-span  button-default form-form-submit\" data-form-number=\"2662\" tabindex=\"\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Submit<\/span><\/button><\/div><\/div><div class=\"form-submission-notices data-notice_1\" id=\"fusion-notices-1\" data-instance=\"1\"><div class=\"fusion-alert alert success alert-success fusion-alert-center fusion-form-response fusion-form-response-success awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-check-circle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">Thank you for your application. It has been sent to the DIAA.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><div class=\"fusion-alert alert error alert-danger fusion-alert-center fusion-form-response fusion-form-response-error awb-alert-native-link-color alert-dismissable awb-alert-close-boxed\" role=\"alert\"><div class=\"fusion-alert-content-wrapper\"><span class=\"alert-icon\"><i class=\"awb-icon-exclamation-triangle\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-alert-content\">There was an error trying to send your application. Please try again later.<\/span><\/div><button type=\"button\" class=\"close toggle-alert\" data-dismiss=\"alert\" aria-label=\"Close\">&times;<\/button><\/div><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"fusion_privacy_expiration_interval\" value=\"48\"><input type=\"hidden\" name=\"privacy_expiration_action\" value=\"anonymize\"><\/form><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":2501,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"protect_children":false,"footnotes":""},"class_list":["post-2669","page","type-page","status-publish","hentry"],"acf":[],"checksum":[""],"sw_mod_date":[""],"_links":{"self":[{"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/pages\/2669","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/comments?post=2669"}],"version-history":[{"count":0,"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/pages\/2669\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/pages\/2501"}],"wp:attachment":[{"href":"https:\/\/education.delaware.gov\/diaa\/wp-json\/wp\/v2\/media?parent=2669"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}