1<!DOCTYPE html> 2<html> 3<head> 4<title>Sign Up for the Hardees College Fund Contest</title> 5<meta name="description" content="Register for a chance at winnings Hardees $10,000 College Fund Contest. This is a great scholarship opportunity for one lucky student in Lexington, KY." /> 6<meta name="keywords" content="" /> 7<meta http-equiv="Content-Type" content="text/html; charset=utf-8"> 8<meta name="viewport" content="width=device-width, initial-scale=1.0"> 9<link href="./css/reset.css" rel="stylesheet" type="text/css"> 10<link href="./css/bootstrap.min.css" rel="stylesheet" type="text/css"> 11<link href="./css/global.css" rel="stylesheet" type="text/css"> 12<link href="./css/global-y.css" rel="stylesheet" type="text/css"> 13<link href="./css/global-m.css" rel="stylesheet" type="text/css"> 14<link href="./css/bootstrap-responsive.css" rel="stylesheet" type="text/css"> 15 16<link href="./css/validationEngine.jquery.css" rel="stylesheet" type="text/css"> 17<link type="text/css" rel="stylesheet" href=".//js/jquery/jquery-ui-1.8.10.custom.css"> 18<link type="text/css" rel="stylesheet" href=".//css/colorbox.css"> 19 20 21<!-- HTML5 shim for IE backwards compatibility --> 22<!--[if lt IE 9]>
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35 36 37</head> 38<body> 39<div id="wrapper" class="homebg"> <!-- header starts --> 40 41<header> 42 43<div class="container clearfix"> 44 45<div id="logo" class="pull-left"><a href="./index.html"><img src="./images/Hardees-white-logo.png" alt="Hardees"></a></div> 46 47<div id="right-head" class="pull-right"> 48 49<a href="./sign_up.html" class="signup">Sign Up</a> 50 51<a href="./rules.html" class="rules">The Rules</a> 52 53</div> 54 55</div> 56 57</header> <!-- end header --> 58 59<div class="header-bg"></div> 60
60<script type="text/javascript"> 61$(document).ready(function(){ 62 $("#signupForm").validationEngine('attach'); 63 }); 64</script>
64 65 66<!-- home section --> 67 68<section id="home-top"> 69 70<div class="container"> 71 72 <iframe src="https://services.cognitoforms.com/f/WztVSXS7q0C229twu6rvXg?id=6" style="position:relative;width:1px;min-width:100%;*width:100%;" frameborder="0" scrolling="yes" seamless="seamless" height="1516" width="100%"></iframe> 73 <!--<div class="cognito"> 74
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75 76 </div>--> 77 78<!--<div class="row-fluid"> 79 80<div class="inner-content"> 81 <h2>CONTEST FORM</h2> 82 83 84 <h3>Personal Information </h3> 85 86 <form name="signupForm" id="signupForm" method="post" action="./sign_up.html/save"> 87 <div class="row-fluid clearfix form-row"> 88 <div class="span6"> 89 <label>First Name</label> 90 <input type="text" placeholder="First name" name="first_name" id="first_name" class="input-block-level validate[required, custom[onlyLetterSp]]"> 91 </div> 92 93 <div class="span6"> 94 <label>Last Name</label> 95 <input type="text" placeholder="Last name" name="last_name" id="last_name" class="input-block-level validate[required, custom[onlyLetterSp]]"> 96 </div> 97 98 </div> 99 100 101 <div class="row-fluid clearfix form-row"> 102 <div class="span3"> 103 <label>Home Address (no P.O. boxes) </label> 104 <input type="text" placeholder="Address" name="address1" id="address1" class="input-block-level validate[required]"> 105 </div> 106 <div class="span3"> 107 <label>Address 2 </label> 108 <input type="text" placeholder="Address 2" name="address2" id="address2" class="input-block-level"> 109 </div> 110 <div class="span3"> 111 <label>City</label> 112 <input type="text" placeholder="City" name="city" id="city" class="input-block-level validate[required]"> 113 </div> 114 115 </div> 116 117 <div class="row-fluid clearfix form-row"> 118 <div class="span3"> 119 <label>State</label> 120 <input type="text" placeholder="State" name="state" id="state" class="input-block-level validate[required]"> 121 </div> 122 <div class="span3"> 123 <label>Zip Code </label> 124 <input type="text" placeholder="Zip Code" name="zip" id="zip" class="input-block-level validate[required]"> 125 </div> 126 <div class="span3"> 127 <label>County </label> 128 <input type="text" placeholder="County" name="county" id="county" class="input-block-level validate[required]"> 129 </div> 130 131 </div> 132 133 134 135 <div class="row-fluid clearfix form-row"> 136 <div class="span1"> 137 <label>Daytime </label> 138 <input type="text" placeholder="" name="daytime" id="daytime" class="input-block-level validate[required]"> 139 </div> 140 141 <div class="span4"> 142 <label>Telephone Number (including area code) </label> 143 <input type="text" placeholder="" name="phone" id="phone" class="input-block-level validate[required, custom[phone]]"> 144 </div> 145 146 </div> 147 148<div class="row-fluid clearfix form-row"> 149 150 <label>Date of Birth</label> 151 <span class="span1" style="margin-left:0"> 152 <select class="input-block-level validate[required]" name="dob_month" id="dob_month"> 153 <option value="">Month</option> 154 <option value="01">Jan</option> 155 <option value="02">Feb</option> 156 <option value="03">Mar</option> 157 <option value="04">Apr</option> 158 <option value="05">May</option> 159 <option value="06">Jun</option> 160 <option value="07">Jul</option> 161 <option value="08">Aug</option> 162 <option value="09">Sept</option> 163 <option value="10">Oct</option> 164 <option value="11">Nov</option> 165 <option value="12">Dec</option> 166 </select> 167 </span> 168 <span class="span1"> 169 <select class="input-block-level validate[required]" name="dob_day" id="dob_day"> 170 <option value="">Day</option> 171 <option value="01">1</option> 172 <option value="02">2</option> 173 <option value="03">3</option> 174 <option value="04">4</option> 175 <option value="05">5</option> 176 <option value="06">6</option> 177 <option value="07">7</option> 178 <option value="08">8</option> 179 <option value="09">9</option> 180 <option value="10">10</option> 181 <option value="11">11</option> 182 <option value="12">12</option> 183 <option value="13">13</option> 184 <option value="14">14</option> 185 <option value="15">15</option> 186 <option value="16">16</option> 187 <option value="17">17</option> 188 <option value="18">18</option> 189 <option value="19">19</option> 190 <option value="20">20</option> 191 <option value="21">21</option> 192 <option value="22">22</option> 193 <option value="23">23</option> 194 <option value="24">24</option> 195 <option value="25">25</option> 196 <option value="26">26</option> 197 <option value="27">27</option> 198 <option value="28">28</option> 199 <option value="29">29</option> 200 <option value="30">30</option> 201 <option value="31">31</option> 202 </select> 203 </span> 204 <span class="span1"> 205 <select class="input-block-level validate[required]" name="dob_year" id="dob_year"> 206 <option value="">Year</option> 207 <option value="1960">1960</option> 208 <option value="1961">1961</option> 209 <option value="1962">1962</option> 210 <option value="1963">1963</option> 211 <option value="1964">1964</option> 212 <option value="1965">1965</option> 213 <option value="1966">1966</option> 214 <option value="1967">1967</option> 215 <option value="1968">1968</option> 216 <option value="1969">1969</option> 217 <option value="1970">1970</option> 218 <option value="1971">1971</option> 219 <option value="1972">1972</option> 220 <option value="1973">1973</option> 221 <option value="1974">1974</option> 222 <option value="1975">1975</option> 223 <option value="1976">1976</option> 224 <option value="1977">1977</option> 225 <option value="1978">1978</option> 226 <option value="1979">1979</option> 227 <option value="1980">1980</option> 228 <option value="1981">1981</option> 229 <option value="1982">1982</option> 230 <option value="1983">1983</option> 231 <option value="1984">1984</option> 232 <option value="1985">1985</option> 233 <option value="1986">1986</option> 234 <option value="1987">1987</option> 235 <option value="1988">1988</option> 236 <option value="1989">
2361989</option> 237 <option value="1990">1990</option> 238 <option value="1991">1991</option> 239 <option value="1992">1992</option> 240 <option value="1993">1993</option> 241 <option value="1994">1994</option> 242 <option value="1995">1995</option> 243 <option value="1996">1996</option> 244 <option value="1997">1997</option> 245 <option value="1998">1998</option> 246 <option value="1999">1999</option> 247 <option value="2000">2000</option> 248 <option value="2001">2001</option> 249 <option value="2002">2002</option> 250 <option value="2003">2003</option> 251 <option value="2004">2004</option> 252 <option value="2005">2005</option> 253 <option value="2006">2006</option> 254 <option value="2007">2007</option> 255 <option value="2008">2008</option> 256 <option value="2009">2009</option> 257 <option value="2010">2010</option> 258 <option value="2011">2011</option> 259 <option value="2012">2012</option> 260 <option value="2013">2013</option> 261 <option value="2014">2014</option> 262 <option value="2015">2015</option> 263 <option value="2016">2016</option> 264 <option value="2017">2017</option> 265 <option value="2018">2018</option> 266 <option value="2019">2019</option> 267 </select> 268 </span> 269</div> 270 271 272 273<div class="row-fluid clearfix form-row"> 274 <div class="span5"> 275 276 <label>Email Address </label> 277 <input type="text" placeholder="" name="email" id="email" class="input-block-level validate[required, custom[email]]"> 278 </div> 279 280</div> 281 282 283<div id="under18"> 284<h5>Oh! You're under 18. That's alright! We just need some more information.</h5> 285 286 <div class="row-fluid clearfix form-row"> 287 <div class="span3"> 288 289 <label>Legal Guardian's Name </label> 290 <input type="text" placeholder="" name="guardian_name" id="guardian_name" class="input-block-level validate[custom[onlyLetterSp]]"> 291 </div> 292 293 <div class="span3"> 294 295 <label>Email </label> 296 <input type="text" placeholder="" name="guardian_email" id="guardian_email" class="input-block-level validate[custom[email]"> 297 </div> 298 299 <div class="span3"> 300 301 <label>Phone </label> 302 <input type="text" placeholder="" name="guardian_phone" id="guardian_phone" class="input-block-level validate[custom[phone]"> 303 </div> 304 305 </div> 306</div> 307 308 309<hr /> 310 311<h3>Essay Questions </h3> 312<p>Please complete the following essay questions within 250 words. All entries will be judged on the following criteria</p> 313 314<ul class="arrow-list"> 315<li>Exemplary community service and commitment to academic excellence </li> 316<li>Creativity and originality </li> 317<li>Quality content, proper grammar, attention to word count </li> 318</ul> 319 320<div class="row-fluid clearfix form-row"> 321<div class="span10"> 322 <label>How would this college fund help you achieve your education goals?</label> 323 <textarea class="input-block-level validate[required]" name="question_1" id="question_1"></textarea> 324</div> 325</div> 326 327<div class="row-fluid clearfix form-row"> 328<div class="span10"> 329 <label>How have you impacted your local community?</label> 330 <textarea class="input-block-level validate[required]" name="question_2" id="question_2"></textarea> 331</div> 332</div> 333 334<div class="row-fluid clearfix form-row"> 335 <label class="checkbox"> 336<input type="checkbox" name="checkbox_gpa" id="checkbox_gpa" value="1" class="validate[required]"> 337I verify that I currently have a minimum 2.5 cumulative grade point average (GPA) at my current educational institution 338</label> 339</div> 340 341 342<div class="row-fluid clearfix form-row"> 343 <label class="checkbox"> 344<input type="checkbox" name="checkbox_resident" id="checkbox_resident" value="1" class="validate[required]"> 345I verify that I am a legal resident of one of the following counties in the State of Kentucky: Anderson, Bath, Bourbon, Boyle, Breathitt, Casey, Clark, Clay, Estill, Fayette, Fleming, Franklin, Garrard, Harrison, Jackson, Jessamine, Knott, Knox, Laurel, Lee, Lincoln, Madison, Magoffin, Menifee, Mercer, Montgomery, Morgan, Nicholas, Owsley, Perry, Powell, Pulaski, Rockcastle, Rowan, Russell, Scott, Wayne, Whitley, Wolfe, or Woodford 346</label> 347</div> 348 349<div class="row-fluid clearfix form-row"> 350 <label class="checkbox"> 351<input type="checkbox" name="checkbox_enrolled" id="checkbox_enrolled" value="1" class="validate[required]"> 352I verify that by December 31, 2017 I will be enrolled as candidate for a degree at a Kentucky college, university or eligible educational institution <a href="./requirements.html" target="_blank">(see official rules for qualifying institutions.)</a> 353</label> 354</div> 355 356<div class="row-fluid clearfix form-row"> 357 <label class="checkbox"> 358<input type="checkbox" name="checkbox_rules" id="checkbox_rules" value="1" class="validate[required]"> 359I verify I have read & understand the <a href="./rules.html" target="_blank">official contest rules</a> 360</label> 361</div> 362 363 364<div class="row-fluid clearfix form-row"> 365 <label class="checkbox"> 366<input type="checkbox" name="checkbox_under18" id="checkbox_under18" value="1" class="validate[required]"> 367I verify that if I am under the age of 18, I have consent of my parent or legal guardian to enter. 368</label> 369</div> 370 371<p class="submit-buttons"> <span class="btn-frame"> 372 <button type="submit" name="submitButton" id="submitButton" value="submit">Submit</button> 373 </span><span class="btn-frame"> 374 <button type="reset" name="cancelButton" id="cancelButton" value="reset">Cancel</button> 375 </span> </p> 376 </form> 377 378 379 380<div class="disclaimer"> 381 NO PURCHASE NECESSARY TO ENTER OR WIN. Contest period: 9/11/17-11/14/17. Open only to legal residents of the following Kentucky state counties: Anderson, Bath, Bourbon, Boyle, Breathitt, Casey, Clark, Clay, Estill, Fayette, Fleming, Franklin, Garrard, Harrison, Jackson, Jessamine, Knott, Knox, Laurel, Lee, Lincoln, Madison, Magoffin, Menifee, Mercer, Montgomery, Morgan, Nicholas, Owsley, Perry, Powell, Pulaski, Rockcastle, Rowan, Russell, Scott, Wayne, Whitley, Wolfe, or Woodford (excluding residents of all other counties in Kentucky and all other 49 States of the United States, including the District of Columbia, Guam, Puerto Rico) 17 or older, with a minimum 2.5 GPA at current educational institution, and by 12/31/17 are candidate for degree at a KY college, university or eligible educational institution. Permission from parent/legal guardian required for individuals under age of majority. <a href="./rules.html">Official Rules</a>. Winner selected based on the entry that best describes exemplary community service, commitment to academic excellence, creativity and originality, and content quality. Sponsor: Viamedia, Inc., 220 Lexington Green Circle, Suite 300, Lexington, KY 40503. 382</div> 383 384 385 386<h3 style="text-align:center">Contest has ended! </h3>--> 387</div> 388 389 390 391</div> 392 393</div> 394 395</section> <!-- home section --> 396 <div id="push"></div> 397</div> 398<!-- end wrapper --> 399<footer> 400 401<div class="container"> 402 403<div class="row"> 404 405<div class="span8"> 406 407<p><a href="./sign_up.html">Sign Up</a> | <a href="./requirements.html">Requirements And Eligibility</a> | <a href="./faq.html">FAQs</a> | <a href="./contact_us.html">Contact Us</a> | <a href="./privacy.html">Privacy Policy</a> | <a href="./terms.html">Terms Of Use</a> | <a href="./rules.html">Contest Rules</a></p> 408 409</div> 410 411<div class="span4 text-right"> 412 413<p>Copyright©2021 Viamedia. All Rights Reserved</p> 414 415</div> 416 417</div> 418 419</div> 420 421</footer> 422
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