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document.write('<script type=\"text/javascript\" src=\"https://assets.bravenet.com/bn/js/emailfwd/bn_email_forms.min.js\"></script><link rel=\"stylesheet\" href=\"https://pub35.bravenet.com/emailfwd/v2/bnet-form.css.php?usernum=2996064010&formid=3687&formpadding=0\"><form method=\"post\" class=\"bnet-form\" enctype=\"multipart/form-data\" action=\"#bn-ajax-post:2996064010:35:3687\"><div class=\"bn-form-header\"><div class=\"bn-form-legend\"><div>AWSA 2021 Conference Scholarship Application</div></div> </div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">First Name: </span> <span class=\"bn-input\"><input type=\"text\" name=\"FirstName\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Last Name: </span> <span class=\"bn-input\"><input type=\"text\" name=\"LastName\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Cell Number: </span> <span class=\"bn-input\"><input type=\"text\" name=\"PhoneNumber\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Email: </span> <span class=\"bn-input\"><input type=\"text\" name=\"Email\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Address Line 1: </span> <span class=\"bn-input\"><input type=\"text\" name=\"AddressLineOne\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Address Line 2: </span> <span class=\"bn-input\"><input type=\"text\" name=\"AddressLineTwo\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">City: </span> <span class=\"bn-input\"><input type=\"text\" name=\"City\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">State/Province: </span> <span class=\"bn-input\"><input type=\"text\" name=\"StateProvince\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Country: </span> <span class=\"bn-input\"><input type=\"text\" name=\"Country\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Zip/Postal Code: </span> <span class=\"bn-input\"><input type=\"text\" name=\"ZipPostalCode\" placeholder=\"\" validator=\"\" value=\"\"></span></label></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">This scholarship is for financial need.  Check \'yes\' if this is your situation.  Note scholarship recipients are kept confidential. </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-159331623768672\" value=\"Yes\"> <span class=\"bn-inner-label\">Yes</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-159331623768672\" value=\"No, I will go to awsafun.com to pay and register.\"> <span class=\"bn-inner-label\">No, I will go to awsafun.com to pay and register.</span></label></span></span></div></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Are you a member in good standing of AWSA Professional or AWSA Protege? </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"AWSAmember\" value=\"Yes\"> <span class=\"bn-inner-label\">Yes</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"AWSAmember\" value=\"No\"> <span class=\"bn-inner-label\">No</span></label></span></span></div></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">If your membership dues are not up to date, do you need a dues scholarship this year as well? </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-159331670935090\" value=\"Yes\"> <span class=\"bn-inner-label\">Yes</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-159331670935090\" value=\"No, it\'s covered.\"> <span class=\"bn-inner-label\">No, it\'s covered.</span></label></span></span></div></div><div class=\"fields-wrapper\"><div class=\"bn-row rowcb\"><span class=\"bn-label\">Have you ever received a Cecil Murphey Scholarship in the past? </span> <span class=\"bn-input\"><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-1623879912307102\" value=\"No\"> <span class=\"bn-inner-label\">No</span></label></span><span class=\"bn-optionwrapper\"><label class=\"bn-radio\"><input type=\"radio\" name=\"Field-1623879912307102\" value=\"Yes\"> <span class=\"bn-inner-label\">Yes</span></label></span></span></div></div><div class=\"fields-wrapper\"><label class=\"bn-row\"><span class=\"bn-label\">Other Comments: </span> <span class=\"bn-input\"><textarea name=\"OtherComments\" placeholder=\"\" validator=\"\"></textarea></span></label></div>  <input type=\"hidden\" name=\"carboncopy\" value=\"LindaReply@gmail.com,arisereply@gmail.com,CarlaReply@gmail.com\"> <input type=\"hidden\" name=\"thankyou\" value=\"\"> <input type=\"hidden\" name=\"thankyoutext\" value=\"THANKS!  Your 2020 AWSA scholarship application has been received.  I (Linda) am praying over you!');
document.write('');
document.write('You will be able to get the complete conference, except for the workshops.  But great news, we are offering you access to the workshops for $20.00. ');
document.write('');
document.write('To take advantage of this offer - which includes over 10 hours of transformation classes that you can watch on-demand, please go to:  https://bit.ly/2020AWSAworkshops20 to order.  ');
document.write('');
document.write('If you would like the workshops but would appreciate them to be scholarshiped in, please send me a quick note when you receive this email and tell me that you would like to have the workshops as a scholarship too.  ');
document.write('Thanks,');
document.write('Linda (LindaReply@gmail.com)');
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