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TitusN

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TitusN
Mar 8th, 2014
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  1. <!doctype html>
  2. <html>
  3. <head>
  4. <script src="https://secure.jotform.com/static/jotform.js?3.2.806" type="text/javascript"></script>
  5. <script type="text/javascript">
  6.    JotForm.init(function(){
  7.       $('input_5').hint('ex: myname@example.com');
  8.    });
  9. </script>
  10. <link href="https://secure.jotform.com/static/formCss.css?3.2.806" rel="stylesheet" type="text/css" />
  11. <link type="text/css" rel="stylesheet" href="https://secure.jotform.com/css/styles/nova.css?3.2.806" />
  12. <link type="text/css" media="print" rel="stylesheet" href="https://secure.jotform.com/css/printForm.css?3.2.806" />
  13. <style type="text/css">
  14.     .form-label{
  15.         width:150px !important;
  16.     }
  17.     .form-label-left{
  18.         width:150px !important;
  19.     }
  20.     .form-line{
  21.         padding-top:12px;
  22.         padding-bottom:12px;
  23.     }
  24.     .form-label-right{
  25.         width:150px !important;
  26.     }
  27.     .form-all{
  28.         width:810px;
  29.         color:Black !important;
  30.         font-family:'Lucida Grande','Lucida Sans Unicode','Lucida Sans','Verdana','Tahoma','sans-serif';
  31.         font-size:16px;
  32.     }
  33.     .form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
  34.         color:Black;
  35.     }
  36.  
  37. </style>
  38. </head>
  39. <body>
  40.  
  41. <form class="jotform-form" action="https://submit.jotform.com/submit/40641665056858/" method="post" enctype="multipart/form-data" name="form_40641665056858" id="40641665056858" accept-charset="utf-8">
  42.   <input type="hidden" name="formID" value="40641665056858" />
  43.   <div class="form-all">
  44.     <ul class="form-section">
  45.       <li class="form-line" id="id_31">
  46.         <div id="cid_31" class="form-input-wide">
  47.           <img alt="" class="form-image" border="0" src="https://www.jotform.com/uploads/islachamberspandc/form_files/Winterfest landscape Banner 2014.png" height="189.6" width="790" />
  48.         </div>
  49.       </li>
  50.       <li id="cid_1" class="form-input-wide">
  51.         <div class="form-header-group">
  52.           <h3 id="header_1" class="form-header">
  53.             Winterfest 2014 Stand Holder Application
  54.           </h3>
  55.         </div>
  56.       </li>
  57.       <li class="form-line" id="id_4">
  58.         <label class="form-label-left" id="label_4" for="input_4">
  59.           Full Name<span class="form-required">*</span>
  60.         </label>
  61.         <div id="cid_4" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q4_fullName[first]" id="first_4" />
  62.             <label class="form-sub-label" for="first_4" id="sublabel_first"> First Name </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q4_fullName[last]" id="last_4" />
  63.             <label class="form-sub-label" for="last_4" id="sublabel_last"> Last Name </label></span>
  64.         </div>
  65.       </li>
  66.       <li class="form-line" id="id_7">
  67.         <label class="form-label-left" id="label_7" for="input_7">
  68.           Business Name<span class="form-required">*</span>
  69.         </label>
  70.         <div id="cid_7" class="form-input">
  71.           <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_7" name="q7_businessName" size="20" value="" />
  72.         </div>
  73.       </li>
  74.       <li class="form-line" id="id_32">
  75.         <label class="form-label-left" id="label_32" for="input_32">
  76.           Contact Number<span class="form-required">*</span>
  77.         </label>
  78.         <div id="cid_32" class="form-input">
  79.           <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_32" name="q32_contactNumber" size="20" value="" />
  80.         </div>
  81.       </li>
  82.       <li class="form-line" id="id_5">
  83.         <label class="form-label-left" id="label_5" for="input_5">
  84.           E-mail<span class="form-required">*</span>
  85.         </label>
  86.         <div id="cid_5" class="form-input">
  87.           <input type="email" class=" form-textbox validate[required, Email]" id="input_5" name="q5_email" size="30" value="" />
  88.         </div>
  89.       </li>
  90.       <li class="form-line" id="id_6">
  91.         <label class="form-label-left" id="label_6" for="input_6">
  92.           Address<span class="form-required">*</span>
  93.         </label>
  94.         <div id="cid_6" class="form-input">
  95.           <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0">
  96.             <tr>
  97.               <td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q6_address6[addr_line1]" id="input_6_addr_line1" />
  98.                   <label class="form-sub-label" for="input_6_addr_line1" id="sublabel_6_addr_line1"> Street Address </label></span>
  99.               </td>
  100.             </tr>
  101.             <tr>
  102.               <td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q6_address6[addr_line2]" id="input_6_addr_line2" size="46" />
  103.                   <label class="form-sub-label" for="input_6_addr_line2" id="sublabel_6_addr_line2"> Street Address Line 2 </label></span>
  104.               </td>
  105.             </tr>
  106.             <tr>
  107.               <td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q6_address6[city]" id="input_6_city" size="21" />
  108.                   <label class="form-sub-label" for="input_6_city" id="sublabel_6_city"> City </label></span>
  109.               </td>
  110.               <td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q6_address6[state]" id="input_6_state" size="22" />
  111.                   <label class="form-sub-label" for="input_6_state" id="sublabel_6_state"> State / Province </label></span>
  112.               </td>
  113.             </tr>
  114.             <tr>
  115.               <td width="50%" function zip(){var iterator=Prototype.K,args=$A(arguments);if(Object.isFunction(args.last())) iterator=args.pop();var collections=[this].concat(args).map($A);return this.map(function(value,index){return iterator(collections.pluck(index));});}><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q6_address6[postal]" id="input_6_postal" size="10" />
  116.                   <label class="form-sub-label" for="input_6_postal" id="sublabel_6_postal"> Postal / Zip Code </label></span>
  117.               </td>
  118.               <td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q6_address6[country]" id="input_6_country">
  119.                     <option value="" selected> Please Select </option>
  120.                     <option value="United States"> United States </option>
  121.                     <option value="Afghanistan"> Afghanistan </option>
  122.                     <option value="Albania"> Albania </option>
  123.                     <option value="Algeria"> Algeria </option>
  124.                     <option value="American Samoa"> American Samoa </option>
  125.                     <option value="Andorra"> Andorra </option>
  126.                     <option value="Angola"> Angola </option>
  127.                     <option value="Anguilla"> Anguilla </option>
  128.                     <option value="Antigua and Barbuda"> Antigua and Barbuda </option>
  129.                     <option value="Argentina"> Argentina </option>
  130.                     <option value="Armenia"> Armenia </option>
  131.                     <option value="Aruba"> Aruba </option>
  132.                     <option value="Australia"> Australia </option>
  133.                     <option value="Austria"> Austria </option>
  134.                     <option value="Azerbaijan"> Azerbaijan </option>
  135.                     <option value="The Bahamas"> The Bahamas </option>
  136.                     <option value="Bahrain"> Bahrain </option>
  137.                     <option value="Bangladesh"> Bangladesh </option>
  138.                     <option value="Barbados"> Barbados </option>
  139.                     <option value="Belarus"> Belarus </option>
  140.                     <option value="Belgium"> Belgium </option>
  141.                     <option value="Belize"> Belize </option>
  142.                     <option value="Benin"> Benin </option>
  143.                     <option value="Bermuda"> Bermuda </option>
  144.                     <option value="Bhutan"> Bhutan </option>
  145.                     <option value="Bolivia"> Bolivia </option>
  146.                     <option value="Bosnia and Herzegovina"> Bosnia and Herzegovina </option>
  147.                     <option value="Botswana"> Botswana </option>
  148.                     <option value="Brazil"> Brazil </option>
  149.                     <option value="Brunei"> Brunei </option>
  150.                     <option value="Bulgaria"> Bulgaria </option>
  151.                     <option value="Burkina Faso"> Burkina Faso </option>
  152.                     <option value="Burundi"> Burundi </option>
  153.                     <option value="Cambodia"> Cambodia </option>
  154.                     <option value="Cameroon"> Cameroon </option>
  155.                     <option value="Canada"> Canada </option>
  156.                     <option value="Cape Verde"> Cape Verde </option>
  157.                     <option value="Cayman Islands"> Cayman Islands </option>
  158.                     <option value="Central African Republic"> Central African Republic </option>
  159.                     <option value="Chad"> Chad </option>
  160.                     <option value="Chile"> Chile </option>
  161.                     <option value="People's Republic of China"> People's Republic of China </option>
  162.                     <option value="Republic of China"> Republic of China </option>
  163.                     <option value="Christmas Island"> Christmas Island </option>
  164.                     <option value="Cocos (Keeling) Islands"> Cocos (Keeling) Islands </option>
  165.                     <option value="Colombia"> Colombia </option>
  166.                     <option value="Comoros"> Comoros </option>
  167.                     <option value="Congo"> Congo </option>
  168.                     <option value="Cook Islands"> Cook Islands </option>
  169.                     <option value="Costa Rica"> Costa Rica </option>
  170.                     <option value="Cote d'Ivoire"> Cote d'Ivoire </option>
  171.                     <option value="Croatia"> Croatia </option>
  172.                     <option value="Cuba"> Cuba </option>
  173.                     <option value="Cyprus"> Cyprus </option>
  174.                     <option value="Czech Republic"> Czech Republic </option>
  175.                     <option value="Denmark"> Denmark </option>
  176.                     <option value="Djibouti"> Djibouti </option>
  177.                     <option value="Dominica"> Dominica </option>
  178.                     <option value="Dominican Republic"> Dominican Republic </option>
  179.                     <option value="Ecuador"> Ecuador </option>
  180.                     <option value="Egypt"> Egypt </option>
  181.                     <option value="El Salvador"> El Salvador </option>
  182.                     <option value="Equatorial Guinea"> Equatorial Guinea </option>
  183.                     <option value="Eritrea"> Eritrea </option>
  184.                     <option value="Estonia"> Estonia </option>
  185.                     <option value="Ethiopia"> Ethiopia </option>
  186.                     <option value="Falkland Islands"> Falkland Islands </option>
  187.                     <option value="Faroe Islands"> Faroe Islands </option>
  188.                     <option value="Fiji"> Fiji </option>
  189.                     <option value="Finland"> Finland </option>
  190.                     <option value="France"> France </option>
  191.                     <option value="French Polynesia"> French Polynesia </option>
  192.                     <option value="Gabon"> Gabon </option>
  193.                     <option value="The Gambia"> The Gambia </option>
  194.                     <option value="Georgia"> Georgia </option>
  195.                     <option value="Germany"> Germany </option>
  196.                     <option value="Ghana"> Ghana </option>
  197.                     <option value="Gibraltar"> Gibraltar </option>
  198.                     <option value="Greece"> Greece </option>
  199.                     <option value="Greenland"> Greenland </option>
  200.                     <option value="Grenada"> Grenada </option>
  201.                     <option value="Guadeloupe"> Guadeloupe </option>
  202.                     <option value="Guam"> Guam </option>
  203.                     <option value="Guatemala"> Guatemala </option>
  204.                     <option value="Guernsey"> Guernsey </option>
  205.                     <option value="Guinea"> Guinea </option>
  206.                     <option value="Guinea-Bissau"> Guinea-Bissau </option>
  207.                     <option value="Guyana"> Guyana </option>
  208.                     <option value="Haiti"> Haiti </option>
  209.                     <option value="Honduras"> Honduras </option>
  210.                     <option value="Hong Kong"> Hong Kong </option>
  211.                     <option value="Hungary"> Hungary </option>
  212.                     <option value="Iceland"> Iceland </option>
  213.                     <option value="India"> India </option>
  214.                     <option value="Indonesia"> Indonesia </option>
  215.                     <option value="Iran"> Iran </option>
  216.                     <option value="Iraq"> Iraq </option>
  217.                     <option value="Ireland"> Ireland </option>
  218.                     <option value="Israel"> Israel </option>
  219.                     <option value="Italy"> Italy </option>
  220.                     <option value="Jamaica"> Jamaica </option>
  221.                     <option value="Japan"> Japan </option>
  222.                     <option value="Jersey"> Jersey </option>
  223.                     <option value="Jordan"> Jordan </option>
  224.                     <option value="Kazakhstan"> Kazakhstan </option>
  225.                     <option value="Kenya"> Kenya </option>
  226.                     <option value="Kiribati"> Kiribati </option>
  227.                     <option value="North Korea"> North Korea </option>
  228.                     <option value="South Korea"> South Korea </option>
  229.                     <option value="Kosovo"> Kosovo </option>
  230.                     <option value="Kuwait"> Kuwait </option>
  231.                     <option value="Kyrgyzstan"> Kyrgyzstan </option>
  232.                     <option value="Laos"> Laos </option>
  233.                     <option value="Latvia"> Latvia </option>
  234.                     <option value="Lebanon"> Lebanon </option>
  235.                     <option value="Lesotho"> Lesotho </option>
  236.                     <option value="Liberia"> Liberia </option>
  237.                     <option value="Libya"> Libya </option>
  238.                     <option value="Liechtenstein"> Liechtenstein </option>
  239.                     <option value="Lithuania"> Lithuania </option>
  240.                     <option value="Luxembourg"> Luxembourg </option>
  241.                     <option value="Macau"> Macau </option>
  242.                     <option value="Macedonia"> Macedonia </option>
  243.                     <option value="Madagascar"> Madagascar </option>
  244.                     <option value="Malawi"> Malawi </option>
  245.                     <option value="Malaysia"> Malaysia </option>
  246.                     <option value="Maldives"> Maldives </option>
  247.                     <option value="Mali"> Mali </option>
  248.                     <option value="Malta"> Malta </option>
  249.                     <option value="Marshall Islands"> Marshall Islands </option>
  250.                     <option value="Martinique"> Martinique </option>
  251.                     <option value="Mauritania"> Mauritania </option>
  252.                     <option value="Mauritius"> Mauritius </option>
  253.                     <option value="Mayotte"> Mayotte </option>
  254.                     <option value="Mexico"> Mexico </option>
  255.                     <option value="Micronesia"> Micronesia </option>
  256.                     <option value="Moldova"> Moldova </option>
  257.                     <option value="Monaco"> Monaco </option>
  258.                     <option value="Mongolia"> Mongolia </option>
  259.                     <option value="Montenegro"> Montenegro </option>
  260.                     <option value="Montserrat"> Montserrat </option>
  261.                     <option value="Morocco"> Morocco </option>
  262.                     <option value="Mozambique"> Mozambique </option>
  263.                     <option value="Myanmar"> Myanmar </option>
  264.                     <option value="Nagorno-Karabakh"> Nagorno-Karabakh </option>
  265.                     <option value="Namibia"> Namibia </option>
  266.                     <option value="Nauru"> Nauru </option>
  267.                     <option value="Nepal"> Nepal </option>
  268.                     <option value="Netherlands"> Netherlands </option>
  269.                     <option value="Netherlands Antilles"> Netherlands Antilles </option>
  270.                     <option value="New Caledonia"> New Caledonia </option>
  271.                     <option value="New Zealand"> New Zealand </option>
  272.                     <option value="Nicaragua"> Nicaragua </option>
  273.                     <option value="Niger"> Niger </option>
  274.                     <option value="Nigeria"> Nigeria </option>
  275.                     <option value="Niue"> Niue </option>
  276.                     <option value="Norfolk Island"> Norfolk Island </option>
  277.                     <option value="Turkish Republic of Northern Cyprus"> Turkish Republic of Northern Cyprus </option>
  278.                     <option value="Northern Mariana"> Northern Mariana </option>
  279.                     <option value="Norway"> Norway </option>
  280.                     <option value="Oman"> Oman </option>
  281.                     <option value="Pakistan"> Pakistan </option>
  282.                     <option value="Palau"> Palau </option>
  283.                     <option value="Palestine"> Palestine </option>
  284.                     <option value="Panama"> Panama </option>
  285.                     <option value="Papua New Guinea"> Papua New Guinea </option>
  286.                     <option value="Paraguay"> Paraguay </option>
  287.                     <option value="Peru"> Peru </option>
  288.                     <option value="Philippines"> Philippines </option>
  289.                     <option value="Pitcairn Islands"> Pitcairn Islands </option>
  290.                     <option value="Poland"> Poland </option>
  291.                     <option value="Portugal"> Portugal </option>
  292.                     <option value="Puerto Rico"> Puerto Rico </option>
  293.                     <option value="Qatar"> Qatar </option>
  294.                     <option value="Romania"> Romania </option>
  295.                     <option value="Russia"> Russia </option>
  296.                     <option value="Rwanda"> Rwanda </option>
  297.                     <option value="Saint Barthelemy"> Saint Barthelemy </option>
  298.                     <option value="Saint Helena"> Saint Helena </option>
  299.                     <option value="Saint Kitts and Nevis"> Saint Kitts and Nevis </option>
  300.                     <option value="Saint Lucia"> Saint Lucia </option>
  301.                     <option value="Saint Martin"> Saint Martin </option>
  302.                     <option value="Saint Pierre and Miquelon"> Saint Pierre and Miquelon </option>
  303.                     <option value="Saint Vincent and the Grenadines"> Saint Vincent and the Grenadines </option>
  304.                     <option value="Samoa"> Samoa </option>
  305.                     <option value="San Marino"> San Marino </option>
  306.                     <option value="Sao Tome and Principe"> Sao Tome and Principe </option>
  307.                     <option value="Saudi Arabia"> Saudi Arabia </option>
  308.                     <option value="Senegal"> Senegal </option>
  309.                     <option value="Serbia"> Serbia </option>
  310.                     <option value="Seychelles"> Seychelles </option>
  311.                     <option value="Sierra Leone"> Sierra Leone </option>
  312.                     <option value="Singapore"> Singapore </option>
  313.                     <option value="Slovakia"> Slovakia </option>
  314.                     <option value="Slovenia"> Slovenia </option>
  315.                     <option value="Solomon Islands"> Solomon Islands </option>
  316.                     <option value="Somalia"> Somalia </option>
  317.                     <option value="Somaliland"> Somaliland </option>
  318.                     <option value="South Africa"> South Africa </option>
  319.                     <option value="South Ossetia"> South Ossetia </option>
  320.                     <option value="Spain"> Spain </option>
  321.                     <option value="Sri Lanka"> Sri Lanka </option>
  322.                     <option value="Sudan"> Sudan </option>
  323.                     <option value="Suriname"> Suriname </option>
  324.                     <option value="Svalbard"> Svalbard </option>
  325.                     <option value="Swaziland"> Swaziland </option>
  326.                     <option value="Sweden"> Sweden </option>
  327.                     <option value="Switzerland"> Switzerland </option>
  328.                     <option value="Syria"> Syria </option>
  329.                     <option value="Taiwan"> Taiwan </option>
  330.                     <option value="Tajikistan"> Tajikistan </option>
  331.                     <option value="Tanzania"> Tanzania </option>
  332.                     <option value="Thailand"> Thailand </option>
  333.                     <option value="Timor-Leste"> Timor-Leste </option>
  334.                     <option value="Togo"> Togo </option>
  335.                     <option value="Tokelau"> Tokelau </option>
  336.                     <option value="Tonga"> Tonga </option>
  337.                     <option value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie </option>
  338.                     <option value="Trinidad and Tobago"> Trinidad and Tobago </option>
  339.                     <option value="Tristan da Cunha"> Tristan da Cunha </option>
  340.                     <option value="Tunisia"> Tunisia </option>
  341.                     <option value="Turkey"> Turkey </option>
  342.                     <option value="Turkmenistan"> Turkmenistan </option>
  343.                     <option value="Turks and Caicos Islands"> Turks and Caicos Islands </option>
  344.                     <option value="Tuvalu"> Tuvalu </option>
  345.                     <option value="Uganda"> Uganda </option>
  346.                     <option value="Ukraine"> Ukraine </option>
  347.                     <option value="United Arab Emirates"> United Arab Emirates </option>
  348.                     <option value="United Kingdom"> United Kingdom </option>
  349.                     <option value="Uruguay"> Uruguay </option>
  350.                     <option value="Uzbekistan"> Uzbekistan </option>
  351.                     <option value="Vanuatu"> Vanuatu </option>
  352.                     <option value="Vatican City"> Vatican City </option>
  353.                     <option value="Venezuela"> Venezuela </option>
  354.                     <option value="Vietnam"> Vietnam </option>
  355.                     <option value="British Virgin Islands"> British Virgin Islands </option>
  356.                     <option value="US Virgin Islands"> US Virgin Islands </option>
  357.                     <option value="Wallis and Futuna"> Wallis and Futuna </option>
  358.                     <option value="Western Sahara"> Western Sahara </option>
  359.                     <option value="Yemen"> Yemen </option>
  360.                     <option value="Zambia"> Zambia </option>
  361.                     <option value="Zimbabwe"> Zimbabwe </option>
  362.                     <option value="other"> Other </option>
  363.                   </select>
  364.                   <label class="form-sub-label" for="input_6_country" id="sublabel_6_country"> Country </label></span>
  365.               </td>
  366.             </tr>
  367.           </table>
  368.         </div>
  369.       </li>
  370.       <li class="form-line" id="id_15">
  371.         <label class="form-label-left" id="label_15" for="input_15">
  372.           Product Category<span class="form-required">*</span>
  373.         </label>
  374.         <div id="cid_15" class="form-input">
  375.           <div class="form-single-column"><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_0" name="q15_productCategory15[]" value="Accessories/Jewellery" />
  376.               <label for="input_15_0"> Accessories/Jewellery </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_1" name="q15_productCategory15[]" value="Bath and Beauty" />
  377.               <label for="input_15_1"> Bath and Beauty </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_2" name="q15_productCategory15[]" value="Candles" />
  378.               <label for="input_15_2"> Candles </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_3" name="q15_productCategory15[]" value="Ceramics and Pottery/Glass/Woodworking" />
  379.               <label for="input_15_3"> Ceramics and Pottery/Glass/Woodworking </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_4" name="q15_productCategory15[]" value="Children" />
  380.               <label for="input_15_4"> Children </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_5" name="q15_productCategory15[]" value="Clothing" />
  381.               <label for="input_15_5"> Clothing </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_6" name="q15_productCategory15[]" value="Crochet/Embroidery/Knitting/Needlecraft" />
  382.               <label for="input_15_6"> Crochet/Embroidery/Knitting/Needlecraft </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_7" name="q15_productCategory15[]" value="Furniture" />
  383.               <label for="input_15_7"> Furniture </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_8" name="q15_productCategory15[]" value="Housewares" />
  384.               <label for="input_15_8"> Housewares </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_9" name="q15_productCategory15[]" value="Paper Goods" />
  385.               <label for="input_15_9"> Paper Goods </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_10" name="q15_productCategory15[]" value="Pets" />
  386.               <label for="input_15_10"> Pets </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_11" name="q15_productCategory15[]" value="Plants and Edibles" />
  387.               <label for="input_15_11"> Plants and Edibles </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_12" name="q15_productCategory15[]" value="Quilts" />
  388.               <label for="input_15_12"> Quilts </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_13" name="q15_productCategory15[]" value="Toys" />
  389.               <label for="input_15_13"> Toys </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_14" name="q15_productCategory15[]" value="Vintage" />
  390.               <label for="input_15_14"> Vintage </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox validate[required]" id="input_15_15" name="q15_productCategory15[]" value="Everything Else" />
  391.               <label for="input_15_15"> Everything Else </label></span><span class="clearfix"></span>
  392.           </div>
  393.         </div>
  394.       </li>
  395.       <li class="form-line" id="id_22">
  396.         <label class="form-label-left" id="label_22" for="input_22">
  397.           Description of your Products:<span class="form-required">*</span>
  398.         </label>
  399.         <div id="cid_22" class="form-input">
  400.           <textarea id="input_22" class="form-textarea validate[required]" name="q22_descriptionOf" cols="40" rows="6"></textarea>
  401.         </div>
  402.       </li>
  403.       <li class="form-line" id="id_33">
  404.         <label class="form-label-left" id="label_33" for="input_33">
  405.           Are you able to donate a prize to our raffle? If yes, please descirbe:<span class="form-required">*</span>
  406.         </label>
  407.         <div id="cid_33" class="form-input">
  408.           <textarea id="input_33" class="form-textarea validate[required]" name="q33_areYou" cols="40" rows="6"></textarea>
  409.         </div>
  410.       </li>
  411.       <li class="form-line" id="id_17">
  412.         <label class="form-label-left" id="label_17" for="input_17">
  413.           Price Range of your Products:<span class="form-required">*</span>
  414.         </label>
  415.         <div id="cid_17" class="form-input">
  416.           <input type="text" class=" form-textbox validate[required]" data-type="input-textbox" id="input_17" name="q17_priceRange" size="20" value="" />
  417.         </div>
  418.       </li>
  419.       <li class="form-line form-line-column" id="id_11">
  420.         <label class="form-label-top" id="label_11" for="input_11"> Facebook Fan Page: </label>
  421.         <div id="cid_11" class="form-input-wide">
  422.           <input type="text" class=" form-textbox" data-type="input-textbox" id="input_11" name="q11_facebookFan11" size="20" value="" />
  423.         </div>
  424.       </li>
  425.       <li class="form-line form-line-column" id="id_13">
  426.         <label class="form-label-top" id="label_13" for="input_13"> Website: </label>
  427.         <div id="cid_13" class="form-input-wide">
  428.           <input type="text" class=" form-textbox" data-type="input-textbox" id="input_13" name="q13_website13" size="20" value="" />
  429.         </div>
  430.       </li>
  431.       <li class="form-line" id="id_20">
  432.         <label class="form-label-left" id="label_20" for="input_20"> Attach photos of your products here: </label>
  433.         <div id="cid_20" class="form-input"><span class="form-sub-label-container"><div class="qq-uploader-buttonText-value">
  434.               Upload a File
  435.             </div>
  436.             <input class="form-upload-multiple" type="file" id="input_20" name="q20_attachPhotos[]" multiple="multiple" file-accept="jpg, jpeg, png, gif" file-maxsize="5000" />
  437.             <label class="form-sub-label" for="input_20"> Accepted file formats: GIF, JPG and PNG </label></span>
  438.         </div>
  439.       </li>
  440.       <li class="form-line" id="id_25">
  441.         <label class="form-label-left" id="label_25" for="input_25"> Stand Options </label>
  442.         <div id="cid_25" class="form-input">
  443.           <select class="form-dropdown" style="width:150px" id="input_25" name="q25_standOptions25">
  444.             <option value="">  </option>
  445.             <option value="$35 - 3x3 Outdoor - Must have own marqueeAll stands must provide their own tables and chairs  "> $35 - 3x3 Outdoor - Must have own marqueeAll stands must provide their own tables and chairs </option>
  446.             <option value="$45 - 3 x3 Outdoor - ALL FOOD VENDORS              All stands must provide their own tables and chairs"> $45 - 3 x3 Outdoor - ALL FOOD VENDORS All stands must provide their own tables and chairs </option>
  447.           </select>
  448.         </div>
  449.       </li>
  450.       <li class="form-line" id="id_27">
  451.         <label class="form-label-left" id="label_27" for="input_27"> I would like to be involved in your Goodie Bags. I will provide 200 Business Cards, Flyers or Promotional Material for you to insert . </label>
  452.         <div id="cid_27" class="form-input">
  453.           <select class="form-dropdown" style="width:150px" id="input_27" name="q27_iWould">
  454.             <option value="">  </option>
  455.             <option value="Yes $10"> Yes $10 </option>
  456.             <option value="No"> No </option>
  457.           </select>
  458.         </div>
  459.       </li>
  460.       <li class="form-line" id="id_29">
  461.         <label class="form-label-left" id="label_29" for="input_29"> I have read and understood the Terms and Conditions set out in the Winterfest Stand Holders Guide </label>
  462.         <div id="cid_29" class="form-input">
  463.           <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_29_0" name="q29_iHave" value="Yes" />
  464.               <label for="input_29_0"> Yes </label></span><span class="clearfix"></span>
  465.           </div>
  466.         </div>
  467.       </li>
  468.       <li class="form-line" id="id_30">
  469.         <div id="cid_30" class="form-input-wide">
  470.           <div id="text_30" class="form-html">
  471.             <p>
  472.               Thank you for wanting to support our school!  We will be in touch shortly to discuss your appliacation.
  473.             </p>
  474.           </div>
  475.         </div>
  476.       </li>
  477.       <li class="form-line" id="id_2">
  478.         <div id="cid_2" class="form-input-wide">
  479.           <div style="margin-left:156px" class="form-buttons-wrapper">
  480.             <button id="input_2" type="submit" class="form-submit-button">
  481.               Submit Form
  482.             </button>
  483.           </div>
  484.         </div>
  485.       </li>
  486.       <li style="display:none">
  487.         Should be Empty:
  488.         <input type="text" name="website" value="" />
  489.       </li>
  490.     </ul>
  491.   </div>
  492.   <input type="hidden" id="simple_spc" name="simple_spc" value="40641665056858" />
  493.   <script type="text/javascript">
  494.   document.getElementById("si" + "mple" + "_spc").value = "40641665056858-40641665056858";
  495.   </script>
  496. </form>
  497. </body>
  498. </html>
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