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<?php
require_once($_SERVER['DOCUMENT_ROOT']."/assets/includes/php_header.php");
if (!isset($tc))
{
$tc = (! isset($_GET['tc'])) ? 'none': $_GET['tc'];
if (isset($_POST['tc'])) { $tc = $_POST['tc'];}
}
require_once("{$_SERVER['DOCUMENT_ROOT']}/tracker/client/TrackerLib.php");
$tracker = new TrackerLib("usafa");
$params = $tracker->URLParameters();
$trackerparams = $tracker->TrackerParameters();
?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta name="viewport" content="initial-scale=1" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>USA Funding Application</title>
<link id="stylesheet" rel="stylesheet" type="text/css" href="/v1/assets/css/styles_1b.css" />
<link id="stylesheet" rel="stylesheet" type="text/css" href="/v1/assets/css/responsive_1b.css" />
<script>
$(document).ready( function() {
$('.subcategory,.subtext,#education_questions,#business_questions').hide().find('input,select,textarea').attr('disabled','disabled');
$('input[name=category_id]').click( function() {
var show_class = $(this).attr('class');
var subcat_elements = $('.subcategory[class~='+show_class+']');
$('.subcategory').hide().find('input,select,textarea').attr('disabled', 'disabled');
if(subcat_elements.length > 0) {
$('#subcategories').show();
subcat_elements.show().find('input,select,textarea').removeAttr('disabled');
} else {
$('#subcategories').hide().find('input,select,textarea').attr('disabled', 'disabled');
}
var granttype = this.className;
$('#granttype_input').val(granttype);
var amount_needed = $('select[name=app_amount_needed]').val();
if(granttype == 'business') {
$('#amount_needed').html('<select name="app_amount_needed"><option selected>Select</option><option value="$500 - $10,000">$500 - $10,000</option><option value="$10,000 - $25,000">$10,000 - $25,000</option><option value="$25,000 - $50,000">$25,000 - $50,000</option><option value="$50,000 - $100,000">$50,000 - $100,000</option><option value="$100,000 - $250,000">$100,000 - $250,000</option><option value="$250,000 - $500,000">$250,000 - $500,000</option><option value="$500,000 - $1,000,000">$500,000 - $1,000,000</option><option value="$1,000,000 +">$1,000,000 +</option></select>');
$('#business_questions').show('slow').find('input,select,textarea').removeAttr('disabled');
} else {
$('#amount_needed').html('<select name="app_amount_needed"><option selected>Select</option><option value="$500 - $10,000">$500 - $10,000</option><option value="$10,000 - $25,000">$10,000 - $25,000</option><option value="$25,000 - $50,000">$25,000 - $50,000</option><option value="$50,000 - $100,000">$50,000 - $100,000</option><option value="$100,000 or More">$100,000 or More</option></select>');
$('#business_questions').hide('slow').find('input,select,textarea').attr('disabled','disabled');
}
/*if(granttype == 'education') {
$('#education_questions').show().find('input,select,textarea').removeAttr('disabled');
} else {
$('#education_questions').hide().find('input,select,textarea').attr('disabled','disabled');
}*/
});
<?php
/*foreach($education_questions['subquestions'] as $slug=>$data) {
echo "$('.".$slug."_sub').hide().find('input,select,textarea').attr('disabled','disabled');";
echo "$('#".$slug."_yes').click(function() {
$('.".$slug."_sub').show().find('input,select,textarea').removeAttr('disabled');
});";
echo "$('#".$slug."_no').click(function() {
$('.".$slug."_sub').hide().find('input,select,textarea').attr('disabled','disabled');
});";
}*/
/*foreach($disability_questions['subquestions'] as $slug=>$data) {
echo "$('.".$slug."_sub').hide().find('input,select,textarea').attr('disabled','disabled');";
echo "$('#".$slug."_yes').click(function() {
$('.".$slug."_sub').slideDown().find('input,select,textarea').removeAttr('disabled');
});";
echo "$('#".$slug."_no').click(function() {
$('.".$slug."_sub').slideUp().find('input,select,textarea').attr('disabled','disabled');
});";
}*/
if(!empty($_REQUEST)) {
echo "$('input:radio[name=category_id]').filter(function() { return $(this).val()=='{$_REQUEST['category_id']}'; }).click();\n";
}
?>
});
// Create an associative array of 'pretty name' values
var prettynames = {
category_id:"Grant Category",
cc_fname:"First Name",
cc_lname:"Last Name",
cc_addr:"Address",
cc_city:"City",
cc_state:"State",
cc_zip:"Zip",
cc_phonearea:"Phone Number Area Code",
cc_phoneprefix:"Phone Number Prefix",
cc_phoneextension:"Phone Number Ending",
cc_email:"Email Address",
app_gender:"Gender",
app_citizenship:"Citizenship",
app_age:"Your age",
app_amount_needed:"The amount needed",
app_usedescription:"Describe what you will use the money for",
app_uniqueness:"Uniqueness",
diploma:"Do you have a high school diploma or GED?",
online_business:"Would you like to start an online business to make money while you go to school if we could help pay for your training?",
serious_scale:"In a scale of 1-10 how serious are you about getting a degree online?",
college:"Have you gone to college?",
degree:"Do you have a degree?",
willing_second_degree:"Are you willing to get a second degree in business?",
have_computer:"Do you have access to a computer for taking the online classes and working on your business?",
/*applied_ssd:"Have you ever applied for Social Security Disability?",
currently_applying:"If yes, \"Are you currently receiving Social Security benefits?\"",
denied_ssd:"Have you been denied for Social Security Disability?",
stopped_work:"Have you stopped working because of a disability?",
why_cant_work:"If yes, \"Why can't you work right now?\"",
out_of_work_12_months:"Do you expect to be out of work for at least 12 months?",
treatment:"Are you currently receiving treatment from a doctor?",
worked_5_years:"Have you worked approximately five of the last ten years?",
have_attorney:"Do you have an attorney helping you with this case?"*/
};
// Utility function that returns true if a string contains only
// whitespace characters
// Taken from "Javascript: The Definitive Guide" pg. 264
function isblank(s)
{
for (var i=0; i < s.length; i++)
{
var c = s.charAt(i);
if ((c!=' ') && (c != '\n') && (c != ''))
{
return false;
}
}
return true;
}
// Credit Card Validation Javascript
// copyright 12th May 2003, by Stephen Chapman, Felgall Pty Ltd
// You have permission to copy and use this javascript provided that
// the content of the script is not changed in any way.
function validateCreditCard(s) {
// remove non-numerics
var v = "0123456789";
var w = "";
for (i=0; i < s.length; i++) {
x = s.charAt(i);
if (v.indexOf(x,0) != -1)
w += x;
}
// validate number
j = w.length / 2;
if (j < 6.5 || j > 8 || j == 7) return false;
k = Math.floor(j);
m = Math.ceil(j) - k;
c = 0;
for (i=0; i<k; i++) {
a = w.charAt(i*2+m) * 2;
c += a > 9 ? Math.floor(a/10 + a%10) : a;
}
for (i=0; i<k+m; i++) c += w.charAt(i*2+1-m) * 1;
return (c%10 == 0);
}
function verify(f)
{
// Taken from "Javascript: The Definitive Guide" pg. 264.
// Modified heavily to suit our needs
// Loop through each element of the form and validate each item
//
// Set the parameters for each field to be valid
// If a field doesn't have any modifiers it is assumed to be
// a text field that can not be blank.
var msg;
var empty_fields = "";
var errors = "";
var required = new Array('category_id','cc_fname','cc_lname','cc_addr','cc_city','cc_state','cc_zip','cc_phonearea','cc_phoneextension','cc_phoneprefix','cc_email','app_age','app_amount_needed','app_citizenship','app_gender','app_uniqueness','app_usedescription');
for (var i=0; i < f.length; i++)
{
var element = f.elements[i];
//document.getElementById('errorconsole').innerHTML += element.name + ":" + element.type + "<br>";
if($.inArray(element.name, required) == -1) {
continue;
}
if ((element.name == 'cc_email')) {
if(/(.+)@(.+){2,}\.(.+){2,}/.test(element.value)) {
//valid email
} else {
errors += "- Please enter a valid email address\n";
}
} else if ((element.type == 'text' || element.type == 'textarea') && (element.name != 'granttype_other'))
{
if ( (element.value == null || element.value == "") || isblank(element.value) )
{
empty_fields += "\n " + prettynames[element.name];
continue;
}
if (element.numeric)
{
var v = parseFloat(element.value);
if (isNaN(v))
{
errors +="- The field " + prettynames[element.name] + " must be a number\n";
}
}
if ( (element.requiredlength > 0) && (element.value.length != element.requiredlength) )
{
errors += "- The field " + prettynames[element.name] + " must be " + element.requiredlength + " digits long\n";
}
}
else if (element.type == 'select-one')
{
// The first option, option[0] can not be selected
if ( (element.value == null || element.value == "" || element.selectedIndex == 0) || isblank(element.value) )
{
empty_fields += "\n " + prettynames[element.name];
continue;
}
}
else if (element.type == 'radio')
{
if (!$('[name='+element.name+']:checked').val() && empty_fields.indexOf(prettynames[element.name]) == -1)
{
empty_fields += "\n " + prettynames[element.name];
continue;
}
}
}
if (!empty_fields && !errors) { return true; }
msg = "__________________________________\n\n";
msg += "The form was not submitted because of the following error(s).\n";
msg += "Please correct these error(s) and re-submit.\n";
msg += "__________________________________\n\n";
if (empty_fields)
{
msg += "- The following required field(s) are empty:" + empty_fields + "\n";
if (errors) { msg += "\n"; }
}
msg += errors;
alert(msg);
return false;
}
function tab_phone(current,next) {
var currentfield = document.getElementById(current);
var nextfield = document.getElementById(next);
if (currentfield.value.length == 3) { nextfield.focus(); }
}
function checkZip(zip,me) {
zip = zip.replace(/[^0-9]/g,'');
if(zip.length==5) {
var str = 'zip='+encodeURIComponent(zip);
$.ajax
({
cache: false,
type: "POST",
dataType:"json",
data: str,
url: "/php/ZipToCity.php",
success: function(data)
{
if(!data.error) {
$('[name=cc_city]').val(data.city);
$('[name=cc_state]').val(data.state);
}
},error: function(jqXHR, textStatus, errorThrown) {
}
});
}
}
$(document).ready(function(){
$('input[name=phone_full]').formatter({
'pattern': '({{999}}) {{999}}-{{9999}}',
'persistent': false
});
});
</script>
</head>
<body>
<div id="size">
<div id="logo"></div>
<div id="text">
<div id="text_new">
<div id="padding_new">
<div id="ads_new">
<!--top graphic-->
<div id="new_testimonials">
<h2>Happy Clients</h2>
<p><em><img style="float:left; padding: 0px 10px 10px 0px;" src="/v1/images/lunise.jpg">"Hey, I recommend everyone and everybody to these services because you can get whatever you need to know about personal, assistance, food & nutrition." </em><br>--Lunice S.</p>
<div class="t_divide"></div>
<p><em><img style="float:left; padding: 0px 10px 10px 0px;" src="/v1/images/roxanne.jpg">"It was so thorough. Not only did it categorize the funding programs but it had tips for the entire process. Also the lay out which is linear is nice with the white on white with colored reference points."</em><br> --Roxann J.</p>
<div class="t_divide"></div>
<p><em><img style="float:left; padding: 0px 10px 10px 0px;" src="/v1/images/steven.jpg"> "I think the USA funding application is a great way to give the less fortunate a chance to live a better life."</em><br>-–Bobbie G.</p>
<div class="t_divide"></div>
<p><em><img style="float:left; padding: 0px 10px 10px 0px;" src="/v1/images/sandra.jpg"> "It was easy to understand it didn't seem like a hassle at all to answer anything that was asked."</em><br> --Sandra G.</p>
<div class="t_divide"></div>
<p><em> <img style="float:left; padding: 0px 10px 10px 0px;" src="/v1/images/karen.jpg"> "It is simple and easy to use. The wording is great and understandable."</em><br>--Karen R.</p>
<div class="t_divide"></div>
<p><em> <img style="float:left; padding: 0px 10px 10px 0px;" src="/v1/images/leslie.jpg">"I especially like the fact that USA Funding Applications have a variety of fields to choose from which allows individuals to pursue their dreams and stay encouraged. The site's complete. It would be nice if more people knew of your site."</em><br> --Leslie A.</p>
</div> <!--end new_testimonials-->
<!--title-->
<div style="text-align:center; margin-top: 20px;">
<img src="/assets/images/ad_title.jpg">
</div>
<!--quotes-->
<div style="margin:10px 0px;" class="ads_quote">
<img src="/assets/images/ad_dallas.jpg" alt="Quote from Dallas Business Journal" />
<img src="/assets/images/ad_tmc.jpg" alt="Quote from TMC.com" />
<img src="/assets/images/ad_philadelphia.jpg" alt="Quote from Philadelphia Business Journal" />
<img src="/assets/images/ad_yahoo.jpg" alt="Quote from Yahoo Finance" />
<!--<img src="/assets/images/ad_silicon.jpg" alt="Quote from Silicon Valley Business Journal" />
<img src="/assets/images/ad_media.jpg" alt="Quote from Media Newswire.com" />
<img src="/assets/images/ad_busfirst.jpg" alt="Quote from Business First" />-->
</div> <!--end quotes-->
<?php /* require_once("ad_romney.php"); */?>
<!--bottom rounded corner-->
<div class="ads_new_bt"> </div>
<?php require_once("ads.php");?>
</div> <!--end ads_new-->
<div class="ads_quote_2">
<img alt="Quote from Dallas Business Journal" src="/assets/images/ad_dallas.jpg">
<img alt="Quote from TMC.com" src="/assets/images/ad_tmc.jpg">
<img alt="Quote from Philadelphia Business Journal" src="/assets/images/ad_philadelphia.jpg">
<img alt="Quote from Yahoo Finance" src="/assets/images/ad_yahoo.jpg">
</div>
<p style="margin-top: 20px;" class="header">Get Access to Funding Applications</p>
<p>It's a documented fact that Billions of Dollars in Free Money are donated every year by American Corporate Giving Programs, Foundations other Charitable Institutions, Individuals, and Other Agencies. We read daily about gigantic sums of Funding being given to businesses and individuals, just like you, to help them fulfill their goals and dreams, but often times these people will not tell you HOW or WHERE they got this Funding. In order to know HOW and WHERE to tap into these vast treasures, don't sit around and hope you hear it through the grapevine, find out for yourself with the help of USA Funding Applications.</p>
<div class="ads_quote_3">
<img alt="Quote from Dallas Business Journal" src="/assets/images/ad_dallas.jpg">
<img alt="Quote from TMC.com" src="/assets/images/ad_tmc.jpg">
<img alt="Quote from Philadelphia Business Journal" src="/assets/images/ad_philadelphia.jpg">
<img alt="Quote from Yahoo Finance" src="/assets/images/ad_yahoo.jpg">
</div>
<p>Many funding opportunities are awarded for projects and businesses for general operating expenses and other capital, such as, a new building or major pieces of equipment. Sometimes you can also include inventory, salaries, labor, advertising, marketing, etc. Also remember that most funding is not available for personal expenses or paying off debt but there are other assistance programs out there to help you out of your situation!</p>
<div id="new_testimonials_2">
<h2>Happy Clients</h2>
<p><em>"Hey, I recommend everyone and everybody to these services because you can get whatever you need to know about personal, assistance, food & nutrition."</em><br>--ENEUNISE</p>
<div class="t_divide"></div>
<p><em>"I think the USA funding application is a great way to give the less fortunate a chance to live a better life."</em><br>-–Bobbie Guillory</p>
<div class="t_divide"></div>
<p><em>"It was easy to understand it didn't seem like a hassle at all to answer anything that was asked."</em><br>--Sandra Gagnon</p>
<div class="t_divide"></div>
<p><em>"I especially like the fact that USA Funding Applications have a variety of fields to choose from which allows individuals to pursue their dreams and stay encouraged. The site's complete. It would be nice if more people knew of your site."</em><br>--Leslie A. Adolphus</p>
<div class="t_divide"></div>
<p><em>"I am getting dizzy looking at all of the funding available."</em><br>--Juanita Andres</p>
</div> <!--end new_testimonials-->
<p>The main areas Funders gift money are:</p>
<ul id="bullet2">
<li>Small and large business start-ups and/or expansion</li>
<li>Various Real Estate ventures</li>
<li>Historical building preservation</li>
<li>Medical research</li>
<li>National security</li>
<li>Education</li>
<li>First-time home purchase</li>
<li>Inventions</li>
<li>Environment preservation</li>
</ul>
<p>Apply today! The early bird gets the worm, even when it comes to Free Funding.</p>
<div id="form">
<form action="https://www.usafundingapplications.org/order.php" method="POST" name="application" onSubmit="return verify(this);">
<div class="personal_info">
<p style="margin-top: 20px;" class="header">USA Funding Applications Registration Form</p>
<p><i>The information you enter below is confidential and is only made available to a USA Funding Applications Specialist.</i></p>
<p><strong>Step 1 of 3:</strong> Tell us about yourself?</p>
<div class="personal">
<input class="full" type="text" name="cc_fname" size="20" placeholder="First Name">
<input class="full" type="text" name="cc_fname" size="20" placeholder="Last Name">
</div>
<div class="personal">
<input class="full" type="text" name="cc_addr" size="20" placeholder="Address">
<input class="full" type="text" name="cc_city" size="20" placeholder="City">
</div>
<div class="personal">
<select name="cc_state">
<option selected>Select State</option>
<option value="AK" <?= ($_REQUEST['cc_state']=='AK') ? 'selected' : '';?>>Alaska</option>
<option value="AL" <?= ($_REQUEST['cc_state']=='AL') ? 'selected' : '';?>>Alabama</option>
<option value="AR" <?= ($_REQUEST['cc_state']=='AR') ? 'selected' : '';?>>Arkansas</option>
<option value="AZ" <?= ($_REQUEST['cc_state']=='AZ') ? 'selected' : '';?>>Arizona</option>
<option value="CA" <?= ($_REQUEST['cc_state']=='CA') ? 'selected' : '';?>>California</option>
<option value="CO" <?= ($_REQUEST['cc_state']=='CO') ? 'selected' : '';?>>Colorado</option>
<option value="CT" <?= ($_REQUEST['cc_state']=='CT') ? 'selected' : '';?>>Connecticut</option>
<option value="DC" <?= ($_REQUEST['cc_state']=='DC') ? 'selected' : '';?>>District of Columbia</option>
<option value="DE" <?= ($_REQUEST['cc_state']=='DE') ? 'selected' : '';?>>Delaware</option>
<option value="FL" <?= ($_REQUEST['cc_state']=='FL') ? 'selected' : '';?>>Florida</option>
<option value="GA" <?= ($_REQUEST['cc_state']=='GA') ? 'selected' : '';?>>Georgia</option>
<option value="HI" <?= ($_REQUEST['cc_state']=='HI') ? 'selected' : '';?>>Hawaii</option>
<option value="IA" <?= ($_REQUEST['cc_state']=='IA') ? 'selected' : '';?>>Iowa</option>
<option value="ID" <?= ($_REQUEST['cc_state']=='ID') ? 'selected' : '';?>>Idaho</option>
<option value="IL" <?= ($_REQUEST['cc_state']=='IL') ? 'selected' : '';?>>Illinois</option>
<option value="IN" <?= ($_REQUEST['cc_state']=='IN') ? 'selected' : '';?>>Indiana</option>
<option value="KS" <?= ($_REQUEST['cc_state']=='KS') ? 'selected' : '';?>>Kansas</option>
<option value="KY" <?= ($_REQUEST['cc_state']=='KY') ? 'selected' : '';?>>Kentucky</option>
<option value="LA" <?= ($_REQUEST['cc_state']=='LA') ? 'selected' : '';?>>Louisiana</option>
<option value="MA" <?= ($_REQUEST['cc_state']=='MA') ? 'selected' : '';?>>Massachusetts</option>
<option value="MD" <?= ($_REQUEST['cc_state']=='MD') ? 'selected' : '';?>>Maryland</option>
<option value="ME" <?= ($_REQUEST['cc_state']=='ME') ? 'selected' : '';?>>Maine</option>
<option value="MI" <?= ($_REQUEST['cc_state']=='MI') ? 'selected' : '';?>>Michigan</option>
<option value="MN" <?= ($_REQUEST['cc_state']=='MN') ? 'selected' : '';?>>Minnesota</option>
<option value="MO" <?= ($_REQUEST['cc_state']=='MO') ? 'selected' : '';?>>Missouri</option>
<option value="MS" <?= ($_REQUEST['cc_state']=='MS') ? 'selected' : '';?>>Mississippi</option>
<option value="MT" <?= ($_REQUEST['cc_state']=='MT') ? 'selected' : '';?>>Montana</option>
<option value="NC" <?= ($_REQUEST['cc_state']=='NC') ? 'selected' : '';?>>North Carolina</option>
<option value="ND" <?= ($_REQUEST['cc_state']=='ND') ? 'selected' : '';?>>North Dakota</option>
<option value="NE" <?= ($_REQUEST['cc_state']=='NE') ? 'selected' : '';?>>Nebraska</option>
<option value="NH" <?= ($_REQUEST['cc_state']=='NH') ? 'selected' : '';?>>New Hampshire</option>
<option value="NJ" <?= ($_REQUEST['cc_state']=='NJ') ? 'selected' : '';?>>New Jersey</option>
<option value="NM" <?= ($_REQUEST['cc_state']=='NM') ? 'selected' : '';?>>New Mexico</option>
<option value="NV" <?= ($_REQUEST['cc_state']=='NV') ? 'selected' : '';?>>Nevada</option>
<option value="NY" <?= ($_REQUEST['cc_state']=='NY') ? 'selected' : '';?>>New York</option>
<option value="OH" <?= ($_REQUEST['cc_state']=='OH') ? 'selected' : '';?>>Ohio</option>
<option value="OK" <?= ($_REQUEST['cc_state']=='OK') ? 'selected' : '';?>>Oklahoma</option>
<option value="OR" <?= ($_REQUEST['cc_state']=='OR') ? 'selected' : '';?>>Oregon</option>
<option value="PA" <?= ($_REQUEST['cc_state']=='PA') ? 'selected' : '';?>>Pennsylvania</option>
<option value="PR" <?= ($_REQUEST['cc_state']=='PR') ? 'selected' : '';?>>Puerto Rico</option>
<option value="RI" <?= ($_REQUEST['cc_state']=='RI') ? 'selected' : '';?>>Rhode Island</option>
<option value="SC" <?= ($_REQUEST['cc_state']=='SC') ? 'selected' : '';?>>South Carolina</option>
<option value="SD" <?= ($_REQUEST['cc_state']=='SD') ? 'selected' : '';?>>South Dakota</option>
<option value="TN" <?= ($_REQUEST['cc_state']=='TN') ? 'selected' : '';?>>Tennessee</option>
<option value="TX" <?= ($_REQUEST['cc_state']=='TX') ? 'selected' : '';?>>Texas</option>
<option value="UT" <?= ($_REQUEST['cc_state']=='UT') ? 'selected' : '';?>>Utah</option>
<option value="VA" <?= ($_REQUEST['cc_state']=='VA') ? 'selected' : '';?>>Virginia</option>
<option value="VT" <?= ($_REQUEST['cc_state']=='VT') ? 'selected' : '';?>>Vermont</option>
<option value="WA" <?= ($_REQUEST['cc_state']=='WA') ? 'selected' : '';?>>Washington</option>
<option value="WI" <?= ($_REQUEST['cc_state']=='WI') ? 'selected' : '';?>>Wisconsin</option>
<option value="WV" <?= ($_REQUEST['cc_state']=='WV') ? 'selected' : '';?>>West Virginia</option>
<option value="WY" <?= ($_REQUEST['cc_state']=='WY') ? 'selected' : '';?>>Wyoming</option>
</select>
<input class="full" type="text" name="cc_fname" size="20" placeholder="Zip">
</div>
<div class="personal">
<select name="app_gender">
<option selected>Select Gender</option>
<option value="M">Male</option>
<option value="F">Female</option>
</select>
<select name="app_age">
<option selected>Select Age</option>
<option value="18-25">18-25</option>
<option value="26-34">26-34</option>
<option value="35-49">35-49</option>
<option value="50-65">50-65</option>
<option value="66-80">66-80</option>
<option value="80+">80 +</option>
</select>
</div>
<div class="personal">
<input type="tel" class="full" name="phone_full" placeholder="Phone" value="<?= $_REQUEST['phone_full'];?>" />
<select name="app_citizenship">
<option selected>Citizenship</option>
<option value="U.S. Citizen">U.S. Citizen</option>
<option value="Resident Alien">Resident Alien</option>
<option value="Green Card Holder">Green Card Holder</option>
<option value="Permanent Resident">Permanent Resident</option>
<option value="Not Sure">Not Sure</option>
</select>
</div>
</div> <!-- End Personal section of form -->
<div class="personal_info">
<p><strong>Step 2 of 3:</strong> Tell us about your Funding Needs?</p>
<div class="personal">
<p>Choose which funding area you are interested in?</p>
<select class="full_select" name="category_id">
<option selected>Select...</option>
<option value="1">Business Funding</option>
<option value="5">Real Estate: Investing / Business</option>
<option value="3">Community Funding</option>
<option value="2">Education / Tuition Funding</option>
<option value="6">Real Estate: 1st Time Home Buyer</option>
<option value="4">Personal Assistance</option>
<option value="7">Personal Assistance: Home Repairs</option>
</select>
</div>
<div class="personal">
<p>How much money are you going to need?</p>
<select class="full_select" name="app_amount_needed">
<option selected>Select...</option>
<option value="$500-$10,000">$500 - $10,000</option>
<option value="$10,000 - $25,000">$10,000 - $25,000</option>
<option value="$25,000 - $50,000">$25,000 - $50,000</option>
<option value="$50,000 - $100,000">$50,000 - $100,000</option>
<?
if ($granttype != 'business')
{
echo "<option value=\"$100,000 or More\">\$100,000 or More</option>";
}
else
{
?>
<option value="$100,000 - $250,000">$100,000 - $250,000</option>
<option value="$250,000 - $500,000">$250,000 - $500,000</option>
<option value="$500,000 - $1,000,000">$500,000 - $1,000,000</option>
<option value="$1,000,000 +">$1,000,000 +</option>
<?
}
?>
</select>
</div>
<div class="personal">
<p>How much money are you going to need?</p>
<select class="full_select" name="app_amount_needed">
<option selected>Select...</option>
<option value="$500-$10,000">$500 - $10,000</option>
<option value="$10,000 - $25,000">$10,000 - $25,000</option>
<option value="$25,000 - $50,000">$25,000 - $50,000</option>
<option value="$50,000 - $100,000">$50,000 - $100,000</option>
<?
if ($granttype != 'business')
{
echo "<option value=\"$100,000 or More\">\$100,000 or More</option>";
}
else
{
?>
<option value="$100,000 - $250,000">$100,000 - $250,000</option>
<option value="$250,000 - $500,000">$250,000 - $500,000</option>
<option value="$500,000 - $1,000,000">$500,000 - $1,000,000</option>
<option value="$1,000,000 +">$1,000,000 +</option>
<?
}
?>
</select>
</div>
<div class="personal">
<p>Describe what you will use the money for?:
<textarea name="app_usedescription" cols="64" rows="6"></textarea>
</div>
<div class="personal">
<p>What unique things would separate you from other applicants applying for this money?:
<textarea name="app_uniqueness" cols="64" rows="6"></textarea>
</div>
</div>
<div class="personal_info">
<p><strong>Step 3 of 3:</strong> Create a Username.</p>
<p>What Email address would you like to use for your Username for your Online Funding Application Account?</p>
<div class="personal">
<p><input class="full" type="text" name="cc_email" size="40"> <i>(ie. yourmail@hotmail.com)</i></p>
</div>
<p><i>** Your email is safe. We hate spam as much as you do!!</i>
<p>** Your <u>Email</u> will be <u>your username</u> for the USA Funding Applications website. Please double check it to be sure it is accurate!</i></p>
<p><center><input type="submit" value="" style="background:url(/v1/assets/images/submit.png) top center no-repeat;width:193px;height:67px;border:0px;margin:20px auto;cursor:pointer"></center>
<input type="hidden" name="application" value="application">
<input type="hidden" name="tc" value="<?= $tc; ?>">
<input type="hidden" name="form_filled_out" value="/index.php" />
<?= $trackerformparams; ?>
</form>
</p>
</div>
</form>
</div>
<div class="application">
<p style="margin-top: 20px;" class="header">Our Promise and Guarantee</p>
<p>In order for us to pay for the expenses we have incurred compiling this information and advertising it on the web, we are forced to charge a small fee of $<?= $_INITIAL_FEE;?> to cover our bare costs. The information also comes with a guarantee. </p>
<p>If you apply for funding using one of the applications you find on our website and you don't receive funding, your membership fees will be refunded to you immediately. All you have to do is provide us with the name of the funding opportunity you applied for and a copy of the rejection letter you received from the funder.</p>
<p>With your membership fee, you will have access to the applications and on-line training information through our members-only site. You can also cancel your membership at any time. </p>
<p>How serious are you? Are you like most people and need the money yesterday? If so, get registered today. Don't procrastinate. USA Funding Applications is here to help you get the info you need today, not next year. "Change your future in <?= (date('m')*1>=10) ? date('Y')+1 : date('Y');?>."</p>
<p>If FREE FUNDING to start a new business, expand an existing business or complete a worthwhile project would change your life and benefit you for the rest of your life, what are you waiting for? Get registered TODAY. We can help you find and apply for the money you need to change your life forever. We are Funding Seeking Specialists.</p>
<p style="font-size:10px;">* To protect the identity of our clients some of the pictures may not represent actual clients.</p>
</div>
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</div> <!--end text_new-->
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