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High School Scholarship Program

Scholarship Distribution Form

This form is intended to be completed by the high school student who will receive a scholarship.

If your school is not in the listed in the prepopulated box below, please choose "Other" and enter your ZIP Code to continue. You will then be prompted to enter your school name in a pop up box.

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"); jQuery(document).ready(function(){ /* load in original library to avoid conflicts */ // $jQueryAEM = jQuery.noConflict(); // jQuery.getScript("https://code.jquery.com/jquery-1.12.4.js") // .done(function( script, textStatus ) { // $jQueryUI = jQuery.noConflict(); // jQuery.getScript("https://code.jquery.com/ui/1.12.1/jquery-ui.js") // .done(function( script, textStatus) { // $ = $jQueryAEM; jQuery = $jQueryAEM; /* begin widget for pre-populated list search */ jQuery( function() { // var itemList = JSON.parse(jQuery("#custom-search-data").text()); var request = new XMLHttpRequest(); request.open("GET","https://www.redcrossblood.org/content/dam/redcrossblood/rcb/hosting-a-blood-drive/resource/HighSchoolAccountNames011121.csv", false); request.send(null); var itemList = JSON.parse(request.responseText); var locationList = []; jQuery.each(itemList, function(index, item) { itemList[index].label = item.key; locationList[item.key] = item.location; }); itemList[itemList.length] = { label: "Other School Not Listed | Write in your own" } jQuery("#custom-search-school").data("location", locationList); jQuery("#custom-search-school").autocomplete({ autoFocus: true, minLength: 3, source: function(request, response) { var results = jQuery.ui.autocomplete.filter(itemList, request.term); response(results.slice(0, 10)); } }); } ); /* end widget for pre-populated list */ // }); // }); /* end library load */ var customPanel = ''; jQuery(customPanel).first().insertAfter(".content-card-with-zip .card-info"); if (window.self !== window.top) { return false; } /* move around items to avoid default dynamic behaviors */ var $link = jQuery("a[data-att-button='custom-button']"); var $button = $link.find("button"); var $form = jQuery("a[data-att-button='custom-button']").closest("form"); var $input = $form.find("input[name='zipSponsor']"); $link.parent().append($button); $link.hide(); $input.parent().prepend(''); $input.hide(); /* end moving around default elements */ jQuery("#fallback").parent().hide(); /* since script is working */ jQuery(".breadcrumb-main .crumb-hidden-container").hide(); jQuery("div[id*=wufoo-]") .closest(".generic-cta-panel").hide(); /* until we collect some info */ customAttachHandler(); }); function customAttachHandler() { jQuery("a[data-att-button='custom-button']") .closest("form").submit(function(event){ event.preventDefault(); var $postal = jQuery("#custom-zip-code"); if (/^\d{5}$/.test($postal.val()) === false) { alert("Please provide a valid five-digit ZIP Code."); return false; } if (/write in/i.test(jQuery("#custom-search-school").val()) === true) { if (confirm("Are you sure you want to continue without selecting a suggested school?") === false) { return false; } else { var customInputName = prompt("Please write in your own High School Name to proceed."); if (customInputName.length < 1) { return false; } customInputName = customInputName + " [writein]"; /* append for lookup to be checked as valid */ var locationList = jQuery("#custom-search-school") .data("location"); locationList[customInputName] = customInputName; jQuery("#custom-search-school").val(customInputName) .data("location", locationList); } } if (typeof jQuery("#custom-search-school") .data("location")[jQuery("#custom-search-school").val()] === "undefined") { alert("Please select a high school from the suggestions."); return false; } customToggleFormStatus(); jQuery.ajax({ async: true, type: 'GET', url: "/bin/region-search.zip=" + $postal.val() + ".json", success: function(data){ if(typeof data.region.regionCode === "undefined") { customToggleFormStatus(); alert("The ZIP Code provided does not match available locations. Please enter a different ZIP Code and try again."); return false; } // lookup tables to match Wufoo values var customUnits = { "041": "Alabama and Central Gulf Coast", "035": "Appalachian", "007": "Arizona", "032": "Badger-Hawkeye", "012": "Carolinas", "016": "Central Ohio", "002": "Central Plains", "033": "Connecticut", "018": "Great Lakes", "027": "Greater Alleghenies", "053": "Greater Chesapeake and Potomac", "055": "Greater Ozarks-Arkansas", "040": "Heart of America", "038": "Indiana-Ohio", "020": "Lewis and Clark", "004": "Massachusetts", "029": "Mid-Atlantic", "009": "Midwest", "011": "Missouri-Illinois", "001": "New York-Penn", "017": "North Central", "030": "Northeastern Pennsylvania", "084": "Northern California", "034": "Northern New England", "042": "Northern Ohio", "021": "Pacific Northwest", "022": "Penn-Jersey", "054": "Puerto Rico", "024": "River Valley", "036": "South Carolina", "013": "Southeastern Michigan", "003": "Southern", "006": "Southern California", "049": "Southwest", "019": "Tennessee Valley", "050": "Western Lake Erie" } jQuery("#custom-unit-name") .val(customUnits[data.region.regionCode]); customToggleFormStatus(); customEmbedForm(); } }); // end ajax return false; }); // end listener } // end customAttachHandler function customToggleFormStatus() { if (this.state === undefined) { this.state = false; } if (!this.state) { jQuery("html, body").css("cursor", "wait"); jQuery("#custom-form-start input").attr("disabled", "disabled"); this.state = true; return this.state; } else { jQuery("html, body").css("cursor", "auto"); jQuery("#custom-form-start input").removeAttr("disabled"); this.state = false; return this.state; } } function customEmbedForm() { jQuery("a[data-att-button='custom-button']") .closest(".content-card-with-zip").hide(); jQuery("div[id*=wufoo-]").closest(".generic-cta-panel").show(); var options = { 'userName':'americanredcross', 'formHash':'zhrajom0iykure', 'autoResize':true, 'defaultValues':'field68=' + jQuery("#custom-unit-name").val() + '&field14=' + jQuery("#custom-search-school").val() + '&field3=' + jQuery("#custom-search-school") .data("location")[jQuery("#custom-search-school").val()], 'height':'1015', 'async':true, 'host':'wufoo.com', 'header':'show', 'ssl':true} zhrajom0iykure = new WufooForm(); zhrajom0iykure.initialize(options); zhrajom0iykure.display(); } // end customEmbedForm
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