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<label for="edit-submitted-school-address">School Street Address <span class="form-required" title="This field is required.">*</span></label> <input type="text" id="edit-submitted-school-address" name="submitted[school_address]" value="" size="60" maxlength="128" class="form-text required"/> </div> <div class="form-item webform-component webform-component-textfield" id="webform-component-school-city"> <label for="edit-submitted-school-city">School City <span class="form-required" title="This field is required.">*</span></label> <input type="text" id="edit-submitted-school-city" name="submitted[school_city]" value="" size="60" maxlength="128" class="form-text required"/> </div> <div class="form-item webform-component webform-component-textfield" id="webform-component-school-state"> <label for="edit-submitted-school-state">School State <span class="form-required" title="This field is required.">*</span></label> <input type="text" id="edit-submitted-school-state" name="submitted[school_state]" value="" size="60" maxlength="128" class="form-text required"/> </div> <div class="form-item webform-component webform-component-textfield" id="webform-component-school-zip-code"> <label for="edit-submitted-school-zip-code">School Zip Code <span class="form-required" title="This field is required.">*</span></label> <input type="text" id="edit-submitted-school-zip-code" name="submitted[school_zip_code]" value="" size="60" maxlength="128" class="form-text required"/> </div> <div class="form-item webform-component webform-component-textfield" id="webform-component-school-phone-number"> <label for="edit-submitted-school-phone-number">School Phone Number <span class="form-required" title="This field is required.">*</span></label> <input type="text" id="edit-submitted-school-phone-number" name="submitted[school_phone_number]" value="" size="60" maxlength="128" class="form-text required"/> </div> <div class="form-item webform-component webform-component-textfield" id="webform-component-home-or-cell-number"> <label for="edit-submitted-home-or-cell-number">Home or Cell Number </label> <input type="text" id="edit-submitted-home-or-cell-number" name="submitted[home_or_cell_number]" value="" size="60" maxlength="128" class="form-text"/> </div> <div class="form-item webform-component webform-component-email" id="webform-component-professional-e-mail-address"> <label for="edit-submitted-professional-e-mail-address">Professional E-Mail Address <span class="form-required" title="This field is required.">*</span></label> <input class="email form-text form-email required" type="email" id="edit-submitted-professional-e-mail-address" name="submitted[professional_e_mail_address]" size="60"/> </div> <div class="form-item webform-component webform-component-textfield" id="webform-component-ereplica-users"> <label for="edit-submitted-ereplica-users">Number of Students Who Will Use e-Replica <span class="form-required" title="This field is required.">*</span></label> <input type="text" id="edit-submitted-ereplica-users" name="submitted[ereplica_users]" value="" size="60" maxlength="128" class="form-text required"/> <div class="description">Formula: Average # students (multiplied by) average # classes a day. Example: 24 students x 4 classes = 96 “copies” or “log-ons”. </div> </div> <div class="form-item webform-component webform-component-date" id="webform-component-start-date"> <label for="edit-submitted-start-date">Start Date <span class="form-required" title="This field is required.">*</span></label> <div class="webform-container-inline webform-datepicker"><div class="form-item form-type-select form-item-submitted-start-date-month"> <label class="element-invisible" for="edit-submitted-start-date-month">Month </label> <select class="month form-select" id="edit-submitted-start-date-month" name="submitted[start_date][month]"><option value="">Month</option><option value="1">Jan</option><option value="2">Feb</option><option value="3">Mar</option><option value="4">Apr</option><option value="5">May</option><option value="6">Jun</option><option value="7">Jul</option><option value="8" selected="selected">Aug</option><option value="9">Sep</option><option value="10">Oct</option><option value="11">Nov</option><option value="12">Dec</option></select> </div> <div class="form-item form-type-select form-item-submitted-start-date-day"> <label class="element-invisible" for="edit-submitted-start-date-day">Day </label> <select class="day form-select" id="edit-submitted-start-date-day" name="submitted[start_date][day]"><option value="">Day</option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24" selected="selected">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select> </div> <div class="form-item form-type-select form-item-submitted-start-date-year"> <label class="element-invisible" for="edit-submitted-start-date-year">Year </label> <select class="year form-select" id="edit-submitted-start-date-year" name="submitted[start_date][year]"><option value="">Year</option><option value="2012">2012</option><option value="2013">2013</option><option value="2014">2014</option><option value="2015" selected="selected">2015</option><option value="2016">2016</option><option value="2017">2017</option><option value="2018">2018</option><option value="2019">2019</option><option value="2020">2020</option><option value="2021">2021</option></select> </div> <input type="image" src="/web/20150905135828im_/https://nie.washingtonpost.com/sites/all/modules/webform/images/calendar.png" class="webform-calendar webform-calendar-start-2012-08-27 webform-calendar-end-2021-09-05 webform-calendar-day-0" alt="Open popup calendar" title="Open popup calendar"/> </div> </div> <div class="form-item webform-component webform-component-date" id="webform-component-end-date"> <label for="edit-submitted-end-date">End Date <span class="form-required" title="This field is required.">*</span></label> <div class="webform-container-inline webform-datepicker"><div class="form-item form-type-select form-item-submitted-end-date-month"> <label class="element-invisible" for="edit-submitted-end-date-month">Month </label> <select class="month form-select" id="edit-submitted-end-date-month" name="submitted[end_date][month]"><option value="">Month</option><option value="1">Jan</option><option value="2">Feb</option><option value="3">Mar</option><option 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