{"id":1224,"date":"2019-10-07T20:52:54","date_gmt":"2019-10-07T20:52:54","guid":{"rendered":"https:\/\/www.hps-sc.com\/?page_id=1224"},"modified":"2023-01-24T21:50:56","modified_gmt":"2023-01-25T02:50:56","slug":"form","status":"publish","type":"page","link":"https:\/\/www.hps-sc.com\/es\/form\/","title":{"rendered":"Consentimiento para Servicios"},"content":{"rendered":"<p><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Consentimiento para Servicios<\/h2>\n                            <span class='gform_description'>Este formulario nos da permiso para tratar a su hijo. Los datos se mantienen confidenciales y se usan solo para el tratamiento y la facturaci\u00f3n, de acuerdo con las leyes estatales y federales. Si la informaci\u00f3n cambia antes del tratamiento, comun\u00edquese con nosotros.<\/span>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/es\/wp-json\/wp\/v2\/pages\/1224#gf_9' novalidate><div id='gf_page_steps_9' class='gf_page_steps'><div id='gf_step_9_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Secci\u00f3n de informaci\u00f3n del estudiante<\/span><\/div><div id='gf_step_9_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Secci\u00f3n M\u00e9dica<\/span><\/div><div id='gf_step_9_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Secci\u00f3n de pago<\/span><\/div><div id='gf_step_9_4' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Firmar y Consentimiento<\/span><\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_9_1' class='gform_page' >\n                                    <div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_9\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n de la Escuela<\/h3><\/div><div id=\"field_9_46\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_46' >Distrito escolar<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_46' id='input_9_46' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County School District<\/option><option value='2' >Aiken County Public Schools<\/option><option value='3' >Allendale County Schools<\/option><option value='10' >Anderson 1 &amp; 2 AVC<\/option><option value='9' >Anderson Alternative School District<\/option><option value='4' >Anderson School District One<\/option><option value='5' >Anderson School District Two<\/option><option value='6' >Anderson School District Three<\/option><option value='7' >Anderson County School District 4<\/option><option value='8' >Anderson School District Five<\/option><option value='11' >Bamberg School District<\/option><option value='16' >Barnwell County AVC<\/option><option value='15' >Barnwell School District 45<\/option><option value='17' >Beaufort County School District<\/option><option value='18' >Beaufort-Jasper Career Center<\/option><option value='19' >Berkeley County School District<\/option><option value='13' >Blackville-Hilda Public Schools<\/option><option value='20' >Calhoun County Public Schools<\/option><option value='21' >Charleston County School District<\/option><option value='105' >Charter Institute at Erskine<\/option><option value='22' >Cherokee County School District<\/option><option value='23' >Chester County School District<\/option><option value='24' >Chesterfield County School District<\/option><option value='25' >Clarendon County School District One<\/option><option value='26' >Clarendon County School District Two<\/option><option value='27' >Clarendon County School District Three<\/option><option value='29' >Colleton County School District<\/option><option value='72' >Cope Area Career Center<\/option><option value='84' >Daniel Morgan Vocational Center<\/option><option value='30' >Darlington County School District<\/option><option value='33' >Dillon County Applied Tech Center<\/option><option value='31' >Dillon School District Three<\/option><option value='32' >Dillon School District Four<\/option><option value='36' >Dorchester County Career School<\/option><option value='34' >Dorchester County School District Two<\/option><option value='35' >Dorchester County School District Four<\/option><option value='37' >Edgefield County School District<\/option><option value='28' >F E Dubose Vocational Center<\/option><option value='38' >Fairfield County School District<\/option><option value='96' >Felton Laboratory School<\/option><option value='39' >Florence School District One<\/option><option value='40' >Florence School District Two<\/option><option value='41' >Florence School District Three<\/option><option value='42' >Florence School District Four<\/option><option value='43' >Florence School District Five<\/option><option value='93' >Fort Mill School District<\/option><option value='44' >Georgetown County School District<\/option><option value='108' >GLEAMNS Human Resources Commission, Inc.<\/option><option value='102' >Governor&#039;s School for Math and Science<\/option><option value='101' >Governor&#039;s School for the Arts and Humanities<\/option><option value='45' >Greenville County School District<\/option><option value='49' >Greenwood County Career Center<\/option><option value='46' >Greenwood County School District 50<\/option><option value='47' >Greenwood County School District 51<\/option><option value='48' >Greenwood County School District 52<\/option><option value='86' >H B Swofford AVC<\/option><option value='50' >Hampton County School District One<\/option><option value='51' >Hampton County School District Two<\/option><option value='52' >Horry County Schools<\/option><option value='53' >Jasper County School District<\/option><option value='97' >John De La Howe<\/option><option value='99' >Juvenile Justice Schools<\/option><option value='54' >Kershaw County School District<\/option><option value='55' >Lancaster County School District<\/option><option value='56' >Laurens County School District No. 55<\/option><option value='57' >Laurens County School District 56<\/option><option value='58' >Lee County School District<\/option><option value='63' >Lexington and Richland School District Five<\/option><option value='59' >Lexington County School District One<\/option><option value='60' >Lexington County School District Two<\/option><option value='61' >Lexington County School District Three<\/option><option value='62' >Lexington County School District Four<\/option><option value='103' >Marion County School District<\/option><option value='66' >Marlboro County School District<\/option><option value='64' >McCormick County School District<\/option><option value='110' >Movement School<\/option><option value='67' >Newberry County School District<\/option><option value='68' >Oconee County School District<\/option><option value='71' >Orangeburg County School District<\/option><option value='100' >Palmetto Unified<\/option><option value='104' >Pee Dee Head Starts<\/option><option value='73' >Pickens County School District<\/option><option value='85' >R D Anderson Applied Technology Center<\/option><option value='74' >Richland County School District One<\/option><option value='75' >Richland County School District Two<\/option><option value='92' >Rock Hill School District Three of York County<\/option><option value='76' >Saluda County School District One<\/option><option value='94' >SC Public School Charter District<\/option><option value='98' >SC School for the Deaf and Blind<\/option><option value='107' >Share Community Action Partnership<\/option><option value='77' >Spartanburg County School District One<\/option><option value='78' >Spartanburg County School District Two<\/option><option value='79' >Spartanburg County School District Three<\/option><option value='80' >Spartanburg County School District Four<\/option><option value='81' >Spartanburg County School District Five<\/option><option value='82' >Spartanburg County School District Six<\/option><option value='83' >Spartanburg County School District Seven<\/option><option value='87' >Sumter School District<\/option><option value='88' >Union County School District<\/option><option value='89' >Williamsburg County School District<\/option><option value='95' >Williamsburg Tech<\/option><option value='14' >Williston School District 29<\/option><option value='90' >York School District One<\/option><option value='91' >York County School District Two<\/option><\/select><\/div><\/div><div id=\"field_9_51\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_51' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_51'>Abbeville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_51' id='input_9_51' class='large gfield_select'  aria-describedby=\"gfield_description_9_51\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County Career Center<\/option><option value='2' >Abbeville High School<\/option><option value='3' >Cherokee Trail Elementary<\/option><option value='4' >Diamond Hill Elementary<\/option><option value='5' >Dixie High School<\/option><option value='6' >John C. Calhoun Elementary<\/option><option value='7' >Long Cane Primary<\/option><option value='8' >Westwood Elementary<\/option><option value='9' >Wright Middle<\/option><\/select><\/div><\/div><div id=\"field_9_52\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_52' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_52'>Aiken County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_52' id='input_9_52' class='large gfield_select'  aria-describedby=\"gfield_description_9_52\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='10' >Aiken County Career Center<\/option><option value='11' >Aiken High School<\/option><option value='12' >Aiken Middle<\/option><option value='13' >Aiken Performing Arts Academy Charter<\/option><option value='14' >Belvedere Elementary<\/option><option value='15' >Busbee Corbett Elementary Middle<\/option><option value='16' >Byrd Elementary<\/option><option value='17' >Chukker Creek Elementary<\/option><option value='18' >Clearwater Elementary<\/option><option value='19' >East Aiken School of the Arts<\/option><option value='20' >Gloverville Elementary<\/option><option value='21' >Greendale Elementary<\/option><option value='22' >Hammond Hill Elementary<\/option><option value='23' >Horse Creek Academy<\/option><option value='24' >J. D. Lever Elementary<\/option><option value='25' >Jackson Middle<\/option><option value='27' >Langley-Bath-Clearwater Middle<\/option><option value='28' >Leavelle McCampbell Middle<\/option><option value='29' >Lloyd-Kennedy Charter<\/option><option value='30' >M. B. Kennedy Middle<\/option><option value='31' >Midland Valley High School<\/option><option value='32' >Millbrook Elementary<\/option><option value='33' >Mossy Creek Elementary<\/option><option value='34' >New Ellenton Middle<\/option><option value='35' >North Aiken Elementary<\/option><option value='36' >North Augusta Elementary<\/option><option value='37' >North Augusta High School<\/option><option value='38' >North Augusta Middle<\/option><option value='39' >Oakwood-Windsor Elementary<\/option><option value='40' >Paul Knox Middle<\/option><option value='41' >Redcliffe Elementary<\/option><option value='42' >Ridge Spring Monetta Elementary<\/option><option value='43' >Ridge Spring-Monetta Middle High School<\/option><option value='44' >Schofield Middle<\/option><option value='45' >Silver Bluff High School<\/option><option value='46' >South Aiken High School<\/option><option value='47' >Wagener-Salley High School<\/option><option value='48' >Warrenville Elementary<\/option><option value='324' >Jefferson Elementary-Aiken<\/option><\/select><\/div><\/div><div id=\"field_9_53\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_53' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_53'>Allendale County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_53' id='input_9_53' class='large gfield_select'  aria-describedby=\"gfield_description_9_53\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='49' >Allendale Elementary<\/option><option value='50' >Allendale Fairfax High School<\/option><option value='51' >Allendale-Fairfax Middle<\/option><option value='52' >Fairfax Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_81\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_81' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_81'>Anderson School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_81' id='input_9_81' class='large gfield_select'  aria-describedby=\"gfield_description_9_81\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='53' >Cedar Grove Elementary<\/option><option value='54' >Concrete Primary<\/option><option value='55' >Hunt Meadows Elementary<\/option><option value='56' >Palmetto Elementary<\/option><option value='57' >Palmetto High School<\/option><option value='58' >Palmetto Middle<\/option><option value='59' >Powdersville Elementary<\/option><option value='60' >Powdersville High School<\/option><option value='61' >Powdersville Middle<\/option><option value='62' >Spearman Elementary<\/option><option value='63' >West Pelzer Elementary<\/option><option value='64' >Wren Elementary<\/option><option value='65' >Wren High School<\/option><option value='66' >Wren Middle<\/option><\/select><\/div><\/div><div id=\"field_9_82\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_82' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_82'>Anderson School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_82' id='input_9_82' class='large gfield_select'  aria-describedby=\"gfield_description_9_82\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='67' >Belton Elementary<\/option><option value='68' >Belton Honea Path High School<\/option><option value='69' >Belton Middle<\/option><option value='70' >Honea Path Elementary<\/option><option value='71' >Honea Path Middle<\/option><option value='72' >Marshall Primary<\/option><option value='73' >Wright Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_83\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_83' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_83'>Anderson School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_83' id='input_9_83' class='large gfield_select'  aria-describedby=\"gfield_description_9_83\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='74' >Crescent High School<\/option><option value='75' >Flat Rock Elementary<\/option><option value='76' >Iva Elementary<\/option><option value='77' >Starr Elementary<\/option><option value='78' >Starr-Iva Middle<\/option><\/select><\/div><\/div><div id=\"field_9_84\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_84' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_84'>Anderson County School District 4<\/div><div class='ginput_container ginput_container_select'><select name='input_84' id='input_9_84' class='large gfield_select'  aria-describedby=\"gfield_description_9_84\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='79' >La France Elementary<\/option><option value='80' >Mt. Lebanon Elementary<\/option><option value='81' >Pendleton Elementary<\/option><option value='82' >Pendleton High School<\/option><option value='83' >Riverside Middle-Anderson<\/option><option value='84' >Townville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_85\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_85' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_85'>Anderson School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_85' id='input_9_85' class='large gfield_select'  aria-describedby=\"gfield_description_9_85\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='85' >Anderson  Five Charter School<\/option><option value='86' >Anderson Five Career Campus<\/option><option value='1291' >Anderson Institute of Technology<\/option><option value='87' >Calhoun Academy of the Arts<\/option><option value='88' >Centerville Elementary-Anderson 5<\/option><option value='89' >Concord Elementary<\/option><option value='90' >Glenview Middle<\/option><option value='91' >Homeland Park Primary<\/option><option value='92' >Lakeside Middle<\/option><option value='93' >McCants Middle<\/option><option value='94' >McLees Elementary<\/option><option value='95' >Midway Elementary School of Science and Engineering<\/option><option value='96' >Nevitt Forest Elementary<\/option><option value='97' >New Prospect Elementary<\/option><option value='98' >North Pointe Elementary<\/option><option value='99' >Robert Anderson Middle<\/option><option value='100' >South Fant School of Early Education<\/option><option value='101' >Southwood Academy of the Arts<\/option><option value='102' >T. L. Hanna High School<\/option><option value='103' >Varennes Elementary<\/option><option value='104' >West Market School of Early Education<\/option><option value='105' >Westside High School<\/option><option value='106' >Whitehall Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_86\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_86' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_86'>Anderson 1 & 2 AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_86' id='input_9_86' class='large gfield_select'  aria-describedby=\"gfield_description_9_86\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='108' >Career Tec Ctr Anderson1&amp;2<\/option><\/select><\/div><\/div><div id=\"field_9_187\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_187' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_187'>Renaissance Academy<\/div><div class='ginput_container ginput_container_select'><select name='input_187' id='input_9_187' class='large gfield_select'  aria-describedby=\"gfield_description_9_187\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='107' >Renaissance Academy<\/option><\/select><\/div><\/div><div id=\"field_9_87\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_87' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_87'>Bamberg School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_87' id='input_9_87' class='large gfield_select'  aria-describedby=\"gfield_description_9_87\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='109' >Bamberg-Ehrhardt High School<\/option><option value='110' >Bamberg-Ehrhardt Middle<\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><option value='111' >Richard Carroll Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_88\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_88' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_88'>Bamberg School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_88' id='input_9_88' class='large gfield_select'  aria-describedby=\"gfield_description_9_88\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><\/select><\/div><\/div><div id=\"field_9_91\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_91' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_91'>Barnwell School District 45<\/div><div class='ginput_container ginput_container_select'><select name='input_91' id='input_9_91' class='large gfield_select'  aria-describedby=\"gfield_description_9_91\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='121' >Barnwell Elementary<\/option><option value='122' >Barnwell High School<\/option><option value='123' >Barnwell Primary<\/option><option value='124' >Guinyard-Butler Middle<\/option><\/select><\/div><\/div><div id=\"field_9_92\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_92' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_92'>Barnwell County AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_92' id='input_9_92' class='large gfield_select'  aria-describedby=\"gfield_description_9_92\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='125' >Barnwell County Career Centertr<\/option><\/select><\/div><\/div><div id=\"field_9_93\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_93' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_93'>Beaufort County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_93' id='input_9_93' class='large gfield_select'  aria-describedby=\"gfield_description_9_93\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='126' >Battery Creek High School<\/option><option value='127' >Beaufort Elementary<\/option><option value='128' >Beaufort High School<\/option><option value='129' >Beaufort Middle<\/option><option value='130' >Bluffton Elementary<\/option><option value='131' >Bluffton High School<\/option><option value='132' >Bluffton Middle<\/option><option value='133' >Broad River Elementary<\/option><option value='134' >Coosa Elementary<\/option><option value='135' >Daufuskie Elem. ANNEX<\/option><option value='136' >H. E. McCracken Middle<\/option><option value='137' >Hilton Head Island Early Childhood Center<\/option><option value='138' >Hilton Head Island Elementary<\/option><option value='139' >Hilton Head Island Elementary School for the Creative Arts<\/option><option value='140' >Hilton Head Island High School<\/option><option value='141' >Hilton Head Island Middle<\/option><option value='142' >Joseph S. Shanklin Elementary<\/option><option value='143' >Lady&#039;s Island Elementary<\/option><option value='144' >Lady&#039;s Island Middle<\/option><option value='145' >Michael C. Riley Elementary<\/option><option value='146' >Mossy Oaks Elementary<\/option><option value='147' >Okatie Elementary<\/option><option value='148' >Port Royal Elementary<\/option><option value='149' >Pritchardville Elementary<\/option><option value='150' >Red Cedar Elementary<\/option><option value='151' >Right Choice  School<\/option><option value='152' >River Ridge Academy<\/option><option value='153' >Riverview Charter School<\/option><option value='154' >Robert Smalls International Academy<\/option><option value='155' >St. Helena Elementary<\/option><option value='156' >Whale Branch Early College High School<\/option><option value='157' >Whale Branch Elementary<\/option><option value='158' >Whale Branch Middle<\/option><\/select><\/div><\/div><div id=\"field_9_95\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_95' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_95'>Beaufort-Jasper Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_95' id='input_9_95' class='large gfield_select'  aria-describedby=\"gfield_description_9_95\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='159' >Beaufort-Jasper Academy For Ex<\/option><\/select><\/div><\/div><div id=\"field_9_94\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_94' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_94'>Berkeley County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_94' id='input_9_94' class='large gfield_select'  aria-describedby=\"gfield_description_9_94\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='160' >Berkeley County Middle College High School<\/option><option value='161' >Berkeley Elementary<\/option><option value='162' >Berkeley High School<\/option><option value='163' >Berkeley Intermediate<\/option><option value='164' >Berkeley Middle<\/option><option value='165' >Boulder Bluff Elementary<\/option><option value='1285' >Bowen&#039;s Corner Elementary<\/option><option value='166' >Cainhoy Elementary Middle<\/option><option value='167' >Cane Bay Elementary<\/option><option value='168' >Cane Bay High School<\/option><option value='169' >Cane Bay Middle<\/option><option value='1443' >Carolyn Lewis School<\/option><option value='170' >College Park Elementary<\/option><option value='171' >College Park Middle<\/option><option value='172' >Cross Elementary<\/option><option value='173' >Cross High School<\/option><option value='174' >Daniel Island School<\/option><option value='175' >Devon Forest Elementary<\/option><option value='1286' >Foxbank Elementary<\/option><option value='176' >Goose Creek High School<\/option><option value='177' >Goose Creek Elementary<\/option><option value='178' >Hanahan Elementary<\/option><option value='179' >Hanahan High School<\/option><option value='180' >Hanahan Middle<\/option><option value='181' >Henry E. Bonner Elementary<\/option><option value='182' >Howe Hall AIMS Elementary<\/option><option value='183' >J. K. Gourdin Elementary<\/option><option value='184' >Macedonia Middle<\/option><option value='185' >Marrington Elementary<\/option><option value='186' >Marrington Middle School of the Arts<\/option><option value='191' >Mount Holly Elementary (formerly Sedgefield Intermediate)<\/option><option value='163' >Moncks Corner Elementary<\/option><option value='187' >Nexton Elementary<\/option><option value='1268' >Philip Simmons Elementary<\/option><option value='1269' >Phillip Simmons Middle<\/option><option value='188' >Sangaree Elementary<\/option><option value='189' >Sangaree Intermediate<\/option><option value='190' >Sangaree Middle<\/option><option value='192' >Sedgefield Middle<\/option><option value='193' >St. Stephen Elementary<\/option><option value='194' >St. Stephen Middle<\/option><option value='195' >Stratford High School<\/option><option value='196' >Timberland High  School<\/option><option value='197' >Westview Elementary<\/option><option value='198' >Westview Middle<\/option><option value='199' >Westview Primary<\/option><option value='200' >Whitesville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_89\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_89' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_89'>Blackville-Hilda Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_89' id='input_9_89' class='large gfield_select'  aria-describedby=\"gfield_description_9_89\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='115' >Blackville-Hilda High School<\/option><option value='116' >Blackville-Hilda Junior High<\/option><option value='117' >Macedonia Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_96\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_96' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_96'>Calhoun County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_96' id='input_9_96' class='large gfield_select'  aria-describedby=\"gfield_description_9_96\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='201' >Calhoun County High School<\/option><option value='202' >Sandy Run School<\/option><option value='203' >St. Matthews K-8 School<\/option><\/select><\/div><\/div><div id=\"field_9_97\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_97' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_97'>Charleston County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_97' id='input_9_97' class='large gfield_select'  aria-describedby=\"gfield_description_9_97\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='204' >A. C. Corcoran Elementary<\/option><option value='205' >Academic Magnet High School<\/option><option value='206' >Allegro Charter School of Music<\/option><option value='207' >Angel Oak Elementary<\/option><option value='208' >Ashley River Creative Arts Elementary<\/option><option value='209' >Baptist Hill High School<\/option><option value='210' >Belle Hall Elementary<\/option><option value='211' >Buist Academy<\/option><option value='212' >Burke High School<\/option><option value='213' >C.E. Williams Middle School<\/option><option value='235' >Camp Middle<\/option><option value='1276' >Cape Romain Environmental Charter School<\/option><option value='1278' >Carolina Park Elementary School<\/option><option value='214' >Carolina Voyager Charter<\/option><option value='215' >Charles Pinckney Elementary<\/option><option value='216' >Charleston Charter School for Math and Science<\/option><option value='217' >Charleston Development Academy Public Charter School<\/option><option value='218' >Charleston Progressive Academy<\/option><option value='219' >Charleston School Of The Arts<\/option><option value='220' >Chicora Elementary School<\/option><option value='1272' >Daniel Jenkins Academy<\/option><option value='221' >Drayton Hall Elementary School<\/option><option value='222' >E.B. Ellington Elementary School<\/option><option value='223' >East Cooper Center for Advanced Studies<\/option><option value='224' >Edith L. Frierson Elementary<\/option><option value='225' >Edmund A. Burns Elementary<\/option><option value='226' >Fort Johnson Middle<\/option><option value='227' >Garrett Academy of Technology<\/option><option value='228' >Greg Mathis Charter High School<\/option><option value='229' >Harbor View Elementary<\/option><option value='230' >Haut Gap Middle<\/option><option value='231' >Hunley Park Elementary<\/option><option value='232' >James B. Edwards Elementary<\/option><option value='233' >James Island Charter High School<\/option><option value='234' >James Island Elementary<\/option><option value='236' >James Simons Montessori School<\/option><option value='237' >Jane Edwards Elementary<\/option><option value='238' >Jennie Moore Elementary<\/option><option value='239' >Jerry Zucker Middle School of Science<\/option><option value='240' >Ladson Elementary<\/option><option value='241' >Laing Middle School of Science and Technology<\/option><option value='242' >Lambs Elementary School<\/option><option value='243' >Laurel Hill Primary<\/option><option value='1267' >Liberty Hill Academy<\/option><option value='244' >Lincoln High School<\/option><option value='245' >Malcolm C. Hursey Elementary<\/option><option value='246' >Mamie Whitesides Elementary<\/option><option value='247' >Mary Ford Early Learning &amp; Family Center<\/option><option value='248' >Matilda Dunston Elementary<\/option><option value='1270' >Meeting Street Academy<\/option><option value='249' >Meeting Street Elementary at Brentwood<\/option><option value='250' >Memminger School of Global Studies<\/option><option value='251' >Midland Park Primary<\/option><option value='252' >Military Magnet Academy<\/option><option value='253' >Minnie Hughes Elementary<\/option><option value='254' >Mitchell Elementary<\/option><option value='255' >Montessori Community School<\/option><option value='256' >Morningside Middle<\/option><option value='257' >Morningside Middle ANNEX<\/option><option value='258' >Moultrie Middle<\/option><option value='259' >Mt. Pleasant Academy<\/option><option value='260' >Mt. Zion Elementary<\/option><option value='261' >Murray LaSaine Elementary<\/option><option value='262' >North Charleston Creative Arts Elementary<\/option><option value='263' >North Charleston Elementary<\/option><option value='264' >North Charleston High School<\/option><option value='265' >Northwoods Middle<\/option><option value='1037' >Oakland Elementary-Charleston<\/option><option value='267' >Orange Grove Elementary Charter<\/option><option value='268' >Pattison&#039;s Academy for Comprehensive Education<\/option><option value='269' >Pepperhill Elementary<\/option><option value='270' >Pinehurst Elementary<\/option><option value='271' >R. B. Stall High School<\/option><option value='272' >Sanders-Clyde Elementary<\/option><option value='1261' >Septima Clarke Alternative<\/option><option value='273' >Simmons Pinckney Middle<\/option><option value='274' >Springfield Elementary<\/option><option value='275' >St. Andrew&#039;s School of Math and Science<\/option><option value='276' >St. James Santee Elementary<\/option><option value='277' >St. John&#039;s High School<\/option><option value='278' >Stiles Point Elementary<\/option><option value='279' >Stono Park Elementary<\/option><option value='280' >Sullivan&#039;s Island Elementary<\/option><option value='281' >Thomas C. Cario Middle<\/option><option value='282' >W. B. Goodwin Elementary<\/option><option value='283' >Wando High School<\/option><option value='284' >West Ashley High School<\/option><option value='285' >West Ashley Middle<\/option><option value='1271' >West Ashley Advanced Study Magnet<\/option><\/select><\/div><\/div><div id=\"field_9_151\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_151' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_151'>Charter Institute at Erskine<\/div><div class='ginput_container ginput_container_select'><select name='input_151' id='input_9_151' class='large gfield_select'  aria-describedby=\"gfield_description_9_151\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1299' >Belton Preparatory Academy<\/option><option value='1300' >Berkeley Preparatory Academy<\/option><option value='1301' >Brashier Middle College Charter School<\/option><option value='1302' >Calhoun Falls Charter School<\/option><option value='1303' >Cherokee Charter Academy<\/option><option value='1304' >Clear Dot Charter School<\/option><option value='1305' >Coastal Leadership Academy<\/option><option value='1306' >Cyber Academy of SC<\/option><option value='1307' >Gates School<\/option><option value='1308' >Gray Collegiate Academy<\/option><option value='1309' >Horse Creek Academy<\/option><option value='1310' >Legion Collegiate Academy<\/option><option value='1311' >Lowcountry Leadership Charter School<\/option><option value='1312' >Lowcountry Connections Academy<\/option><option value='1313' >Mevers School of Excellence<\/option><option value='1218' >Midlands STEM Institute<\/option><option value='1316' >Oceanside Collegiate Academy<\/option><option value='1317' >Odyssey Online Learning<\/option><option value='1318' >Royal Live Oaks Academy<\/option><option value='1319' >South Carolina Connections Academy<\/option><option value='1320' >SC Preparatory Academy<\/option><option value='1321' >South Carolina Virtual Charter School<\/option><option value='1322' >Summit Classical School<\/option><option value='1315' >The Montessori School of Camden<\/option><option value='1323' >Thornwell Charter School<\/option><option value='1324' >Virtus Academy of South Carolina<\/option><\/select><\/div><\/div><div id=\"field_9_98\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_98' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_98'>Cherokee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_98' id='input_9_98' class='large gfield_select'  aria-describedby=\"gfield_description_9_98\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='286' >Alma Elementary<\/option><option value='287' >B. D. Lee Elementary<\/option><option value='288' >Blacksburg Elementary<\/option><option value='289' >Blacksburg High School<\/option><option value='290' >Blacksburg Middle<\/option><option value='291' >Blacksburg Primary<\/option><option value='292' >Cherokee Technology Center<\/option><option value='293' >Corinth Elementary<\/option><option value='294' >Draytonville Elementary<\/option><option value='295' >Gaffney High School<\/option><option value='296' >Gaffney Middle<\/option><option value='297' >Goucher Elementary<\/option><option value='298' >Granard Middle<\/option><option value='299' >Grassy Pond Elementary<\/option><option value='300' >John E. Ewing Middle<\/option><option value='301' >Limestone-Central Elementary<\/option><option value='302' >Luther L. Vaughan  Elementary<\/option><option value='303' >Mary Bramlett Elementary<\/option><option value='304' >Northwest Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_99\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_99' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_99'>Chester County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_99' id='input_9_99' class='large gfield_select'  aria-describedby=\"gfield_description_9_99\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='305' >Academy for Teaching and Learning  K-8<\/option><option value='306' >Chester County Career Center<\/option><option value='307' >Chester Middle<\/option><option value='308' >Chester Park Elementary of Inquiry<\/option><option value='309' >Chester Park Elementary School for the Arts<\/option><option value='310' >Chester Park Elementary School of Literacy and Technology<\/option><option value='311' >Chester Senior High School<\/option><option value='312' >Great Falls Elementary<\/option><option value='313' >Great Falls High School<\/option><option value='314' >Lewisville Elementary<\/option><option value='315' >Lewisville High School<\/option><option value='316' >Lewisville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_100\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_100' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_100'>Chesterfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_100' id='input_9_100' class='large gfield_select'  aria-describedby=\"gfield_description_9_100\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='317' >Central High School<\/option><option value='1274' >Cheraw Headstart<\/option><option value='318' >Cheraw High School<\/option><option value='319' >Cheraw Intermediate<\/option><option value='320' >Cheraw Primary<\/option><option value='321' >Chesterfield High School<\/option><option value='322' >Chesterfield-Ruby Middle<\/option><option value='323' >Edwards Elementary<\/option><option value='26' >Jefferson Elementary-Chesterfield<\/option><option value='325' >Long Middle<\/option><option value='326' >McBee Elementary<\/option><option value='1262' >McBee HeadStart<\/option><option value='327' >McBee High School<\/option><option value='328' >New Heights Middle<\/option><option value='329' >Pageland Elementary<\/option><option value='330' >Petersburg Primary<\/option><option value='331' >Plainview Elementary<\/option><option value='332' >Ruby Elementary<\/option><option value='1263' >Ruby HeadStart<\/option><option value='1296' >Pageland Headstart<\/option><\/select><\/div><\/div><div id=\"field_9_101\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_101' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_101'>Clarendon County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_101' id='input_9_101' class='large gfield_select'  aria-describedby=\"gfield_description_9_101\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='333' >Scott&#039;s Branch High School<\/option><option value='334' >Scott&#039;s Branch Middle<\/option><option value='335' >St. Paul Elementary<\/option><option value='336' >Summerton Early Childhood Center<\/option><\/select><\/div><\/div><div id=\"field_9_102\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_102' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_102'>Clarendon County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_102' id='input_9_102' class='large gfield_select'  aria-describedby=\"gfield_description_9_102\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='337' >Manning Early Childhood Center<\/option><option value='338' >Manning Elementary<\/option><option value='339' >Manning High School<\/option><option value='340' >Manning Junior High<\/option><option value='341' >Manning Primary<\/option><option value='342' >Phoenix Charter High School<\/option><\/select><\/div><\/div><div id=\"field_9_103\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_103' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_103'>Clarendon County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_103' id='input_9_103' class='large gfield_select'  aria-describedby=\"gfield_description_9_103\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='343' >East Clarendon Middle-High School<\/option><option value='344' >Walker-Gamble Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_105\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_105' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_105'>Colleton County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_105' id='input_9_105' class='large gfield_select'  aria-describedby=\"gfield_description_9_105\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='346' >Bells Elementary<\/option><option value='347' >Black Street Early Childhood Center<\/option><option value='348' >Colleton County High School<\/option><option value='349' >Colleton County Middle<\/option><option value='350' >Cottageville Elementary<\/option><option value='351' >Forest Hills Elementary<\/option><option value='352' >Hendersonville Elementary<\/option><option value='353' >Northside Elementary-Colleton<\/option><option value='354' >Thunderbolt Career and Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_152\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_152' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_152'>Cope Area Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_152' id='input_9_152' class='large gfield_select'  aria-describedby=\"gfield_description_9_152\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='902' >Cope Area Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_153\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_153' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_153'>Daniel Morgan Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_153' id='input_9_153' class='large gfield_select'  aria-describedby=\"gfield_description_9_153\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1088' >Daniel Morgan Technolgy Center<\/option><\/select><\/div><\/div><div id=\"field_9_106\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_106' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_106'>Darlington County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_106' id='input_9_106' class='large gfield_select'  aria-describedby=\"gfield_description_9_106\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='355' >Brockington Elementary<\/option><option value='356' >Brunson-Dargan Elementary<\/option><option value='357' >Cain Elementary<\/option><option value='358' >Carolina Elementary<\/option><option value='359' >Darlington County Institute Of<\/option><option value='360' >Darlington High School<\/option><option value='361' >Darlington Middle<\/option><option value='362' >Hartsville High School<\/option><option value='363' >Hartsville Middle<\/option><option value='364' >Lamar Elementary<\/option><option value='365' >Lamar High School<\/option><option value='366' >Mayo High School for Math, Science, and Technology<\/option><option value='367' >North Hartsville Elementary<\/option><option value='368' >Pate Elementary<\/option><option value='369' >Rosenwald Elementary-Middle<\/option><option value='370' >Southside Early Childhood Education Center<\/option><option value='371' >Spaulding Elementary<\/option><option value='372' >Spaulding Middle<\/option><option value='373' >St. Johns Elementary<\/option><option value='374' >Thornwell School for the Arts<\/option><option value='375' >Washington St. Elementary<\/option><option value='376' >West Hartsville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_109\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_109' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_109'>Dillon County Applied Tech Center<\/div><div class='ginput_container ginput_container_select'><select name='input_109' id='input_9_109' class='large gfield_select'  aria-describedby=\"gfield_description_9_109\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='388' >Dillon County Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_107\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_107' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_107'>Dillon School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_107' id='input_9_107' class='large gfield_select'  aria-describedby=\"gfield_description_9_107\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='377' >Latta Elementary<\/option><option value='378' >Latta High School<\/option><option value='379' >Latta Middle<\/option><\/select><\/div><\/div><div id=\"field_9_108\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_108' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_108'>Dillon School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_108' id='input_9_108' class='large gfield_select'  aria-describedby=\"gfield_description_9_108\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='380' >Dillon High School<\/option><option value='381' >Dillon Middle<\/option><option value='382' >East Elementary<\/option><option value='383' >Gordon Elementary<\/option><option value='384' >Lake View Elementary<\/option><option value='385' >Lake View High School<\/option><option value='386' >South Elementary<\/option><option value='387' >Stewart Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_154\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_154' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_154'>Spartanburg County District One<\/div><div class='ginput_container ginput_container_select'><select name='input_154' id='input_9_154' class='large gfield_select'  aria-describedby=\"gfield_description_9_154\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1015' >Campobello-Gramling School<\/option><option value='1016' >Chapman High School<\/option><option value='1017' >Holly Springs-Motlow Elementary<\/option><option value='1018' >Inman Elementary<\/option><option value='1019' >Inman Intermediate<\/option><option value='1020' >Landrum High School<\/option><option value='1021' >Landrum Middle<\/option><option value='1022' >New Prospect Elementary<\/option><option value='1023' >O. P. Earle Elementary<\/option><option value='1024' >T. E. Mabry Middle<\/option><\/select><\/div><\/div><div id=\"field_9_112\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_112' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_112'>Dorchester County Career School<\/div><div class='ginput_container ginput_container_select'><select name='input_112' id='input_9_112' class='large gfield_select'  aria-describedby=\"gfield_description_9_112\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='416' >Dorchester County Career &amp; Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_110\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_110' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_110'>Dorchester County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_110' id='input_9_110' class='large gfield_select'  aria-describedby=\"gfield_description_9_110\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='389' >Alston Middle<\/option><option value='390' >Ashley Ridge High School<\/option><option value='391' >Beech Hill Elementary<\/option><option value='392' >Charles B. DuBose Middle<\/option><option value='393' >Eagle Nest Elementary<\/option><option value='394' >Flowertown Elementary<\/option><option value='395' >Fort Dorchester Elementary<\/option><option value='396' >Fort Dorchester High School<\/option><option value='397' >Gregg Middle<\/option><option value='398' >James H. Spann Elementary<\/option><option value='399' >Joseph R. Pye Elementary<\/option><option value='400' >Knightsville Elementary<\/option><option value='401' >Newington Elementary<\/option><option value='402' >Oakbrook Elementary<\/option><option value='403' >Oakbrook Middle<\/option><option value='404' >River Oaks Middle<\/option><option value='405' >Rollings Middle School of the Arts<\/option><option value='406' >Summerville Elementary<\/option><option value='407' >Summerville High School<\/option><option value='408' >William M. Reeves Elementary<\/option><option value='409' >Windsor Hill Arts Infused Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_111\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_111' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_111'>Dorchester County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_111' id='input_9_111' class='large gfield_select'  aria-describedby=\"gfield_description_9_111\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='410' >Clay Hill Elementary<\/option><option value='411' >Harleyville Elementary<\/option><option value='414' >Williams Memorial Elementary<\/option><option value='415' >Woodland High School<\/option><option value='1449' >Woodland Middle<\/option><\/select><\/div><\/div><div id=\"field_9_113\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_113' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_113'>Edgefield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_113' id='input_9_113' class='large gfield_select'  aria-describedby=\"gfield_description_9_113\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='417' >Douglas Elementary<\/option><option value='418' >Johnston Elementary<\/option><option value='419' >Johnston-Edgefield-Trenton Middle<\/option><option value='420' >Merriwether Elementary<\/option><option value='421' >Merriwether Middle<\/option><option value='422' >Strom Thurmond Career Center<\/option><option value='423' >Strom Thurmond High School<\/option><option value='424' >W. E. Parker Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_104\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_104' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_104'>F E Dubose Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_104' id='input_9_104' class='large gfield_select'  aria-describedby=\"gfield_description_9_104\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='345' >F E Dubose Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_114\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_114' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_114'>Fairfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_114' id='input_9_114' class='large gfield_select'  aria-describedby=\"gfield_description_9_114\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='425' >Fairfield Career and Technology Center<\/option><option value='426' >Fairfield Central High School<\/option><option value='427' >Fairfield Elementary<\/option><option value='428' >Fairfield Magnet for Math and Science<\/option><option value='429' >Fairfield Middle<\/option><option value='430' >Geiger Elementary<\/option><option value='431' >Kelly Miller Elementary<\/option><option value='432' >McCrorey-Liston School of Technology<\/option><\/select><\/div><\/div><div id=\"field_9_156\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_156' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_156'>Felton Laboratory School<\/div><div class='ginput_container ginput_container_select'><select name='input_156' id='input_9_156' class='large gfield_select'  aria-describedby=\"gfield_description_9_156\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1235' >Felton Laboratory Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_115\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_115' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_115'>Florence School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_115' id='input_9_115' class='large gfield_select'  aria-describedby=\"gfield_description_9_115\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='433' >Alfred Rush Academy<\/option><option value='434' >Beck Learning Center<\/option><option value='435' >Briggs Elementary<\/option><option value='436' >Carver Elementary<\/option><option value='437' >Child Development Center at Woods Road<\/option><option value='438' >Delmae Elementary<\/option><option value='439' >Dewey-Carter Elementary<\/option><option value='440' >Florence Career Center<\/option><option value='441' >Greenwood Elementary<\/option><option value='442' >Henry L. Sneed Middle<\/option><option value='443' >Henry Timrod Elementary<\/option><option value='444' >John W. Moore Middle<\/option><option value='445' >Lucy T. Davis Elementary<\/option><option value='446' >McLaurin Elementary<\/option><option value='447' >North Vista Elementary<\/option><option value='448' >Palmetto Youth Academy Charter<\/option><option value='449' >Poynor Center<\/option><option value='450' >Royall Elementary<\/option><option value='451' >Savannah Grove Elementary<\/option><option value='452' >South Florence High School<\/option><option value='453' >Southside Middle<\/option><option value='454' >Theodore Lester Elementary<\/option><option value='455' >Wallace Gregg Elementary<\/option><option value='456' >West Florence High School<\/option><option value='457' >Williams Middle<\/option><option value='458' >Wilson High School<\/option><\/select><\/div><\/div><div id=\"field_9_116\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_116' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_116'>Florence School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_116' id='input_9_116' class='large gfield_select'  aria-describedby=\"gfield_description_9_116\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='459' >Early Childhood Success Center ANNEX<\/option><option value='460' >Hannah Pamplico High School<\/option><option value='461' >Hannah-Pamplico Elementary and Middle<\/option><\/select><\/div><\/div><div id=\"field_9_117\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_117' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_117'>Florence School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_117' id='input_9_117' class='large gfield_select'  aria-describedby=\"gfield_description_9_117\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='462' >J. C. Lynch Elementary<\/option><option value='463' >J. Paul Truluck Intermediate<\/option><option value='464' >Lake City Early Childhood Center<\/option><option value='465' >Lake City High School<\/option><option value='466' >Main Street Elementary<\/option><option value='467' >Olanta Elementary<\/option><option value='468' >Ronald E. McNair Junior High<\/option><option value='469' >Scranton Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_118\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_118' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_118'>Florence School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_118' id='input_9_118' class='large gfield_select'  aria-describedby=\"gfield_description_9_118\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='470' >Brockington Elementary<\/option><option value='471' >Johnson Middle<\/option><option value='472' >Timmonsville High School<\/option><option value='1275' >Woods Road HeadStart<\/option><\/select><\/div><\/div><div id=\"field_9_119\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_119' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_119'>Florence School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_119' id='input_9_119' class='large gfield_select'  aria-describedby=\"gfield_description_9_119\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='473' >Johnsonville Elementary<\/option><option value='474' >Johnsonville High School<\/option><option value='475' >Johnsonville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_162\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_162' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_162'>Fort Mill School District<\/div><div class='ginput_container ginput_container_select'><select name='input_162' id='input_9_162' class='large gfield_select'  aria-describedby=\"gfield_description_9_162\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1187' >Banks Trail Middle<\/option><option value='1188' >Doby&#039;s Bridge Elementary<\/option><option value='1189' >Fort Mill Elementary<\/option><option value='1190' >Fort Mill High School<\/option><option value='1191' >Fort Mill Middle<\/option><option value='1192' >Gold Hill Elementary<\/option><option value='1193' >Gold Hill Middle<\/option><option value='1194' >Nation Ford High School<\/option><option value='1195' >Orchard Park Elementary-Fort Mill<\/option><option value='1196' >Pleasant Knoll Elementary<\/option><option value='1283' >Pleasant Knoll Middle<\/option><option value='1197' >Riverview Elementary<\/option><option value='1198' >Springfield Elementary<\/option><option value='1199' >Springfield Middle<\/option><option value='1200' >Sugar Creek Elementary<\/option><option value='1201' >Tega Cay Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_120\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_120' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_120'>Georgetown County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_120' id='input_9_120' class='large gfield_select'  aria-describedby=\"gfield_description_9_120\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='476' >Andrews Elementary<\/option><option value='477' >Andrews High School<\/option><option value='478' >Brown&#039;s Ferry Elementary<\/option><option value='479' >Carvers Bay High School<\/option><option value='480' >Carvers Bay Middle<\/option><option value='481' >Coastal Montessori Charter School<\/option><option value='482' >Georgetown High School<\/option><option value='483' >Georgetown Middle<\/option><option value='484' >Kensington Elementary<\/option><option value='485' >Maryville Elementary<\/option><option value='486' >McDonald Elementary<\/option><option value='487' >Plantersville Elementary<\/option><option value='488' >Pleasant Hill Elementary<\/option><option value='489' >Rosemary Middle<\/option><option value='490' >Sampit Elementary<\/option><option value='491' >Waccamaw Elementary<\/option><option value='492' >Waccamaw High  School<\/option><option value='493' >Waccamaw Intermediate<\/option><option value='494' >Waccamaw Middle<\/option><\/select><\/div><\/div><div id=\"field_9_163\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_163' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_163'>GLEAMNS Human Resources Commission, Inc.<\/div><div class='ginput_container ginput_container_select'><select name='input_163' id='input_9_163' class='large gfield_select'  aria-describedby=\"gfield_description_9_163\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1419' >Abbeville Early Head Start &amp; Head Start Center<\/option><option value='1420' >Batesburg Head Start Center<\/option><option value='1421' >Blythewood Head Start Center<\/option><option value='1422' >Edgefield Early Head Start &amp;  Head Start Center<\/option><option value='1423' >Greenwood Early Head Start &amp;  Head Start Center<\/option><option value='1424' >Lexington Head Start Center<\/option><option value='1425' >McCormick Head Start Center<\/option><option value='1426' >North Hodges Head Start Center<\/option><option value='1427' >Pineview  Head Start Center<\/option><option value='1428' >Platt Springs Head Start Center<\/option><option value='1429' >Rikard Head Start Center<\/option><option value='1430' >Saluda Early Head Start &amp; Head Start Center<\/option><option value='1431' >Sanders Head Start Center<\/option><option value='1432' >St. Andrews Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_164\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_164' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_164'>Governor's School for the Arts and Humanities<\/div><div class='ginput_container ginput_container_select'><select name='input_164' id='input_9_164' class='large gfield_select'  aria-describedby=\"gfield_description_9_164\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1254' >SC Governor&#039;s School for the Arts and Humanities<\/option><\/select><\/div><\/div><div id=\"field_9_165\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_165' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_165'>Governor's School for Math and Science<\/div><div class='ginput_container ginput_container_select'><select name='input_165' id='input_9_165' class='large gfield_select'  aria-describedby=\"gfield_description_9_165\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1255' >Governor&#039;s School for Math and Science<\/option><\/select><\/div><\/div><div id=\"field_9_121\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_121' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_121'>Greenville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_121' id='input_9_121' class='large gfield_select'  aria-describedby=\"gfield_description_9_121\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='495' >A.J. Whittenburg Elementary<\/option><option value='496' >Alexander Elementary<\/option><option value='497' >Armstrong Elementary<\/option><option value='498' >Augusta Circle Elementary<\/option><option value='499' >Beck Academy<\/option><option value='500' >Bell&#039;s Crossing Elementary<\/option><option value='501' >Berea Elementary<\/option><option value='502' >Berea High School<\/option><option value='503' >Berea Middle<\/option><option value='504' >Bethel Elementary<\/option><option value='505' >Blue Ridge High School<\/option><option value='506' >Blue Ridge Middle<\/option><option value='507' >Blythe Academy<\/option><option value='508' >Brashier Middle College Charter School<\/option><option value='509' >Brook Glenn Elementary<\/option><option value='510' >Brushy Creek Elementary<\/option><option value='511' >Bryson Elementary<\/option><option value='512' >Bryson Middle<\/option><option value='513' >Buena Vista Elementary<\/option><option value='514' >Carolina Academy<\/option><option value='515' >Chandler Creek Elementary<\/option><option value='516' >Cherrydale Elementary<\/option><option value='517' >Crestview Elementary<\/option><option value='518' >Donaldson Career Center<\/option><option value='519' >Dr. Phinnize J. Fisher Middle<\/option><option value='520' >Duncan Chapel Elementary<\/option><option value='521' >East North Street Academy<\/option><option value='522' >Eastside High School<\/option><option value='523' >Ellen Woodside Elementary<\/option><option value='524' >Enoree Career Center<\/option><option value='525' >Fork Shoals School<\/option><option value='526' >Fountain Inn Elementary<\/option><option value='527' >Gateway Elementary<\/option><option value='528' >Golden Strip Career and Technology Center<\/option><option value='529' >Greenbrier Elementary<\/option><option value='530' >Greenville Middle Academy<\/option><option value='531' >Greenville Senior High Academy<\/option><option value='532' >Greenville Technical Charter High School<\/option><option value='533' >Greer High School<\/option><option value='534' >Greer Middle<\/option><option value='535' >Greer Middle College Charter School<\/option><option value='536' >Grove Elementary<\/option><option value='537' >Heritage Elementary<\/option><option value='538' >Hillcrest High School<\/option><option value='539' >Hillcrest Middle<\/option><option value='540' >Hollis Academy<\/option><option value='541' >Hughes Academy of Science and Technology<\/option><option value='542' >J. Harley Bonds Career Center<\/option><option value='543' >J. L. Mann High Academy<\/option><option value='544' >Lake Forest Elementary<\/option><option value='545' >Lakeview Middle<\/option><option value='546' >Langston Charter Middle<\/option><option value='547' >League Academy<\/option><option value='548' >Legacy Charter School<\/option><option value='549' >Mauldin Elementary<\/option><option value='550' >Mauldin High School<\/option><option value='551' >Mauldin Middle<\/option><option value='552' >Meyer Center for Special Children Charter<\/option><option value='553' >Mitchell Road Elementary<\/option><option value='554' >Monarch Elementary-Greenville<\/option><option value='555' >Monaview Elementary<\/option><option value='556' >Mountain View Elementary<\/option><option value='557' >Northwest Middle<\/option><option value='558' >Northwood Middle<\/option><option value='559' >Oakview Elementary<\/option><option value='560' >Overbrook Child Development Center<\/option><option value='561' >Paris Elementary<\/option><option value='562' >Pelham Road Elementary<\/option><option value='563' >Plain Elementary<\/option><option value='564' >Ralph Chandler Middle<\/option><option value='565' >Riverside High School<\/option><option value='566' >Riverside Middle-Greenville<\/option><option value='567' >Robert E. Cashion Elementary<\/option><option value='568' >Rudolph Gordon Elementary<\/option><option value='569' >Sara Collins Elementary<\/option><option value='570' >Sevier Middle<\/option><option value='571' >Simpsonville Elementary<\/option><option value='572' >Skyland Elementary<\/option><option value='573' >Slater Marietta Elementary<\/option><option value='574' >Southside High School<\/option><option value='575' >Sterling School<\/option><option value='576' >Stone Academy<\/option><option value='577' >Sue Cleveland Elementary<\/option><option value='578' >Summit Drive Elementary<\/option><option value='579' >Tanglewood Middle<\/option><option value='580' >Taylors Elementary<\/option><option value='581' >Thomas E. Kerns Elementary<\/option><option value='582' >Tigerville Elementary<\/option><option value='583' >Travelers Rest High School<\/option><option value='584' >Wade Hampton High School<\/option><option value='585' >Washington Center<\/option><option value='586' >Welcome Elementary<\/option><option value='587' >Westcliffe Elementary<\/option><option value='588' >Woodland Elementary<\/option><option value='589' >Woodmont High School<\/option><option value='590' >Woodmont Middle<\/option><\/select><\/div><\/div><div id=\"field_9_125\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_125' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_125'>Greenwood County Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_125' id='input_9_125' class='large gfield_select'  aria-describedby=\"gfield_description_9_125\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='612' >G Frank Russell Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_122\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_122' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_122'>Greenwood County School District 50<\/div><div class='ginput_container ginput_container_select'><select name='input_122' id='input_9_122' class='large gfield_select'  aria-describedby=\"gfield_description_9_122\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='591' >Brewer Middle<\/option><option value='592' >Eleanor S. Rice Elementary<\/option><option value='593' >Emerald High School<\/option><option value='594' >Greenwood Early Childhood Center<\/option><option value='595' >Greenwood High School<\/option><option value='596' >Hodges Elementary<\/option><option value='597' >Lakeview Elementary<\/option><option value='598' >Mathews Elementary<\/option><option value='599' >Merrywood Elementary<\/option><option value='600' >Northside Middle-Greenwood<\/option><option value='601' >Pinecrest Elementary<\/option><option value='602' >Springfield Elementary<\/option><option value='603' >Westview Middle<\/option><option value='604' >Woodfields Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_123\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_123' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_123'>Greenwood County School District 51<\/div><div class='ginput_container ginput_container_select'><select name='input_123' id='input_9_123' class='large gfield_select'  aria-describedby=\"gfield_description_9_123\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='605' >Ware Shoals Elementary Middle<\/option><option value='606' >Ware Shoals High School<\/option><option value='607' >Ware Shoals Primary<\/option><\/select><\/div><\/div><div id=\"field_9_124\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_124' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_124'>Greenwood County School District 52<\/div><div class='ginput_container ginput_container_select'><select name='input_124' id='input_9_124' class='large gfield_select'  aria-describedby=\"gfield_description_9_124\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='608' >Edgewood Middle<\/option><option value='609' >Ninety Six Elementary<\/option><option value='610' >Ninety Six High School<\/option><option value='611' >Ninety Six Primary<\/option><\/select><\/div><\/div><div id=\"field_9_166\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_166' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_166'>H B Swofford AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_166' id='input_9_166' class='large gfield_select'  aria-describedby=\"gfield_description_9_166\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1090' >H B Swofford Career Center<\/option><\/select><\/div><\/div><div id=\"field_9_126\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_126' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_126'>Hampton County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_126' id='input_9_126' class='large gfield_select'  aria-describedby=\"gfield_description_9_126\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='613' >Ben Hazel Primary<\/option><option value='614' >Brunson Elementary<\/option><option value='615' >Fennell Elementary<\/option><option value='616' >Hampton Elementary<\/option><option value='617' >North District Middle<\/option><option value='618' >Varnville Elementary<\/option><option value='619' >Wade Hampton High School<\/option><\/select><\/div><\/div><div id=\"field_9_127\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_127' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_127'>Hampton County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_127' id='input_9_127' class='large gfield_select'  aria-describedby=\"gfield_description_9_127\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='620' >Estill Elementary<\/option><option value='621' >Estill High School<\/option><option value='622' >Estill Middle<\/option><\/select><\/div><\/div><div id=\"field_9_128\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_128' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_128'>Horry County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_128' id='input_9_128' class='large gfield_select'  aria-describedby=\"gfield_description_9_128\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='623' >Academy For Arts Science Techn<\/option><option value='624' >Academy For Technolgy and Acad<\/option><option value='625' >Academy of Hope Charter<\/option><option value='626' >Aynor Elementary<\/option><option value='627' >Aynor High School<\/option><option value='628' >Aynor Middle<\/option><option value='629' >Black Water Middle<\/option><option value='630' >Bridgewater Academy Charter<\/option><option value='631' >Burgess Elementary<\/option><option value='632' >Carolina Forest Elementary<\/option><option value='633' >Carolina Forest High School<\/option><option value='634' >Conway Elementary<\/option><option value='635' >Conway High School<\/option><option value='636' >Conway Middle<\/option><option value='637' >Daisy Elementary<\/option><option value='638' >Forestbrook Elementary<\/option><option value='639' >Forestbrook Middle<\/option><option value='640' >Green Sea Floyds Elementary<\/option><option value='641' >Green Sea Floyds High School<\/option><option value='642' >HCS Early College High School<\/option><option value='643' >Homewood Elementary<\/option><option value='644' >Kingston Elementary<\/option><option value='645' >Lakewood Elementary<\/option><option value='646' >Loris Elementary<\/option><option value='647' >Loris High School<\/option><option value='648' >Loris Middle<\/option><option value='649' >Midland Elementary<\/option><option value='650' >Myrtle Beach Elementary<\/option><option value='651' >Myrtle Beach High School<\/option><option value='652' >Myrtle Beach Intermediate<\/option><option value='653' >Myrtle Beach Middle<\/option><option value='654' >Myrtle Beach Primary<\/option><option value='655' >North Myrtle Beach High School<\/option><option value='656' >North Myrtle Beach Middle<\/option><option value='657' >Ocean Bay Elementary<\/option><option value='658' >Ocean Bay Middle<\/option><option value='659' >Ocean Drive Elementary<\/option><option value='660' >Palmetto Academy for Learning Motorsports<\/option><option value='661' >Palmetto Academy of Learning and Success Charter<\/option><option value='662' >Palmetto Bays Elementary<\/option><option value='663' >Pee Dee Elementary<\/option><option value='664' >River Oaks Elementary<\/option><option value='665' >Riverside Elementary<\/option><option value='666' >Seaside Elementary<\/option><option value='667' >Socastee Elementary<\/option><option value='668' >Socastee High School<\/option><option value='669' >South Conway Elementary<\/option><option value='670' >St. James Elementary<\/option><option value='671' >St. James High School<\/option><option value='672' >St. James Middle<\/option><option value='673' >Waccamaw Elementary<\/option><option value='674' >Waterway Elementary<\/option><option value='675' >Whittemore Park Middle<\/option><\/select><\/div><\/div><div id=\"field_9_129\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_129' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_129'>Jasper County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_129' id='input_9_129' class='large gfield_select'  aria-describedby=\"gfield_description_9_129\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='676' >Hardeeville Elementary<\/option><option value='677' >Hardeeville-Ridgeland Middle<\/option><option value='678' >Ridgeland Elementary<\/option><option value='679' >Ridgeland-Hardeeville High School<\/option><\/select><\/div><\/div><div id=\"field_9_167\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_167' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_167'>John De La Howe<\/div><div class='ginput_container ginput_container_select'><select name='input_167' id='input_9_167' class='large gfield_select'  aria-describedby=\"gfield_description_9_167\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1236' >John De La Howe School<\/option><\/select><\/div><\/div><div id=\"field_9_168\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_168' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_168'>Juvenile Justice Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_168' id='input_9_168' class='large gfield_select'  aria-describedby=\"gfield_description_9_168\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1242' >Birchwood School<\/option><option value='1243' >Evaluation and Detention Center<\/option><option value='1244' >Willow Lane School<\/option><\/select><\/div><\/div><div id=\"field_9_130\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_130' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_130'>Kershaw County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_130' id='input_9_130' class='large gfield_select'  aria-describedby=\"gfield_description_9_130\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='680' >Applied Technology Education Campus<\/option><option value='681' >Baron Dekalb Elementary<\/option><option value='682' >Bethune Elementary<\/option><option value='683' >Blaney Elementary<\/option><option value='684' >Camden Elementary of the Creative Arts<\/option><option value='685' >Camden High School<\/option><option value='686' >Camden Middle<\/option><option value='687' >Doby&#039;s Mill Elementary<\/option><option value='688' >Jackson School<\/option><option value='689' >Leslie M. Stover Middle<\/option><option value='690' >Lugoff Elementary<\/option><option value='691' >Lugoff-Elgin High School<\/option><option value='692' >Lugoff-Elgin Middle<\/option><option value='693' >Midway Elementary<\/option><option value='694' >Mt. Pisgah Elementary<\/option><option value='695' >North Central High School<\/option><option value='696' >North Central Middle<\/option><option value='697' >Pine Tree Hill Elementary<\/option><option value='698' >Wateree Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_131\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_131' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_131'>Lancaster County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_131' id='input_9_131' class='large gfield_select'  aria-describedby=\"gfield_description_9_131\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='699' >A. R. Rucker Middle<\/option><option value='700' >Andrew Jackson High School<\/option><option value='701' >Andrew Jackson Middle<\/option><option value='702' >Brooklyn Springs Elementary<\/option><option value='703' >Buford Elementary<\/option><option value='704' >Buford High School<\/option><option value='705' >Buford Middle<\/option><option value='728' >Clinton Elementary-Lancaster<\/option><option value='707' >Discovery Charter of Lancaster<\/option><option value='708' >Erwin Elementary<\/option><option value='709' >Harrisburg Elementary<\/option><option value='710' >Heath Springs Elementary<\/option><option value='711' >Indian Land Elementary<\/option><option value='712' >Indian Land High School<\/option><option value='713' >Indian Land Middle<\/option><option value='714' >Kershaw Elementary<\/option><option value='715' >Lancaster High School<\/option><option value='716' >McDonald Green Elementary<\/option><option value='717' >North Elementary<\/option><option value='718' >South Middle<\/option><\/select><\/div><\/div><div id=\"field_9_132\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_132' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_132'>Laurens County School District No. 55\n<\/div><div class='ginput_container ginput_container_select'><select name='input_132' id='input_9_132' class='large gfield_select'  aria-describedby=\"gfield_description_9_132\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='719' >E. B. Morse Elementary<\/option><option value='720' >Ford Elementary<\/option><option value='721' >Gray Court-Owings Elementary-Middle<\/option><option value='722' >Hickory Tavern Elementary-Middle<\/option><option value='723' >Laurens District 55 High School<\/option><option value='724' >Laurens Elementary<\/option><option value='725' >Laurens Middle<\/option><option value='726' >Sanders Middle<\/option><option value='727' >Waterloo Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_133\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_133' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_133'>Laurens County School District 56<\/div><div class='ginput_container ginput_container_select'><select name='input_133' id='input_9_133' class='large gfield_select'  aria-describedby=\"gfield_description_9_133\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='706' >Clinton Elementary-Laurens<\/option><option value='729' >Clinton High School<\/option><option value='730' >Clinton Middle<\/option><option value='731' >Eastside Elementary<\/option><option value='732' >Joanna-Woodson Elementary<\/option><option value='733' >M. S. Bailey Child Development Center<\/option><option value='1295' >Summit Classical Charter School<\/option><option value='1294' >Thornwell Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_134\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_134' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_134'>Lee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_134' id='input_9_134' class='large gfield_select'  aria-describedby=\"gfield_description_9_134\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='734' >Dennis Elementary<\/option><option value='735' >Lee Central High School<\/option><option value='736' >Lee Central Middle<\/option><option value='737' >Lee County Career and Technology Center<\/option><option value='738' >Lower Lee Elementary<\/option><option value='739' >West Lee Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_135\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_135' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_135'>Lexington County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_135' id='input_9_135' class='large gfield_select'  aria-describedby=\"gfield_description_9_135\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1293' >Beechwood Middle<\/option><option value='740' >Carolina Springs Elementary<\/option><option value='741' >Carolina Springs Middle<\/option><option value='1297' >Centerville Elementary-Lexington 1<\/option><option value='742' >Deerfield Elementary<\/option><option value='1265' >East Pointe Academy Charter School<\/option><option value='743' >Forts Pond Elementary<\/option><option value='744' >Gilbert Elementary<\/option><option value='745' >Gilbert High School<\/option><option value='746' >Gilbert Middle<\/option><option value='747' >Gilbert Primary<\/option><option value='748' >Lake Murray Elementary<\/option><option value='1444' >Lakeside Middle School<\/option><option value='749' >Lexington Elementary<\/option><option value='750' >Lexington High School<\/option><option value='751' >Lexington Middle<\/option><option value='752' >Lexington Technology Center<\/option><option value='753' >Meadow Glen Elementary<\/option><option value='754' >Meadow Glen Middle<\/option><option value='755' >Midway Elementary<\/option><option value='756' >New Providence Elementary<\/option><option value='757' >Oak Grove Elementary<\/option><option value='758' >Pelion Elementary<\/option><option value='759' >Pelion High School<\/option><option value='760' >Pelion Middle<\/option><option value='761' >Pleasant Hill Elementary<\/option><option value='762' >Pleasant Hill Middle<\/option><option value='763' >Red Bank Elementary<\/option><option value='764' >River Bluff High School<\/option><option value='765' >Rocky Creek Elementary<\/option><option value='766' >Saxe Gotha Elementary<\/option><option value='1446' >South Lake Elementary<\/option><option value='767' >White Knoll Elementary<\/option><option value='768' >White Knoll High School<\/option><option value='769' >White Knoll Middle<\/option><\/select><\/div><\/div><div id=\"field_9_136\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_136' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_136'>Lexington County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_136' id='input_9_136' class='large gfield_select'  aria-describedby=\"gfield_description_9_136\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='770' >Airport High School<\/option><option value='771' >Brookland Cayce Grammar School No. 1<\/option><option value='772' >Brookland-Cayce Senior High School<\/option><option value='1277' >Cayce Elementary<\/option><option value='774' >Congaree Elementary<\/option><option value='775' >Congaree-Wood Early Childhood Center<\/option><option value='776' >Cyril B. Busbee Creative Arts Academy<\/option><option value='777' >Herbert A. Wood Elementary<\/option><option value='1256' >New Bridge Academy<\/option><option value='778' >Northside Middle-Lexington 2<\/option><option value='779' >Pine Ridge Middle<\/option><option value='780' >Pineview Elementary<\/option><option value='781' >R. Earle Davis-CLOSED<\/option><option value='782' >R. H. Fulmer Middle<\/option><option value='1288' >Riverbank Elementary School<\/option><option value='783' >Saluda River Academy for the Arts<\/option><option value='784' >Springdale Elementary<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_9_137\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_137' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_137'>Lexington County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_137' id='input_9_137' class='large gfield_select'  aria-describedby=\"gfield_description_9_137\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='785' >Batesburg-Leesville Elementary<\/option><option value='786' >Batesburg-Leesville High School<\/option><option value='787' >Batesburg-Leesville Middle<\/option><option value='788' >Batesburg-Leesville Primary<\/option><\/select><\/div><\/div><div id=\"field_9_138\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_138' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_138'>Lexington County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_138' id='input_9_138' class='large gfield_select'  aria-describedby=\"gfield_description_9_138\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='789' >Frances F. Mack Intermediate<\/option><option value='790' >Lexington Four Early Childhood Center<\/option><option value='791' >Sandhills Elementary<\/option><option value='792' >Sandhills Middle<\/option><option value='793' >Sandhills Primary<\/option><option value='794' >Swansea High Freshman Academy<\/option><option value='795' >Swansea High School<\/option><\/select><\/div><\/div><div id=\"field_9_139\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_139' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_139'>Lexington and Richland School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_139' id='input_9_139' class='large gfield_select'  aria-describedby=\"gfield_description_9_139\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='796' >Ballentine Elementary<\/option><option value='797' >Center for Advanced Technical Studies<\/option><option value='798' >Chapin Elementary<\/option><option value='799' >Chapin High School<\/option><option value='800' >Chapin Intermediate<\/option><option value='801' >Chapin Middle<\/option><option value='802' >CrossRoads Intermediate<\/option><option value='803' >Dutch Fork Elementary<\/option><option value='804' >Dutch Fork High School<\/option><option value='805' >Dutch Fork Middle<\/option><option value='806' >H. E. Corley Elementary<\/option><option value='807' >Harbison West Elementary<\/option><option value='808' >Irmo Elementary<\/option><option value='809' >Irmo High School<\/option><option value='810' >Irmo Middle<\/option><option value='811' >Lake Murray Elementary<\/option><option value='812' >Leaphart Elementary<\/option><option value='813' >Nursery Road Elementary<\/option><option value='814' >Oak Pointe Elementary<\/option><option value='1433' >Piney Woods Elementary<\/option><option value='815' >River Springs Elementary<\/option><option value='816' >Seven Oaks Elementary<\/option><option value='817' >Spring Hill High School<\/option><\/select><\/div><\/div><div id=\"field_9_169\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_169' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_169'>Marion County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_169' id='input_9_169' class='large gfield_select'  aria-describedby=\"gfield_description_9_169\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='821' >Academy of Careers and Technology<\/option><option value='822' >Britton&#039;s Neck Elementary<\/option><option value='823' >Creek Bridge High School<\/option><option value='824' >Easterling Primary<\/option><option value='825' >Johnakin Middle<\/option><option value='828' >McCormick Elementary-Marion<\/option><option value='826' >Manning High School<\/option><option value='1287' >Marion High School<\/option><option value='827' >Marion Intermediate<\/option><option value='829' >Mullins Early Childhood Center ANNEX<\/option><option value='830' >Mullins High School<\/option><option value='831' >North Mullins Primary<\/option><option value='832' >Palmetto Middle<\/option><\/select><\/div><\/div><div id=\"field_9_141\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_141' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_141'>Marlboro County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_141' id='input_9_141' class='large gfield_select'  aria-describedby=\"gfield_description_9_141\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='833' >Bennettsville Intermediate<\/option><option value='834' >Bennettsville Primary<\/option><option value='1264' >Blenheim HeadStart<\/option><option value='835' >Blenheim Middle School of Discovery<\/option><option value='836' >Clio Elementary<\/option><option value='837' >Marlboro County High School<\/option><option value='838' >Marlboro School of Discovery<\/option><option value='839' >McColl Elementary-Middle<\/option><option value='840' >Wallace Elementary-Middle<\/option><\/select><\/div><\/div><div id=\"field_9_140\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_140' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_140'>McCormick County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_140' id='input_9_140' class='large gfield_select'  aria-describedby=\"gfield_description_9_140\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='818' >McCormick Elementary-McCormick<\/option><option value='819' >McCormick High School<\/option><option value='820' >McCormick Middle<\/option><\/select><\/div><\/div><div id=\"field_9_190\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_190' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_190'>Movement School<\/div><div class='ginput_container ginput_container_select'><select name='input_190' id='input_9_190' class='large gfield_select'  aria-describedby=\"gfield_description_9_190\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='1451' >Bridge View Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_142\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_142' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_142'>Newberry County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_142' id='input_9_142' class='large gfield_select'  aria-describedby=\"gfield_description_9_142\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='841' >Boundary Street Elementary<\/option><option value='842' >Gallman Elementary<\/option><option value='843' >Little Mountain Elementary<\/option><option value='844' >Mid-Carolina High School<\/option><option value='845' >Mid-Carolina Middle<\/option><option value='846' >Newberry County Career Center<\/option><option value='847' >Newberry Elementary<\/option><option value='848' >Newberry High School<\/option><option value='849' >Newberry Middle<\/option><option value='850' >Pomaria-Garmany Elementary<\/option><option value='851' >Prosperity-Rikard Elementary<\/option><option value='852' >Reuben Elementary<\/option><option value='853' >Whitmire Community High School<\/option><option value='854' >Whitmire Community School (Elementary)<\/option><\/select><\/div><\/div><div id=\"field_9_143\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_143' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_143'>Oconee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_143' id='input_9_143' class='large gfield_select'  aria-describedby=\"gfield_description_9_143\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='855' >Blue Ridge Elementary<\/option><option value='856' >Fair-Oak Elementary<\/option><option value='857' >Fred P. Hamilton Career Center<\/option><option value='858' >James M. Brown Elementary<\/option><option value='859' >Keowee Elementary<\/option><option value='860' >Northside Elementary-Oconee<\/option><option value='861' >Orchard Park Elementary<\/option><option value='862' >Ravenel Elementary<\/option><option value='863' >Seneca High School<\/option><option value='864' >Seneca Middle<\/option><option value='865' >Tamassee-Salem Elementary<\/option><option value='866' >Tamassee-Salem Middle-High School<\/option><option value='867' >Walhalla Elementary<\/option><option value='868' >Walhalla High School<\/option><option value='869' >Walhalla Middle<\/option><option value='870' >West Oak Middle<\/option><option value='871' >West-Oak High School<\/option><option value='872' >Westminster Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_146\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_146' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_146'>Orangeburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_146' id='input_9_146' class='large gfield_select'  aria-describedby=\"gfield_description_9_146\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='887' >Bethune-Bowman Elementary<\/option><option value='888' >Bethune-Bowman Middle-High School<\/option><option value='879' >Branchville High School<\/option><option value='889' >Brookdale Elementary<\/option><option value='880' >Carver Edisto Middle<\/option><option value='890' >Dover Elementary<\/option><option value='1454' >East Lake Elementary School<\/option><option value='881' >Edisto Elementary<\/option><option value='882' >Edisto High<\/option><option value='883' >Edisto Primary<\/option><option value='873' >Elloree Elementary<\/option><option value='884' >Hunter-Kinard-Tyler Elementary<\/option><option value='885' >Hunter-Kinard-Tyler High<\/option><option value='1455' >Lake Marion Middle School<\/option><option value='876' >Lake Marion High<\/option><option value='886' >Lockett Elementary<\/option><option value='891' >Marshall Elementary<\/option><option value='892' >Mellichamp Elementary<\/option><option value='893' >North Middle-High School<\/option><option value='894' >OCSD5 High School for Health Professions<\/option><option value='895' >Orangeburg Consolitated School District Five Technology Center<\/option><option value='896' >Orangeburg Wilkinson High School<\/option><option value='899' >Sheridan Elementary<\/option><option value='900' >Whittaker Elementary<\/option><option value='901' >William J. Clark Middle<\/option><\/select><\/div><\/div><div id=\"field_9_171\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_171' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_171'>Palmetto Unified<\/div><div class='ginput_container ginput_container_select'><select name='input_171' id='input_9_171' class='large gfield_select'  aria-describedby=\"gfield_description_9_171\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1245' >Lee  High School<\/option><option value='1246' >MacDougall High School<\/option><option value='1247' >Manning High School<\/option><option value='1248' >Ridgeland High School<\/option><option value='1249' >Sara Babb High School<\/option><option value='1250' >Trenton High School<\/option><option value='1251' >Turbeville High School<\/option><option value='1252' >Tyger River High School<\/option><option value='1253' >Wateree River High School<\/option><\/select><\/div><\/div><div id=\"field_9_170\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_170' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_170'>Pee Dee Head Starts<\/div><div class='ginput_container ginput_container_select'><select name='input_170' id='input_9_170' class='large gfield_select'  aria-describedby=\"gfield_description_9_170\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1292' >Lake City HS Center<\/option><\/select><\/div><\/div><div id=\"field_9_172\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_172' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_172'>Pickens County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_172' id='input_9_172' class='large gfield_select'  aria-describedby=\"gfield_description_9_172\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='903' >A. R. Lewis Elementary<\/option><option value='904' >Ambler Elementary<\/option><option value='905' >Central Elementary<\/option><option value='906' >Liberty Primary<\/option><option value='907' >Clemson Elementary<\/option><option value='908' >Crosswell Elementary-Pickens<\/option><option value='909' >D. W. Daniel High School<\/option><option value='910' >Dacusville Elementary<\/option><option value='911' >Dacusville Middle<\/option><option value='912' >Easley High School<\/option><option value='913' >East End Elementary<\/option><option value='914' >Forest Acres Elementary<\/option><option value='915' >Hagood Elementary<\/option><option value='916' >Holly Springs Elementary<\/option><option value='917' >Liberty Elementary<\/option><option value='918' >Liberty High School<\/option><option value='919' >Liberty Middle<\/option><option value='920' >McKissick Elementary<\/option><option value='921' >Pickens County Career and Technolgy Center<\/option><option value='922' >Pickens Elementary<\/option><option value='923' >Pickens High School<\/option><option value='924' >Pickens Middle<\/option><option value='925' >R. C. Edwards Middle<\/option><option value='926' >Richard H. Gettys Middle<\/option><option value='927' >Six Mile Elementary<\/option><option value='928' >West End Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_173\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_173' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_173'>R D Anderson Applied Technology Center<\/div><div class='ginput_container ginput_container_select'><select name='input_173' id='input_9_173' class='large gfield_select'  aria-describedby=\"gfield_description_9_173\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1089' >R. D. Anderson Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_174\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_174' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_174'>Richland County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_174' id='input_9_174' class='large gfield_select'  aria-describedby=\"gfield_description_9_174\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='929' >A. C. Flora High School<\/option><option value='930' >A. C. Moore Elementary<\/option><option value='931' >A. J. Lewis Greenview Elementary<\/option><option value='932' >Alcorn Middle<\/option><option value='933' >Annie Burnside Elementary<\/option><option value='934' >Arden Elementary<\/option><option value='935' >Bradley Elementary<\/option><option value='936' >Brennen Elementary<\/option><option value='937' >Brockman Elementary<\/option><option value='938' >Burton Pack Elementary<\/option><option value='939' >C. A. Johnson High School<\/option><option value='940' >Carolina School for Inquiry<\/option><option value='941' >Carver-Lyon Elementary<\/option><option value='942' >Caughman Road Elementary<\/option><option value='943' >Columbia High School<\/option><option value='944' >Crayton Middle<\/option><option value='945' >Dreher High School<\/option><option value='946' >Eau Claire High School<\/option><option value='947' >Edward E. Taylor Elementary<\/option><option value='948' >Forest Heights Elementary<\/option><option value='949' >Gadsden Elementary<\/option><option value='950' >H. B. Rhame Elementary<\/option><option value='951' >Hall Institute<\/option><option value='952' >Hand Middle<\/option><option value='953' >Heyward Gibbes Middle<\/option><option value='954' >Hopkins Elementary<\/option><option value='955' >Hopkins Middle<\/option><option value='956' >Horrell Hill Elementary<\/option><option value='957' >Hyatt Park Elementary<\/option><option value='958' >J. P. Thomas Elementary<\/option><option value='959' >Logan Elementary<\/option><option value='960' >Lower Richland High School<\/option><option value='961' >Meadowfield Elementary<\/option><option value='962' >Mill Creek Elementary<\/option><option value='963' >Pendergrass Fairwold School<\/option><option value='964' >Pine Grove Elementary<\/option><option value='965' >Richland One Charter Middle College<\/option><option value='966' >Rosewood Elementary<\/option><option value='967' >Samuel A. Heyward Career and Tech Center<\/option><option value='968' >Sandel Elementary<\/option><option value='969' >Satchel Ford Elementary<\/option><option value='970' >South Kilbourne Elementary<\/option><option value='971' >Southeast Middle<\/option><option value='972' >St. Andrews Middle<\/option><option value='973' >W. A. Perry Middle<\/option><option value='974' >W. G. Sanders Middle<\/option><option value='975' >W.J. Keenan High School<\/option><option value='976' >Watkins-Nance Elementary<\/option><option value='977' >Webber School<\/option><\/select><\/div><\/div><div id=\"field_9_175\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_175' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_175'>Richland County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_175' id='input_9_175' class='large gfield_select'  aria-describedby=\"gfield_description_9_175\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='978' >Bethel-Hanberry Elementary<\/option><option value='979' >Blythewood High School<\/option><option value='980' >Blythewood Middle School<\/option><option value='981' >Bookman Road Elementary<\/option><option value='982' >Bridge Creek Elementary<\/option><option value='983' >Catawba Trail Elementary<\/option><option value='984' >Dent Middle<\/option><option value='985' >E. L. Wright Middle<\/option><option value='986' >Forest Lake Elementary<\/option><option value='1280' >Jackson Creek Elementary<\/option><option value='987' >Joseph Keels Elementary<\/option><option value='988' >Kelly Mill Middle<\/option><option value='989' >Killian Elementary<\/option><option value='990' >L. B. Nelson Elementary<\/option><option value='991' >L. W. Conder Elementary<\/option><option value='992' >Lake Carolina Elementary<\/option><option value='993' >Lake Carolina Elementary Upper Campus<\/option><option value='994' >Langford Elementary<\/option><option value='995' >Longleaf Middle<\/option><option value='996' >Muller Road Middle<\/option><option value='997' >North Springs Elementary<\/option><option value='998' >Polo Road Elementary<\/option><option value='999' >Pontiac Elementary<\/option><option value='1000' >Rice Creek Elementary<\/option><option value='1001' >Richland Northeast High School<\/option><option value='1002' >Richland Two Charter High School<\/option><option value='1003' >Ridge View High School<\/option><option value='1004' >Round Top Elementary<\/option><option value='1005' >Sandlapper Elementary<\/option><option value='1006' >Spring Valley High School<\/option><option value='1007' >Summit Parkway Middle<\/option><option value='1008' >Westwood High School<\/option><option value='1009' >Windsor Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_176\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_176' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_176'>Rock Hill School District Three of York County<\/div><div class='ginput_container ginput_container_select'><select name='input_176' id='input_9_176' class='large gfield_select'  aria-describedby=\"gfield_description_9_176\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1159' >Applied Technology Center<\/option><option value='1160' >Belleview Elementary<\/option><option value='1161' >Castle Heights Middle<\/option><option value='1162' >Central Child Development Center<\/option><option value='1163' >Dutchman Creek Middle<\/option><option value='1164' >Ebenezer Avenue Elementary<\/option><option value='1165' >Ebinport Elementary<\/option><option value='1166' >Finley Road Elementary<\/option><option value='1167' >Independence Elementary<\/option><option value='1168' >India Hook Elementary<\/option><option value='1169' >Lesslie Elementary<\/option><option value='1170' >Mount Gallant Elementary<\/option><option value='1171' >Mount Holly Elementary<\/option><option value='1172' >Northside Elementary-York 3<\/option><option value='1173' >Northwestern High School<\/option><option value='1174' >Oakdale Elementary<\/option><option value='1175' >Old Pointe Elementary<\/option><option value='1176' >Rawlinson Road Middle<\/option><option value='1177' >Richmond Drive Elementary<\/option><option value='1178' >Rock Hill High School<\/option><option value='1179' >Rosewood Elementary<\/option><option value='1180' >Saluda Trail Middle<\/option><option value='1181' >South Pointe High School<\/option><option value='1182' >Sunset Park Center for Accelerated Studies<\/option><option value='1183' >The Children&#039;s School at Sylvia Circle<\/option><option value='1184' >The Palmetto School at the Children&#039;s Attention Home<\/option><option value='1185' >W. C. Sullivan Middle<\/option><option value='1186' >York Road Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_177\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_177' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_177'>Saluda County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_177' id='input_9_177' class='large gfield_select'  aria-describedby=\"gfield_description_9_177\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1010' >Hollywood Elementary<\/option><option value='1011' >Saluda Elementary<\/option><option value='1012' >Saluda High School<\/option><option value='1013' >Saluda Middle<\/option><option value='1014' >Saluda Primary<\/option><\/select><\/div><\/div><div id=\"field_9_178\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_178' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_178'>SC Public School Charter District<\/div><div class='ginput_container ginput_container_select'><select name='input_178' id='input_9_178' class='large gfield_select'  aria-describedby=\"gfield_description_9_178\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1202' >Bridges Preparatory School<\/option><option value='1203' >Calhoun Falls Charter School<\/option><option value='1204' >Cape Romain Environmental Education Charter<\/option><option value='1205' >Coastal Leadership Academy<\/option><option value='1206' >Cyber Academy of South Carolina<\/option><option value='1207' >East Point Academy<\/option><option value='1208' >Fox Creek High School<\/option><option value='1209' >Garden City Preparatory Academy for Boys<\/option><option value='1210' >Gray Collegiate Academy<\/option><option value='1211' >GREEN Charter School<\/option><option value='1212' >High Point Academy<\/option><option value='1213' >Imagine Columbia Leadership Academy Charter<\/option><option value='1214' >Lead Academy<\/option><option value='1215' >Lowcountry Leadership Charter School<\/option><option value='1216' >Lowcountry Montessori School<\/option><option value='1217' >Midlands Middle College<\/option><option value='1219' >NEXT High School<\/option><option value='1279' >Oceanside Collegiate Academy<\/option><option value='1220' >Palmetto Scholars Academy<\/option><option value='1221' >Pee Dee Math, Science, and Technology Academy<\/option><option value='1222' >Provost Academy South Carolina<\/option><option value='1223' >Quest Leadership Academy<\/option><option value='1224' >Riverwalk Academy<\/option><option value='1225' >Royal Live Oaks Academy of the Arts and Sciences Charter<\/option><option value='1226' >SC Connections Academy<\/option><option value='1227' >SC Science Academy<\/option><option value='1228' >SC Virtual Charter School<\/option><option value='1229' >SC Whitmore School<\/option><option value='1230' >South Carolina Calvert Academy<\/option><option value='1231' >Spartanburg Preparatory School<\/option><option value='1232' >York Preparatory Academy<\/option><option value='1233' >Youth Leadership Academy Charter<\/option><\/select><\/div><\/div><div id=\"field_9_179\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_179' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_179'>SC School for the Deaf and Blind<\/div><div class='ginput_container ginput_container_select'><select name='input_179' id='input_9_179' class='large gfield_select'  aria-describedby=\"gfield_description_9_179\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1237' >Cedar Springs Academy<\/option><option value='1238' >SC School For Blind Elementary-Middle<\/option><option value='1239' >SC School For Deaf Elementary-Middle<\/option><option value='1240' >SC School for the Blind High School<\/option><option value='1241' >SC School for the Deaf High School<\/option><\/select><\/div><\/div><div id=\"field_9_180\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_180' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_180'>Share Community Action Partnership<\/div><div class='ginput_container ginput_container_select'><select name='input_180' id='input_9_180' class='large gfield_select'  aria-describedby=\"gfield_description_9_180\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1399' >BHW Head Start\/Early Head Start Center<\/option><option value='1404' >Children&#039;s Center &quot;B&quot; Head Start Center<\/option><option value='1415' >Clemson  Head Start Center<\/option><option value='1405' >Easley Bridge Road Head Start Center<\/option><option value='1407' >Golden Strip Head Start\/Early Head Start Center<\/option><option value='1412' >Margaret A. Sherred Head Start Center<\/option><option value='1406' >North Franklin Road Head Start Center<\/option><option value='1409' >North Greenville  Head Start Center<\/option><option value='1408' >Parker Head Start\/Early Head Start Center<\/option><option value='1400' >Pendleton Head Start Center<\/option><option value='1416' >Pickens  Head Start Center<\/option><option value='1417' >Reece Mill Road Head Start\/Early Head Start Center<\/option><option value='1411' >Rubye H. Jones Head Start\/Early Head Start Center<\/option><option value='1414' >Seneca  Head Start\/Early Head Start Center<\/option><option value='1418' >Simpson Head  Head Start Center<\/option><option value='1401' >Starr Head Start Center<\/option><option value='1410' >Tommie C. Brooks Early Head Start Center<\/option><option value='1413' >Watkins Road  Head Start\/Early Head Start Center<\/option><option value='1402' >Westside Head Start Center<\/option><option value='1403' >Willis H. Crosby Head Start\/Early Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_159\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_159' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_159'>Spartanburg County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_159' id='input_9_159' class='large gfield_select'  aria-describedby=\"gfield_description_9_159\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='266' >Oakland Elementary-Spartanburg<\/option><option value='1025' >Boiling Springs Elementary<\/option><option value='1026' >Boiling Springs High Ninth Grade Campus<\/option><option value='1027' >Boiling Springs High School<\/option><option value='1028' >Sugar Ridge Elementary<\/option><option value='1029' >Boiling Springs Middle<\/option><option value='1030' >Carlisle-Foster&#039;s Grove Elementary<\/option><option value='1031' >Chesnee Elementary<\/option><option value='1032' >Chesnee High School<\/option><option value='1033' >Chesnee Middle<\/option><option value='1034' >Cooley Springs-Fingerville Elementary<\/option><option value='1035' >James H. Hendrix  Elementary<\/option><option value='1036' >Mayo Elementary<\/option><option value='1038' >Rainbow Lake Middle<\/option><option value='1260' >Shoally Creek Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_160\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_160' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_160'>Spartanburg County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_160' id='input_9_160' class='large gfield_select'  aria-describedby=\"gfield_description_9_160\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1039' >Broome High School<\/option><option value='1040' >Cannons Elementary<\/option><option value='1041' >Cliffdale Middle<\/option><option value='1042' >Cowpens Elementary<\/option><option value='1045' >Pacolet Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_161\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_161' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_161'>Spartanburg County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_161' id='input_9_161' class='large gfield_select'  aria-describedby=\"gfield_description_9_161\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1046' >Woodruff Elementary<\/option><option value='1047' >Woodruff High School<\/option><option value='1048' >Woodruff Middle<\/option><option value='1049' >Woodruff Primary<\/option><\/select><\/div><\/div><div id=\"field_9_155\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_155' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_155'>Spartanburg County School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_155' id='input_9_155' class='large gfield_select'  aria-describedby=\"gfield_description_9_155\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1050' >Abner Creek Academy<\/option><option value='1051' >Beech Springs Intermediate<\/option><option value='1052' >Berry Shoals Intermediate<\/option><option value='1053' >D. R. Hill Middle<\/option><option value='1054' >Duncan Elementary<\/option><option value='1055' >Florence Chapel Middle<\/option><option value='1056' >James Byrnes Freshman Academy<\/option><option value='1057' >James F. Byrnes High School<\/option><option value='1058' >Lyman Elementary<\/option><option value='1059' >Reidville Elementary<\/option><option value='1060' >River Ridge Elementary<\/option><option value='1061' >Wellford Academy of Science and Techology<\/option><\/select><\/div><\/div><div id=\"field_9_158\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_158' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_158'>Spartanburg County School District Six<\/div><div class='ginput_container ginput_container_select'><select name='input_158' id='input_9_158' class='large gfield_select'  aria-describedby=\"gfield_description_9_158\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1062' >Anderson Mill Elementary<\/option><option value='1063' >Arcadia Elementary<\/option><option value='1064' >Dorman High Freshman Campus<\/option><option value='1065' >Dorman High School<\/option><option value='1066' >Fairforest Elementary<\/option><option value='1067' >Fairforest Middle<\/option><option value='1068' >Jesse S. Bobo Elementary<\/option><option value='1069' >L. E. Gable Middle<\/option><option value='1070' >Lone Oak Elementary<\/option><option value='1071' >Pauline Glenn Springs Elementary<\/option><option value='1072' >R. P. Dawkins Middle<\/option><option value='1073' >Roebuck Elementary<\/option><option value='1074' >West View Elementary<\/option><option value='1075' >Woodland Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_157\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_157' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_157'>Spartanburg County School District Seven<\/div><div class='ginput_container ginput_container_select'><select name='input_157' id='input_9_157' class='large gfield_select'  aria-describedby=\"gfield_description_9_157\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1076' >Carver Middle<\/option><option value='1077' >Cleveland Academy of Leadership<\/option><option value='1078' >E. P. Todd School<\/option><option value='1079' >Houston Elementary<\/option><option value='1080' >Jesse Boyd Elementary<\/option><option value='1081' >Mary H. Wright Elementary<\/option><option value='1082' >McCracken Middle<\/option><option value='1083' >Pine Street Elementary<\/option><option value='1084' >Spartanburg Freshman Academy<\/option><option value='1085' >Spartanburg High School<\/option><option value='1086' >Spartanburg School District 7 Early Childhood Center<\/option><option value='1087' >W. Herbert Chapman Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_181\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_181' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_181'>Sumter School District<\/div><div class='ginput_container ginput_container_select'><select name='input_181' id='input_9_181' class='large gfield_select'  aria-describedby=\"gfield_description_9_181\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1092' >Alice Drive Elementary<\/option><option value='1091' >Alice Drive Middle<\/option><option value='1093' >Bates Middle<\/option><option value='1273' >Brewington Alternative<\/option><option value='1094' >Cherryvale Elementary<\/option><option value='1095' >Chestnut Oaks Middle<\/option><option value='1096' >Crestwood High School<\/option><option value='1097' >Crosswell Elementary-Sumter<\/option><option value='1098' >Ebenezer Middle<\/option><option value='1099' >F. J. Delaine Elementary<\/option><option value='1100' >Furman Middle<\/option><option value='1101' >High Hills Elementary<\/option><option value='1102' >Hillcrest Middle<\/option><option value='1103' >Kingsbury  Elementary<\/option><option value='1104' >Lakewood High  School<\/option><option value='1105' >Lemira Elementary<\/option><option value='1106' >Manchester Elementary<\/option><option value='1107' >Mayewood Middle<\/option><option value='1108' >Millwood Elementary<\/option><option value='1109' >Oakland Primary-Sumter<\/option><option value='1110' >Pocalla Springs Elementary<\/option><option value='1111' >R. E. Davis College Preperatory Academy<\/option><option value='1112' >Rafting Creek Elementary<\/option><option value='1113' >Shaw Heights Elementary<\/option><option value='1114' >Sumter Career and Technology Center<\/option><option value='1115' >Sumter High  School<\/option><option value='1116' >Wilder Elementary<\/option><option value='1117' >Willow Drive Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_182\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_182' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_182'>Union County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_182' id='input_9_182' class='large gfield_select'  aria-describedby=\"gfield_description_9_182\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1118' >Buffalo Elementary<\/option><option value='1119' >Foster Park Elementary<\/option><option value='1120' >Jonesville Elementary<\/option><option value='1121' >Jonesville Middle<\/option><option value='1122' >Lockhart School<\/option><option value='1123' >Lockhart School ANNEX<\/option><option value='1124' >Monarch Elementary-Union<\/option><option value='1125' >Sims Middle<\/option><option value='1126' >Union County Career and Technology Center<\/option><option value='1127' >Union County High School<\/option><\/select><\/div><\/div><div id=\"field_9_183\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_183' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_183'>Williamsburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_183' id='input_9_183' class='large gfield_select'  aria-describedby=\"gfield_description_9_183\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1445' >C. E. Murray Elementary School<\/option><option value='1129' >C.E. Murray Middle<\/option><option value='1130' >D.P. Cooper Charter<\/option><option value='1331' >Greeleyville Primary<\/option><option value='1132' >Hemingway Career and Technology Center<\/option><option value='1133' >Hemingway Elementary<\/option><option value='1134' >Hemingway High School<\/option><option value='1135' >Hemingway MB Lee Middle<\/option><option value='1136' >Kenneth Gardner Leadership Academy<\/option><option value='1137' >Kingstree High School<\/option><option value='1138' >Kingstree Middle Magnet<\/option><option value='1139' >W.M. Anderson Primary<\/option><option value='1140' >Williamsburg Co. Magnet School<\/option><\/select><\/div><\/div><div id=\"field_9_184\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_184' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_184'>Williamsburg Tech<\/div><div class='ginput_container ginput_container_select'><select name='input_184' id='input_9_184' class='large gfield_select'  aria-describedby=\"gfield_description_9_184\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1234' >Wmsbg Tec Voc Adult Ed Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_90\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_90' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_90'>Williston School District (Barnwell County 29)<\/div><div class='ginput_container ginput_container_select'><select name='input_90' id='input_9_90' class='large gfield_select'  aria-describedby=\"gfield_description_9_90\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='118' >Kelly Edwards Elementary<\/option><option value='119' >Williston-Elko High School<\/option><option value='120' >Williston-Elko Middle<\/option><\/select><\/div><\/div><div id=\"field_9_186\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_186' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_186'>York School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_186' id='input_9_186' class='large gfield_select'  aria-describedby=\"gfield_description_9_186\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1141' >Cotton Belt Elementary<\/option><option value='1142' >Floyd D. Johnson Technology Ctr<\/option><option value='1143' >Harold C. Johnson Elementary<\/option><option value='1144' >Hickory Grove-Sharon Elementary<\/option><option value='1145' >Hunter Street Elementary<\/option><option value='1146' >Jefferson Elementary-York 1<\/option><option value='1147' >York Comprehensive High School<\/option><option value='1148' >York Intermediate<\/option><option value='1149' >York Middle<\/option><\/select><\/div><\/div><div id=\"field_9_185\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_185' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_185'>York County School District Two\n<\/div><div class='ginput_container ginput_container_select'><select name='input_185' id='input_9_185' class='large gfield_select'  aria-describedby=\"gfield_description_9_185\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1150' >Bethany Elementary<\/option><option value='1151' >Bethel Elementary<\/option><option value='1284' >Blue Eagle Academy<\/option><option value='1152' >Clover High School<\/option><option value='1153' >Clover Middle<\/option><option value='1282' >Clover Ninth Grade Campus<\/option><option value='1154' >Crowders Creek Elem<\/option><option value='1155' >Griggs Road Elementary<\/option><option value='1156' >Kinard Elementary<\/option><option value='1157' >Larne Elementary<\/option><option value='1289' >Oakridge Elementary<\/option><option value='1158' >Oakridge Middle<\/option><\/select><\/div><\/div><div id=\"field_9_50\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n del Estudiante<\/h3><\/div><fieldset id=\"field_9_2\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name' id='input_9_2'>\n                            \n                            <span id='input_9_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_9_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_3' >Primeiro<\/label>\n                                                <\/span>\n                            <span id='input_9_2_4_container' class='name_middle' >\n                                                    <input type='text' name='input_2.4' id='input_9_2_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_2_4' >Meio<\/label>\n                                                <\/span>\n                            <span id='input_9_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_9_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_6' >Sobrenome<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_9_3\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Sexo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_3'>\n\t\t\t<div class='gchoice gchoice_9_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Male'  id='choice_9_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_0' id='label_9_3_0'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Female'  id='choice_9_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_1' id='label_9_3_1'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_10\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de Nacimiento del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_10' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_10_1_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_10_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_10_2_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_10_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_10_3_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_10_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_9_188\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_188' >Grado<\/label><div class='ginput_container ginput_container_text'><input name='input_188' id='input_9_188' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_189\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_189' >Maestra Tutora<\/label><div class='ginput_container ginput_container_text'><input name='input_189' id='input_9_189' type='text' value='' class='large'  aria-describedby=\"gfield_description_9_189\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_189'>Maestra tutora \/ \"Homeroom Teacher\"<\/div><\/div><div id=\"field_9_48\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_48' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_48' id='input_9_48' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_11\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_11' >Telefono de Casa<\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_9_11' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_75\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de correo electronico pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_9_75'>La Direccion de correo electronico debe ser valida ya que recibir\u00e1 una copia de la informaci\u00f3n enviada en el mismo<\/div><div class='ginput_complex ginput_container ginput_container_email' id='input_9_75_container'>\n                                <span id='input_9_75_1_container' class='ginput_left'>\n                                    <input class='' type='email' name='input_75' id='input_9_75' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75' >ingrese correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <span id='input_9_75_2_container' class='ginput_right'>\n                                    <input class='' type='email' name='input_75_2' id='input_9_75_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75_2' >Confirmar correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_9_5\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direcci\u00f3n del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_9_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_9_5_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_5_1' id='input_9_5_1_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_9_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_9_5_2' value=''   placeholder='Street 2'  aria-required='false'   \/>\n                                        <label for='input_9_5_2' id='input_9_5_2_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_9_5_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_5_3' id='input_9_5_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_5_4_container' >\n                                        <select name='input_5.4' id='input_9_5_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_5_4' id='input_9_5_4_label' class='hidden_sub_label screen-reader-text'>Provincia<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_9_5_5' value=''   placeholder='ZIP Code' aria-required='true'    \/>\n                                    <label for='input_9_5_5' id='input_9_5_5_label' class='hidden_sub_label screen-reader-text'>C\u00f3digo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_9_5_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_54' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_8\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Preguntas M\u00e9dicas<\/h3><\/div><div id=\"field_9_15\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_15' >Doctor del ni\u00f1o<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_9_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_13\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_13' >Dentista de ni\u00f1os<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_9_13' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_14\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de ultima limpieza dental<\/legend><div id='input_9_14' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_14_1_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_14_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_14_2_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_14_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_14_3_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_14_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><fieldset id=\"field_9_16\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfSu hijo tiene alergias?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_16'>\n\t\t\t<div class='gchoice gchoice_9_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Yes'  id='choice_9_16_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_16\"   \/>\n\t\t\t\t\t<label for='choice_9_16_0' id='label_9_16_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='No'  id='choice_9_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_16_1' id='label_9_16_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_9_16'>(incluyendo alimentos, medicamentos y\/o l\u00e1tex?)<\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_17\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_17' >En caso afirmativo, enumere<\/label><div class='gfield_description' id='gfield_description_9_17'>Por favor enum\u00e9relos aqu\u00ed. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_9_17' class='textarea medium'  aria-describedby=\"gfield_description_9_17\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_18\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez su hijo tuvo un reemplazo artificial de articulaci\u00f3n?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_18'>\n\t\t\t<div class='gchoice gchoice_9_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Yes'  id='choice_9_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_0' id='label_9_18_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='No'  id='choice_9_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_1' id='label_9_18_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_20\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez le han diagnosticado a su hijo fiebre reum\u00e1tica?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_20'>\n\t\t\t<div class='gchoice gchoice_9_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_9_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_0' id='label_9_20_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_9_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_1' id='label_9_20_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_21\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfTiene su hijo anemia de c\u00e9lulas falciformes o rasgo drepanoc\u00edtico?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_21'>\n\t\t\t<div class='gchoice gchoice_9_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_9_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_0' id='label_9_21_0'>Ninguno<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Trait'  id='choice_9_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_1' id='label_9_21_1'>rasgo falciforme<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Anemia'  id='choice_9_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_2' id='label_9_21_2'>anemia falciforme<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_25\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_25' >Problemas de Salud<\/label><div class='gfield_description' id='gfield_description_9_25'>Por favor utilice el siguiente espacio para enumerar cualquier otro problema grave de salud que su hijo haya tenido o tenga ahora.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_9_25' class='textarea medium'  aria-describedby=\"gfield_description_9_25\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_24\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_24' >Lista de Medicamentos<\/label><div class='gfield_description' id='gfield_description_9_24'>Haga una lista de todos los medicamentos, medicamentos de venta libre o suplementos herbales que su hijo est\u00e9 tomando en este momento.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_9_24' class='textarea medium'  aria-describedby=\"gfield_description_9_24\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_55' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_55' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_26\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informacion de pago<\/h3><div class='gsection_description' id='gfield_description_9_26'>DEBE verificar y completar y firmar en la parte inferior<\/div><\/div><fieldset id=\"field_9_72\" class=\"gfield gfield--width-third field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label'  >Informacion de pago<\/legend><div class='gfield_description' id='gfield_description_9_72'>Elige uno.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_72\"   \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0'>Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid and Insurance'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1'>Seguro Privado y Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Private Insurance'  id='choice_9_72_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_2' id='label_9_72_2'>Seguro Privado<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Self-pay\/no insurance'  id='choice_9_72_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_3' id='label_9_72_3'>No tengo seguro\/Soy responsable del pago<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 8;\"><\/div><div id=\"field_9_71\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_71' >Numero de MEDICAID<\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_9_71' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_71\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_71'>N\u00famero individual de 10 d\u00edgitos del NI\u00d1O(A) - NO EL # DE PLAN.<\/div><\/div><div id=\"field_9_61\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado y Medicaid<\/h3><\/div><fieldset id=\"field_9_58\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian que tiene seguro<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_58'>\n                            \n                            <span id='input_9_58_3_container' class='name_first' >\n                                                    <input type='text' name='input_58.3' id='input_9_58_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_58_6_container' class='name_last' >\n                                                    <input type='text' name='input_58.6' id='input_9_58_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_63\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_63' >Nombre de la seguro compania<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_9_63' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_65\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_65' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_65' id='input_9_65' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_66\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado<\/h3><\/div><div id=\"field_9_148\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_148' >Nombre de la compania para la cual trabaja el pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_9_148' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_67\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de Padre o Guardian asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_67' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_67_1_container' >\n                                        <input type='text' name='input_67.1' id='input_9_67_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_67_1' id='input_9_67_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_67_3_container' >\n                                    <input type='text' name='input_67.3' id='input_9_67_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_67_3' id='input_9_67_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_67_4_container' >\n                                        <select name='input_67.4' id='input_9_67_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_67_4' id='input_9_67_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_67_5_container' >\n                                    <input type='text' name='input_67.5' id='input_9_67_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_67_5' id='input_9_67_5_label' class='hidden_sub_label screen-reader-text'>Codigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_67.6' id='input_9_67_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_78\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_78' >N\u00famero de seguridad social<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_9_78' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_35\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre de la empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_35' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_35_1_container' >\n                                        <input type='text' name='input_35.1' id='input_9_35_1' value=''   placeholder='Street' aria-required='true'    \/>\n                                        <label for='input_9_35_1' id='input_9_35_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_35_3_container' >\n                                    <input type='text' name='input_35.3' id='input_9_35_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_35_3' id='input_9_35_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_35_4_container' >\n                                        <select name='input_35.4' id='input_9_35_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_35_4' id='input_9_35_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_35_5_container' >\n                                    <input type='text' name='input_35.5' id='input_9_35_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_35_5' id='input_9_35_5_label' class='hidden_sub_label screen-reader-text'>Condigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_35.6' id='input_9_35_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_147\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_147' >Numero de Seguro<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_9_147' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_79\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_79' >Identificaci\u00f3n # del grupo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_9_79' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_69\" class=\"gfield gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de nacimiento de padre o guardian que esta asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_69' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_69_1_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_69_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_69_2_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_69_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_69_3_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_69_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_37\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_37' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_37' id='input_9_37' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_80\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_80' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_80' id='input_9_80' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_80\"  \/><\/div><div class='gfield_description' id='gfield_description_9_80'>Vuelva a confirmar su n\u00famero de tel\u00e9fono celular; nos pondremos en contacto con usted antes del servicio.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_74' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_74' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_70\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent Section<\/h3><\/div><div id=\"field_9_44\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Parent Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_44'>I agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022\u00a0Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_150\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Financial Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_150'>I understand if my child is not eligible for Medicaid or private insurance coverage, I am financially responsible and agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022 Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_38\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent<\/h3><div class='gsection_description' id='gfield_description_9_38'><b>Printed name is considered legal signature.<\/b>\n\n\nSolicito y autorizo a HPS, a sus odont\u00f3logos contratantes y al personal, debidamente autorizado como Doctores en Odontolog\u00eda o higienistas dentales con licencia, a realizar cualquier procedimiento de diagn\u00f3stico, procedimientos preventivos o procedimientos de tratamiento para mi hijo. <br>Entiendo que los servicios preventivos no reemplazan un examen realizado por un dentista con licencia. Entiendo que las fotos pueden tomarse con fines educativos. <br>Adem\u00e1s, entiendo que si mi hijo no est\u00e1 inscrito en Medicaid, soy financieramente responsable ante HPS por los servicios prestados. <br>Autorizo el pago de Medicaid o beneficios de seguro directamente a HPS y sus dentistas asociados. Solicito y autorizo la divulgaci\u00f3n de cualquier informaci\u00f3n en este formulario o adquirida en el transcurso del tratamiento para fines de pago, referencia, y para todo el personal escolar apropiado y SC ORS y SC DHEC, seg\u00fan lo considere necesario por HPS. La firma da permiso para que el informe se env\u00ede por correo electr\u00f3nico o mensaje de texto. <br><b>El nombre impreso del padre o guardian se considera firma.<\/b><\/div><\/div><fieldset id=\"field_9_39\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_39'>\n                            \n                            <span id='input_9_39_3_container' class='name_first' >\n                                                    <input type='text' name='input_39.3' id='input_9_39_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_39_6_container' class='name_last' >\n                                                    <input type='text' name='input_39.6' id='input_9_39_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_41\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_41' >Firma impresa<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_9_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_42\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_42' >Relacion hacia el ni\u00f1o(a)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_9_42' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button button' value='Previous'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' value='WyJ7XCI3MlwiOltcIjdlMDY1ZTAyYjU1YjBmOTcxNDUxN2MyYzZhNGEyNzMzXCIsXCJmMTEyNDUwMjlmOTk5ZDZhOTVmYThlMDA1ZWVkMWZkM1wiLFwiMWRkOWM3MDczY2VhODVlYTM0NDU5YWFiYjVkZjQ0ZTdcIixcIjhiZDBiMzgzZWZjZGY1Njg3NTUwMzE0ZGJkMTE2MjM4XCJdfSIsIjI2YjE2ZmRiOThhZTJlODM2ZWFmNmJjMDNiNWI0YzU3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Consentimiento para Servicios<\/h2>\n                            <span class='gform_description'>Este formulario nos da permiso para tratar a su hijo. Los datos se mantienen confidenciales y se usan solo para el tratamiento y la facturaci\u00f3n, de acuerdo con las leyes estatales y federales. Si la informaci\u00f3n cambia antes del tratamiento, comun\u00edquese con nosotros.<\/span>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/es\/wp-json\/wp\/v2\/pages\/1224#gf_9' novalidate><div id='gf_page_steps_9' class='gf_page_steps'><div id='gf_step_9_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Secci\u00f3n de informaci\u00f3n del estudiante<\/span><\/div><div id='gf_step_9_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Secci\u00f3n M\u00e9dica<\/span><\/div><div id='gf_step_9_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Secci\u00f3n de pago<\/span><\/div><div id='gf_step_9_4' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Firmar y Consentimiento<\/span><\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_9_1' class='gform_page' >\n                                    <div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_9\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n de la Escuela<\/h3><\/div><div id=\"field_9_46\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_46' >Distrito escolar<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_46' id='input_9_46' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County School District<\/option><option value='2' >Aiken County Public Schools<\/option><option value='3' >Allendale County Schools<\/option><option value='10' >Anderson 1 &amp; 2 AVC<\/option><option value='9' >Anderson Alternative School District<\/option><option value='4' >Anderson School District One<\/option><option value='5' >Anderson School District Two<\/option><option value='6' >Anderson School District Three<\/option><option value='7' >Anderson County School District 4<\/option><option value='8' >Anderson School District Five<\/option><option value='11' >Bamberg School District<\/option><option value='16' >Barnwell County AVC<\/option><option value='15' >Barnwell School District 45<\/option><option value='17' >Beaufort County School District<\/option><option value='18' >Beaufort-Jasper Career Center<\/option><option value='19' >Berkeley County School District<\/option><option value='13' >Blackville-Hilda Public Schools<\/option><option value='20' >Calhoun County Public Schools<\/option><option value='21' >Charleston County School District<\/option><option value='105' >Charter Institute at Erskine<\/option><option value='22' >Cherokee County School District<\/option><option value='23' >Chester County School District<\/option><option value='24' >Chesterfield County School District<\/option><option value='25' >Clarendon County School District One<\/option><option value='26' >Clarendon County School District Two<\/option><option value='27' >Clarendon County School District Three<\/option><option value='29' >Colleton County School District<\/option><option value='72' >Cope Area Career Center<\/option><option value='84' >Daniel Morgan Vocational Center<\/option><option value='30' >Darlington County School District<\/option><option value='33' >Dillon County Applied Tech Center<\/option><option value='31' >Dillon School District Three<\/option><option value='32' >Dillon School District Four<\/option><option value='36' >Dorchester County Career School<\/option><option value='34' >Dorchester County School District Two<\/option><option value='35' >Dorchester County School District Four<\/option><option value='37' >Edgefield County School District<\/option><option value='28' >F E Dubose Vocational Center<\/option><option value='38' >Fairfield County School District<\/option><option value='96' >Felton Laboratory School<\/option><option value='39' >Florence School District One<\/option><option value='40' >Florence School District Two<\/option><option value='41' >Florence School District Three<\/option><option value='42' >Florence School District Four<\/option><option value='43' >Florence School District Five<\/option><option value='93' >Fort Mill School District<\/option><option value='44' >Georgetown County School District<\/option><option value='108' >GLEAMNS Human Resources Commission, Inc.<\/option><option value='102' >Governor&#039;s School for Math and Science<\/option><option value='101' >Governor&#039;s School for the Arts and Humanities<\/option><option value='45' >Greenville County School District<\/option><option value='49' >Greenwood County Career Center<\/option><option value='46' >Greenwood County School District 50<\/option><option value='47' >Greenwood County School District 51<\/option><option value='48' >Greenwood County School District 52<\/option><option value='86' >H B Swofford AVC<\/option><option value='50' >Hampton County School District One<\/option><option value='51' >Hampton County School District Two<\/option><option value='52' >Horry County Schools<\/option><option value='53' >Jasper County School District<\/option><option value='97' >John De La Howe<\/option><option value='99' >Juvenile Justice Schools<\/option><option value='54' >Kershaw County School District<\/option><option value='55' >Lancaster County School District<\/option><option value='56' >Laurens County School District No. 55<\/option><option value='57' >Laurens County School District 56<\/option><option value='58' >Lee County School District<\/option><option value='63' >Lexington and Richland School District Five<\/option><option value='59' >Lexington County School District One<\/option><option value='60' >Lexington County School District Two<\/option><option value='61' >Lexington County School District Three<\/option><option value='62' >Lexington County School District Four<\/option><option value='103' >Marion County School District<\/option><option value='66' >Marlboro County School District<\/option><option value='64' >McCormick County School District<\/option><option value='110' >Movement School<\/option><option value='67' >Newberry County School District<\/option><option value='68' >Oconee County School District<\/option><option value='71' >Orangeburg County School District<\/option><option value='100' >Palmetto Unified<\/option><option value='104' >Pee Dee Head Starts<\/option><option value='73' >Pickens County School District<\/option><option value='85' >R D Anderson Applied Technology Center<\/option><option value='74' >Richland County School District One<\/option><option value='75' >Richland County School District Two<\/option><option value='92' >Rock Hill School District Three of York County<\/option><option value='76' >Saluda County School District One<\/option><option value='94' >SC Public School Charter District<\/option><option value='98' >SC School for the Deaf and Blind<\/option><option value='107' >Share Community Action Partnership<\/option><option value='77' >Spartanburg County School District One<\/option><option value='78' >Spartanburg County School District Two<\/option><option value='79' >Spartanburg County School District Three<\/option><option value='80' >Spartanburg County School District Four<\/option><option value='81' >Spartanburg County School District Five<\/option><option value='82' >Spartanburg County School District Six<\/option><option value='83' >Spartanburg County School District Seven<\/option><option value='87' >Sumter School District<\/option><option value='88' >Union County School District<\/option><option value='89' >Williamsburg County School District<\/option><option value='95' >Williamsburg Tech<\/option><option value='14' >Williston School District 29<\/option><option value='90' >York School District One<\/option><option value='91' >York County School District Two<\/option><\/select><\/div><\/div><div id=\"field_9_51\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_51' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_51'>Abbeville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_51' id='input_9_51' class='large gfield_select'  aria-describedby=\"gfield_description_9_51\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County Career Center<\/option><option value='2' >Abbeville High School<\/option><option value='3' >Cherokee Trail Elementary<\/option><option value='4' >Diamond Hill Elementary<\/option><option value='5' >Dixie High School<\/option><option value='6' >John C. Calhoun Elementary<\/option><option value='7' >Long Cane Primary<\/option><option value='8' >Westwood Elementary<\/option><option value='9' >Wright Middle<\/option><\/select><\/div><\/div><div id=\"field_9_52\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_52' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_52'>Aiken County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_52' id='input_9_52' class='large gfield_select'  aria-describedby=\"gfield_description_9_52\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='10' >Aiken County Career Center<\/option><option value='11' >Aiken High School<\/option><option value='12' >Aiken Middle<\/option><option value='13' >Aiken Performing Arts Academy Charter<\/option><option value='14' >Belvedere Elementary<\/option><option value='15' >Busbee Corbett Elementary Middle<\/option><option value='16' >Byrd Elementary<\/option><option value='17' >Chukker Creek Elementary<\/option><option value='18' >Clearwater Elementary<\/option><option value='19' >East Aiken School of the Arts<\/option><option value='20' >Gloverville Elementary<\/option><option value='21' >Greendale Elementary<\/option><option value='22' >Hammond Hill Elementary<\/option><option value='23' >Horse Creek Academy<\/option><option value='24' >J. D. Lever Elementary<\/option><option value='25' >Jackson Middle<\/option><option value='27' >Langley-Bath-Clearwater Middle<\/option><option value='28' >Leavelle McCampbell Middle<\/option><option value='29' >Lloyd-Kennedy Charter<\/option><option value='30' >M. B. Kennedy Middle<\/option><option value='31' >Midland Valley High School<\/option><option value='32' >Millbrook Elementary<\/option><option value='33' >Mossy Creek Elementary<\/option><option value='34' >New Ellenton Middle<\/option><option value='35' >North Aiken Elementary<\/option><option value='36' >North Augusta Elementary<\/option><option value='37' >North Augusta High School<\/option><option value='38' >North Augusta Middle<\/option><option value='39' >Oakwood-Windsor Elementary<\/option><option value='40' >Paul Knox Middle<\/option><option value='41' >Redcliffe Elementary<\/option><option value='42' >Ridge Spring Monetta Elementary<\/option><option value='43' >Ridge Spring-Monetta Middle High School<\/option><option value='44' >Schofield Middle<\/option><option value='45' >Silver Bluff High School<\/option><option value='46' >South Aiken High School<\/option><option value='47' >Wagener-Salley High School<\/option><option value='48' >Warrenville Elementary<\/option><option value='324' >Jefferson Elementary-Aiken<\/option><\/select><\/div><\/div><div id=\"field_9_53\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_53' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_53'>Allendale County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_53' id='input_9_53' class='large gfield_select'  aria-describedby=\"gfield_description_9_53\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='49' >Allendale Elementary<\/option><option value='50' >Allendale Fairfax High School<\/option><option value='51' >Allendale-Fairfax Middle<\/option><option value='52' >Fairfax Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_81\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_81' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_81'>Anderson School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_81' id='input_9_81' class='large gfield_select'  aria-describedby=\"gfield_description_9_81\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='53' >Cedar Grove Elementary<\/option><option value='54' >Concrete Primary<\/option><option value='55' >Hunt Meadows Elementary<\/option><option value='56' >Palmetto Elementary<\/option><option value='57' >Palmetto High School<\/option><option value='58' >Palmetto Middle<\/option><option value='59' >Powdersville Elementary<\/option><option value='60' >Powdersville High School<\/option><option value='61' >Powdersville Middle<\/option><option value='62' >Spearman Elementary<\/option><option value='63' >West Pelzer Elementary<\/option><option value='64' >Wren Elementary<\/option><option value='65' >Wren High School<\/option><option value='66' >Wren Middle<\/option><\/select><\/div><\/div><div id=\"field_9_82\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_82' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_82'>Anderson School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_82' id='input_9_82' class='large gfield_select'  aria-describedby=\"gfield_description_9_82\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='67' >Belton Elementary<\/option><option value='68' >Belton Honea Path High School<\/option><option value='69' >Belton Middle<\/option><option value='70' >Honea Path Elementary<\/option><option value='71' >Honea Path Middle<\/option><option value='72' >Marshall Primary<\/option><option value='73' >Wright Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_83\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_83' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_83'>Anderson School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_83' id='input_9_83' class='large gfield_select'  aria-describedby=\"gfield_description_9_83\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='74' >Crescent High School<\/option><option value='75' >Flat Rock Elementary<\/option><option value='76' >Iva Elementary<\/option><option value='77' >Starr Elementary<\/option><option value='78' >Starr-Iva Middle<\/option><\/select><\/div><\/div><div id=\"field_9_84\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_84' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_84'>Anderson County School District 4<\/div><div class='ginput_container ginput_container_select'><select name='input_84' id='input_9_84' class='large gfield_select'  aria-describedby=\"gfield_description_9_84\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='79' >La France Elementary<\/option><option value='80' >Mt. Lebanon Elementary<\/option><option value='81' >Pendleton Elementary<\/option><option value='82' >Pendleton High School<\/option><option value='83' >Riverside Middle-Anderson<\/option><option value='84' >Townville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_85\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_85' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_85'>Anderson School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_85' id='input_9_85' class='large gfield_select'  aria-describedby=\"gfield_description_9_85\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='85' >Anderson  Five Charter School<\/option><option value='86' >Anderson Five Career Campus<\/option><option value='1291' >Anderson Institute of Technology<\/option><option value='87' >Calhoun Academy of the Arts<\/option><option value='88' >Centerville Elementary-Anderson 5<\/option><option value='89' >Concord Elementary<\/option><option value='90' >Glenview Middle<\/option><option value='91' >Homeland Park Primary<\/option><option value='92' >Lakeside Middle<\/option><option value='93' >McCants Middle<\/option><option value='94' >McLees Elementary<\/option><option value='95' >Midway Elementary School of Science and Engineering<\/option><option value='96' >Nevitt Forest Elementary<\/option><option value='97' >New Prospect Elementary<\/option><option value='98' >North Pointe Elementary<\/option><option value='99' >Robert Anderson Middle<\/option><option value='100' >South Fant School of Early Education<\/option><option value='101' >Southwood Academy of the Arts<\/option><option value='102' >T. L. Hanna High School<\/option><option value='103' >Varennes Elementary<\/option><option value='104' >West Market School of Early Education<\/option><option value='105' >Westside High School<\/option><option value='106' >Whitehall Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_86\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_86' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_86'>Anderson 1 & 2 AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_86' id='input_9_86' class='large gfield_select'  aria-describedby=\"gfield_description_9_86\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='108' >Career Tec Ctr Anderson1&amp;2<\/option><\/select><\/div><\/div><div id=\"field_9_187\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_187' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_187'>Renaissance Academy<\/div><div class='ginput_container ginput_container_select'><select name='input_187' id='input_9_187' class='large gfield_select'  aria-describedby=\"gfield_description_9_187\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='107' >Renaissance Academy<\/option><\/select><\/div><\/div><div id=\"field_9_87\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_87' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_87'>Bamberg School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_87' id='input_9_87' class='large gfield_select'  aria-describedby=\"gfield_description_9_87\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='109' >Bamberg-Ehrhardt High School<\/option><option value='110' >Bamberg-Ehrhardt Middle<\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><option value='111' >Richard Carroll Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_88\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_88' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_88'>Bamberg School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_88' id='input_9_88' class='large gfield_select'  aria-describedby=\"gfield_description_9_88\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><\/select><\/div><\/div><div id=\"field_9_91\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_91' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_91'>Barnwell School District 45<\/div><div class='ginput_container ginput_container_select'><select name='input_91' id='input_9_91' class='large gfield_select'  aria-describedby=\"gfield_description_9_91\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='121' >Barnwell Elementary<\/option><option value='122' >Barnwell High School<\/option><option value='123' >Barnwell Primary<\/option><option value='124' >Guinyard-Butler Middle<\/option><\/select><\/div><\/div><div id=\"field_9_92\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_92' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_92'>Barnwell County AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_92' id='input_9_92' class='large gfield_select'  aria-describedby=\"gfield_description_9_92\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='125' >Barnwell County Career Centertr<\/option><\/select><\/div><\/div><div id=\"field_9_93\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_93' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_93'>Beaufort County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_93' id='input_9_93' class='large gfield_select'  aria-describedby=\"gfield_description_9_93\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='126' >Battery Creek High School<\/option><option value='127' >Beaufort Elementary<\/option><option value='128' >Beaufort High School<\/option><option value='129' >Beaufort Middle<\/option><option value='130' >Bluffton Elementary<\/option><option value='131' >Bluffton High School<\/option><option value='132' >Bluffton Middle<\/option><option value='133' >Broad River Elementary<\/option><option value='134' >Coosa Elementary<\/option><option value='135' >Daufuskie Elem. ANNEX<\/option><option value='136' >H. E. McCracken Middle<\/option><option value='137' >Hilton Head Island Early Childhood Center<\/option><option value='138' >Hilton Head Island Elementary<\/option><option value='139' >Hilton Head Island Elementary School for the Creative Arts<\/option><option value='140' >Hilton Head Island High School<\/option><option value='141' >Hilton Head Island Middle<\/option><option value='142' >Joseph S. Shanklin Elementary<\/option><option value='143' >Lady&#039;s Island Elementary<\/option><option value='144' >Lady&#039;s Island Middle<\/option><option value='145' >Michael C. Riley Elementary<\/option><option value='146' >Mossy Oaks Elementary<\/option><option value='147' >Okatie Elementary<\/option><option value='148' >Port Royal Elementary<\/option><option value='149' >Pritchardville Elementary<\/option><option value='150' >Red Cedar Elementary<\/option><option value='151' >Right Choice  School<\/option><option value='152' >River Ridge Academy<\/option><option value='153' >Riverview Charter School<\/option><option value='154' >Robert Smalls International Academy<\/option><option value='155' >St. Helena Elementary<\/option><option value='156' >Whale Branch Early College High School<\/option><option value='157' >Whale Branch Elementary<\/option><option value='158' >Whale Branch Middle<\/option><\/select><\/div><\/div><div id=\"field_9_95\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_95' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_95'>Beaufort-Jasper Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_95' id='input_9_95' class='large gfield_select'  aria-describedby=\"gfield_description_9_95\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='159' >Beaufort-Jasper Academy For Ex<\/option><\/select><\/div><\/div><div id=\"field_9_94\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_94' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_94'>Berkeley County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_94' id='input_9_94' class='large gfield_select'  aria-describedby=\"gfield_description_9_94\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='160' >Berkeley County Middle College High School<\/option><option value='161' >Berkeley Elementary<\/option><option value='162' >Berkeley High School<\/option><option value='163' >Berkeley Intermediate<\/option><option value='164' >Berkeley Middle<\/option><option value='165' >Boulder Bluff Elementary<\/option><option value='1285' >Bowen&#039;s Corner Elementary<\/option><option value='166' >Cainhoy Elementary Middle<\/option><option value='167' >Cane Bay Elementary<\/option><option value='168' >Cane Bay High School<\/option><option value='169' >Cane Bay Middle<\/option><option value='1443' >Carolyn Lewis School<\/option><option value='170' >College Park Elementary<\/option><option value='171' >College Park Middle<\/option><option value='172' >Cross Elementary<\/option><option value='173' >Cross High School<\/option><option value='174' >Daniel Island School<\/option><option value='175' >Devon Forest Elementary<\/option><option value='1286' >Foxbank Elementary<\/option><option value='176' >Goose Creek High School<\/option><option value='177' >Goose Creek Elementary<\/option><option value='178' >Hanahan Elementary<\/option><option value='179' >Hanahan High School<\/option><option value='180' >Hanahan Middle<\/option><option value='181' >Henry E. Bonner Elementary<\/option><option value='182' >Howe Hall AIMS Elementary<\/option><option value='183' >J. K. Gourdin Elementary<\/option><option value='184' >Macedonia Middle<\/option><option value='185' >Marrington Elementary<\/option><option value='186' >Marrington Middle School of the Arts<\/option><option value='191' >Mount Holly Elementary (formerly Sedgefield Intermediate)<\/option><option value='163' >Moncks Corner Elementary<\/option><option value='187' >Nexton Elementary<\/option><option value='1268' >Philip Simmons Elementary<\/option><option value='1269' >Phillip Simmons Middle<\/option><option value='188' >Sangaree Elementary<\/option><option value='189' >Sangaree Intermediate<\/option><option value='190' >Sangaree Middle<\/option><option value='192' >Sedgefield Middle<\/option><option value='193' >St. Stephen Elementary<\/option><option value='194' >St. Stephen Middle<\/option><option value='195' >Stratford High School<\/option><option value='196' >Timberland High  School<\/option><option value='197' >Westview Elementary<\/option><option value='198' >Westview Middle<\/option><option value='199' >Westview Primary<\/option><option value='200' >Whitesville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_89\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_89' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_89'>Blackville-Hilda Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_89' id='input_9_89' class='large gfield_select'  aria-describedby=\"gfield_description_9_89\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='115' >Blackville-Hilda High School<\/option><option value='116' >Blackville-Hilda Junior High<\/option><option value='117' >Macedonia Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_96\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_96' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_96'>Calhoun County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_96' id='input_9_96' class='large gfield_select'  aria-describedby=\"gfield_description_9_96\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='201' >Calhoun County High School<\/option><option value='202' >Sandy Run School<\/option><option value='203' >St. Matthews K-8 School<\/option><\/select><\/div><\/div><div id=\"field_9_97\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_97' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_97'>Charleston County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_97' id='input_9_97' class='large gfield_select'  aria-describedby=\"gfield_description_9_97\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='204' >A. C. Corcoran Elementary<\/option><option value='205' >Academic Magnet High School<\/option><option value='206' >Allegro Charter School of Music<\/option><option value='207' >Angel Oak Elementary<\/option><option value='208' >Ashley River Creative Arts Elementary<\/option><option value='209' >Baptist Hill High School<\/option><option value='210' >Belle Hall Elementary<\/option><option value='211' >Buist Academy<\/option><option value='212' >Burke High School<\/option><option value='213' >C.E. Williams Middle School<\/option><option value='235' >Camp Middle<\/option><option value='1276' >Cape Romain Environmental Charter School<\/option><option value='1278' >Carolina Park Elementary School<\/option><option value='214' >Carolina Voyager Charter<\/option><option value='215' >Charles Pinckney Elementary<\/option><option value='216' >Charleston Charter School for Math and Science<\/option><option value='217' >Charleston Development Academy Public Charter School<\/option><option value='218' >Charleston Progressive Academy<\/option><option value='219' >Charleston School Of The Arts<\/option><option value='220' >Chicora Elementary School<\/option><option value='1272' >Daniel Jenkins Academy<\/option><option value='221' >Drayton Hall Elementary School<\/option><option value='222' >E.B. Ellington Elementary School<\/option><option value='223' >East Cooper Center for Advanced Studies<\/option><option value='224' >Edith L. Frierson Elementary<\/option><option value='225' >Edmund A. Burns Elementary<\/option><option value='226' >Fort Johnson Middle<\/option><option value='227' >Garrett Academy of Technology<\/option><option value='228' >Greg Mathis Charter High School<\/option><option value='229' >Harbor View Elementary<\/option><option value='230' >Haut Gap Middle<\/option><option value='231' >Hunley Park Elementary<\/option><option value='232' >James B. Edwards Elementary<\/option><option value='233' >James Island Charter High School<\/option><option value='234' >James Island Elementary<\/option><option value='236' >James Simons Montessori School<\/option><option value='237' >Jane Edwards Elementary<\/option><option value='238' >Jennie Moore Elementary<\/option><option value='239' >Jerry Zucker Middle School of Science<\/option><option value='240' >Ladson Elementary<\/option><option value='241' >Laing Middle School of Science and Technology<\/option><option value='242' >Lambs Elementary School<\/option><option value='243' >Laurel Hill Primary<\/option><option value='1267' >Liberty Hill Academy<\/option><option value='244' >Lincoln High School<\/option><option value='245' >Malcolm C. Hursey Elementary<\/option><option value='246' >Mamie Whitesides Elementary<\/option><option value='247' >Mary Ford Early Learning &amp; Family Center<\/option><option value='248' >Matilda Dunston Elementary<\/option><option value='1270' >Meeting Street Academy<\/option><option value='249' >Meeting Street Elementary at Brentwood<\/option><option value='250' >Memminger School of Global Studies<\/option><option value='251' >Midland Park Primary<\/option><option value='252' >Military Magnet Academy<\/option><option value='253' >Minnie Hughes Elementary<\/option><option value='254' >Mitchell Elementary<\/option><option value='255' >Montessori Community School<\/option><option value='256' >Morningside Middle<\/option><option value='257' >Morningside Middle ANNEX<\/option><option value='258' >Moultrie Middle<\/option><option value='259' >Mt. Pleasant Academy<\/option><option value='260' >Mt. Zion Elementary<\/option><option value='261' >Murray LaSaine Elementary<\/option><option value='262' >North Charleston Creative Arts Elementary<\/option><option value='263' >North Charleston Elementary<\/option><option value='264' >North Charleston High School<\/option><option value='265' >Northwoods Middle<\/option><option value='1037' >Oakland Elementary-Charleston<\/option><option value='267' >Orange Grove Elementary Charter<\/option><option value='268' >Pattison&#039;s Academy for Comprehensive Education<\/option><option value='269' >Pepperhill Elementary<\/option><option value='270' >Pinehurst Elementary<\/option><option value='271' >R. B. Stall High School<\/option><option value='272' >Sanders-Clyde Elementary<\/option><option value='1261' >Septima Clarke Alternative<\/option><option value='273' >Simmons Pinckney Middle<\/option><option value='274' >Springfield Elementary<\/option><option value='275' >St. Andrew&#039;s School of Math and Science<\/option><option value='276' >St. James Santee Elementary<\/option><option value='277' >St. John&#039;s High School<\/option><option value='278' >Stiles Point Elementary<\/option><option value='279' >Stono Park Elementary<\/option><option value='280' >Sullivan&#039;s Island Elementary<\/option><option value='281' >Thomas C. Cario Middle<\/option><option value='282' >W. B. Goodwin Elementary<\/option><option value='283' >Wando High School<\/option><option value='284' >West Ashley High School<\/option><option value='285' >West Ashley Middle<\/option><option value='1271' >West Ashley Advanced Study Magnet<\/option><\/select><\/div><\/div><div id=\"field_9_151\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_151' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_151'>Charter Institute at Erskine<\/div><div class='ginput_container ginput_container_select'><select name='input_151' id='input_9_151' class='large gfield_select'  aria-describedby=\"gfield_description_9_151\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1299' >Belton Preparatory Academy<\/option><option value='1300' >Berkeley Preparatory Academy<\/option><option value='1301' >Brashier Middle College Charter School<\/option><option value='1302' >Calhoun Falls Charter School<\/option><option value='1303' >Cherokee Charter Academy<\/option><option value='1304' >Clear Dot Charter School<\/option><option value='1305' >Coastal Leadership Academy<\/option><option value='1306' >Cyber Academy of SC<\/option><option value='1307' >Gates School<\/option><option value='1308' >Gray Collegiate Academy<\/option><option value='1309' >Horse Creek Academy<\/option><option value='1310' >Legion Collegiate Academy<\/option><option value='1311' >Lowcountry Leadership Charter School<\/option><option value='1312' >Lowcountry Connections Academy<\/option><option value='1313' >Mevers School of Excellence<\/option><option value='1218' >Midlands STEM Institute<\/option><option value='1316' >Oceanside Collegiate Academy<\/option><option value='1317' >Odyssey Online Learning<\/option><option value='1318' >Royal Live Oaks Academy<\/option><option value='1319' >South Carolina Connections Academy<\/option><option value='1320' >SC Preparatory Academy<\/option><option value='1321' >South Carolina Virtual Charter School<\/option><option value='1322' >Summit Classical School<\/option><option value='1315' >The Montessori School of Camden<\/option><option value='1323' >Thornwell Charter School<\/option><option value='1324' >Virtus Academy of South Carolina<\/option><\/select><\/div><\/div><div id=\"field_9_98\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_98' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_98'>Cherokee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_98' id='input_9_98' class='large gfield_select'  aria-describedby=\"gfield_description_9_98\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='286' >Alma Elementary<\/option><option value='287' >B. D. Lee Elementary<\/option><option value='288' >Blacksburg Elementary<\/option><option value='289' >Blacksburg High School<\/option><option value='290' >Blacksburg Middle<\/option><option value='291' >Blacksburg Primary<\/option><option value='292' >Cherokee Technology Center<\/option><option value='293' >Corinth Elementary<\/option><option value='294' >Draytonville Elementary<\/option><option value='295' >Gaffney High School<\/option><option value='296' >Gaffney Middle<\/option><option value='297' >Goucher Elementary<\/option><option value='298' >Granard Middle<\/option><option value='299' >Grassy Pond Elementary<\/option><option value='300' >John E. Ewing Middle<\/option><option value='301' >Limestone-Central Elementary<\/option><option value='302' >Luther L. Vaughan  Elementary<\/option><option value='303' >Mary Bramlett Elementary<\/option><option value='304' >Northwest Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_99\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_99' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_99'>Chester County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_99' id='input_9_99' class='large gfield_select'  aria-describedby=\"gfield_description_9_99\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='305' >Academy for Teaching and Learning  K-8<\/option><option value='306' >Chester County Career Center<\/option><option value='307' >Chester Middle<\/option><option value='308' >Chester Park Elementary of Inquiry<\/option><option value='309' >Chester Park Elementary School for the Arts<\/option><option value='310' >Chester Park Elementary School of Literacy and Technology<\/option><option value='311' >Chester Senior High School<\/option><option value='312' >Great Falls Elementary<\/option><option value='313' >Great Falls High School<\/option><option value='314' >Lewisville Elementary<\/option><option value='315' >Lewisville High School<\/option><option value='316' >Lewisville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_100\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_100' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_100'>Chesterfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_100' id='input_9_100' class='large gfield_select'  aria-describedby=\"gfield_description_9_100\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='317' >Central High School<\/option><option value='1274' >Cheraw Headstart<\/option><option value='318' >Cheraw High School<\/option><option value='319' >Cheraw Intermediate<\/option><option value='320' >Cheraw Primary<\/option><option value='321' >Chesterfield High School<\/option><option value='322' >Chesterfield-Ruby Middle<\/option><option value='323' >Edwards Elementary<\/option><option value='26' >Jefferson Elementary-Chesterfield<\/option><option value='325' >Long Middle<\/option><option value='326' >McBee Elementary<\/option><option value='1262' >McBee HeadStart<\/option><option value='327' >McBee High School<\/option><option value='328' >New Heights Middle<\/option><option value='329' >Pageland Elementary<\/option><option value='330' >Petersburg Primary<\/option><option value='331' >Plainview Elementary<\/option><option value='332' >Ruby Elementary<\/option><option value='1263' >Ruby HeadStart<\/option><option value='1296' >Pageland Headstart<\/option><\/select><\/div><\/div><div id=\"field_9_101\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_101' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_101'>Clarendon County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_101' id='input_9_101' class='large gfield_select'  aria-describedby=\"gfield_description_9_101\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='333' >Scott&#039;s Branch High School<\/option><option value='334' >Scott&#039;s Branch Middle<\/option><option value='335' >St. Paul Elementary<\/option><option value='336' >Summerton Early Childhood Center<\/option><\/select><\/div><\/div><div id=\"field_9_102\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_102' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_102'>Clarendon County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_102' id='input_9_102' class='large gfield_select'  aria-describedby=\"gfield_description_9_102\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='337' >Manning Early Childhood Center<\/option><option value='338' >Manning Elementary<\/option><option value='339' >Manning High School<\/option><option value='340' >Manning Junior High<\/option><option value='341' >Manning Primary<\/option><option value='342' >Phoenix Charter High School<\/option><\/select><\/div><\/div><div id=\"field_9_103\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_103' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_103'>Clarendon County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_103' id='input_9_103' class='large gfield_select'  aria-describedby=\"gfield_description_9_103\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='343' >East Clarendon Middle-High School<\/option><option value='344' >Walker-Gamble Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_105\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_105' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_105'>Colleton County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_105' id='input_9_105' class='large gfield_select'  aria-describedby=\"gfield_description_9_105\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='346' >Bells Elementary<\/option><option value='347' >Black Street Early Childhood Center<\/option><option value='348' >Colleton County High School<\/option><option value='349' >Colleton County Middle<\/option><option value='350' >Cottageville Elementary<\/option><option value='351' >Forest Hills Elementary<\/option><option value='352' >Hendersonville Elementary<\/option><option value='353' >Northside Elementary-Colleton<\/option><option value='354' >Thunderbolt Career and Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_152\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_152' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_152'>Cope Area Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_152' id='input_9_152' class='large gfield_select'  aria-describedby=\"gfield_description_9_152\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='902' >Cope Area Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_153\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_153' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_153'>Daniel Morgan Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_153' id='input_9_153' class='large gfield_select'  aria-describedby=\"gfield_description_9_153\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1088' >Daniel Morgan Technolgy Center<\/option><\/select><\/div><\/div><div id=\"field_9_106\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_106' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_106'>Darlington County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_106' id='input_9_106' class='large gfield_select'  aria-describedby=\"gfield_description_9_106\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='355' >Brockington Elementary<\/option><option value='356' >Brunson-Dargan Elementary<\/option><option value='357' >Cain Elementary<\/option><option value='358' >Carolina Elementary<\/option><option value='359' >Darlington County Institute Of<\/option><option value='360' >Darlington High School<\/option><option value='361' >Darlington Middle<\/option><option value='362' >Hartsville High School<\/option><option value='363' >Hartsville Middle<\/option><option value='364' >Lamar Elementary<\/option><option value='365' >Lamar High School<\/option><option value='366' >Mayo High School for Math, Science, and Technology<\/option><option value='367' >North Hartsville Elementary<\/option><option value='368' >Pate Elementary<\/option><option value='369' >Rosenwald Elementary-Middle<\/option><option value='370' >Southside Early Childhood Education Center<\/option><option value='371' >Spaulding Elementary<\/option><option value='372' >Spaulding Middle<\/option><option value='373' >St. Johns Elementary<\/option><option value='374' >Thornwell School for the Arts<\/option><option value='375' >Washington St. Elementary<\/option><option value='376' >West Hartsville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_109\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_109' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_109'>Dillon County Applied Tech Center<\/div><div class='ginput_container ginput_container_select'><select name='input_109' id='input_9_109' class='large gfield_select'  aria-describedby=\"gfield_description_9_109\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='388' >Dillon County Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_107\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_107' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_107'>Dillon School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_107' id='input_9_107' class='large gfield_select'  aria-describedby=\"gfield_description_9_107\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='377' >Latta Elementary<\/option><option value='378' >Latta High School<\/option><option value='379' >Latta Middle<\/option><\/select><\/div><\/div><div id=\"field_9_108\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_108' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_108'>Dillon School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_108' id='input_9_108' class='large gfield_select'  aria-describedby=\"gfield_description_9_108\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='380' >Dillon High School<\/option><option value='381' >Dillon Middle<\/option><option value='382' >East Elementary<\/option><option value='383' >Gordon Elementary<\/option><option value='384' >Lake View Elementary<\/option><option value='385' >Lake View High School<\/option><option value='386' >South Elementary<\/option><option value='387' >Stewart Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_154\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_154' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_154'>Spartanburg County District One<\/div><div class='ginput_container ginput_container_select'><select name='input_154' id='input_9_154' class='large gfield_select'  aria-describedby=\"gfield_description_9_154\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1015' >Campobello-Gramling School<\/option><option value='1016' >Chapman High School<\/option><option value='1017' >Holly Springs-Motlow Elementary<\/option><option value='1018' >Inman Elementary<\/option><option value='1019' >Inman Intermediate<\/option><option value='1020' >Landrum High School<\/option><option value='1021' >Landrum Middle<\/option><option value='1022' >New Prospect Elementary<\/option><option value='1023' >O. P. Earle Elementary<\/option><option value='1024' >T. E. Mabry Middle<\/option><\/select><\/div><\/div><div id=\"field_9_112\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_112' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_112'>Dorchester County Career School<\/div><div class='ginput_container ginput_container_select'><select name='input_112' id='input_9_112' class='large gfield_select'  aria-describedby=\"gfield_description_9_112\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='416' >Dorchester County Career &amp; Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_110\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_110' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_110'>Dorchester County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_110' id='input_9_110' class='large gfield_select'  aria-describedby=\"gfield_description_9_110\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='389' >Alston Middle<\/option><option value='390' >Ashley Ridge High School<\/option><option value='391' >Beech Hill Elementary<\/option><option value='392' >Charles B. DuBose Middle<\/option><option value='393' >Eagle Nest Elementary<\/option><option value='394' >Flowertown Elementary<\/option><option value='395' >Fort Dorchester Elementary<\/option><option value='396' >Fort Dorchester High School<\/option><option value='397' >Gregg Middle<\/option><option value='398' >James H. Spann Elementary<\/option><option value='399' >Joseph R. Pye Elementary<\/option><option value='400' >Knightsville Elementary<\/option><option value='401' >Newington Elementary<\/option><option value='402' >Oakbrook Elementary<\/option><option value='403' >Oakbrook Middle<\/option><option value='404' >River Oaks Middle<\/option><option value='405' >Rollings Middle School of the Arts<\/option><option value='406' >Summerville Elementary<\/option><option value='407' >Summerville High School<\/option><option value='408' >William M. Reeves Elementary<\/option><option value='409' >Windsor Hill Arts Infused Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_111\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_111' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_111'>Dorchester County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_111' id='input_9_111' class='large gfield_select'  aria-describedby=\"gfield_description_9_111\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='410' >Clay Hill Elementary<\/option><option value='411' >Harleyville Elementary<\/option><option value='414' >Williams Memorial Elementary<\/option><option value='415' >Woodland High School<\/option><option value='1449' >Woodland Middle<\/option><\/select><\/div><\/div><div id=\"field_9_113\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_113' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_113'>Edgefield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_113' id='input_9_113' class='large gfield_select'  aria-describedby=\"gfield_description_9_113\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='417' >Douglas Elementary<\/option><option value='418' >Johnston Elementary<\/option><option value='419' >Johnston-Edgefield-Trenton Middle<\/option><option value='420' >Merriwether Elementary<\/option><option value='421' >Merriwether Middle<\/option><option value='422' >Strom Thurmond Career Center<\/option><option value='423' >Strom Thurmond High School<\/option><option value='424' >W. E. Parker Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_104\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_104' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_104'>F E Dubose Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_104' id='input_9_104' class='large gfield_select'  aria-describedby=\"gfield_description_9_104\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='345' >F E Dubose Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_114\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_114' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_114'>Fairfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_114' id='input_9_114' class='large gfield_select'  aria-describedby=\"gfield_description_9_114\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='425' >Fairfield Career and Technology Center<\/option><option value='426' >Fairfield Central High School<\/option><option value='427' >Fairfield Elementary<\/option><option value='428' >Fairfield Magnet for Math and Science<\/option><option value='429' >Fairfield Middle<\/option><option value='430' >Geiger Elementary<\/option><option value='431' >Kelly Miller Elementary<\/option><option value='432' >McCrorey-Liston School of Technology<\/option><\/select><\/div><\/div><div id=\"field_9_156\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_156' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_156'>Felton Laboratory School<\/div><div class='ginput_container ginput_container_select'><select name='input_156' id='input_9_156' class='large gfield_select'  aria-describedby=\"gfield_description_9_156\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1235' >Felton Laboratory Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_115\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_115' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_115'>Florence School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_115' id='input_9_115' class='large gfield_select'  aria-describedby=\"gfield_description_9_115\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='433' >Alfred Rush Academy<\/option><option value='434' >Beck Learning Center<\/option><option value='435' >Briggs Elementary<\/option><option value='436' >Carver Elementary<\/option><option value='437' >Child Development Center at Woods Road<\/option><option value='438' >Delmae Elementary<\/option><option value='439' >Dewey-Carter Elementary<\/option><option value='440' >Florence Career Center<\/option><option value='441' >Greenwood Elementary<\/option><option value='442' >Henry L. Sneed Middle<\/option><option value='443' >Henry Timrod Elementary<\/option><option value='444' >John W. Moore Middle<\/option><option value='445' >Lucy T. Davis Elementary<\/option><option value='446' >McLaurin Elementary<\/option><option value='447' >North Vista Elementary<\/option><option value='448' >Palmetto Youth Academy Charter<\/option><option value='449' >Poynor Center<\/option><option value='450' >Royall Elementary<\/option><option value='451' >Savannah Grove Elementary<\/option><option value='452' >South Florence High School<\/option><option value='453' >Southside Middle<\/option><option value='454' >Theodore Lester Elementary<\/option><option value='455' >Wallace Gregg Elementary<\/option><option value='456' >West Florence High School<\/option><option value='457' >Williams Middle<\/option><option value='458' >Wilson High School<\/option><\/select><\/div><\/div><div id=\"field_9_116\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_116' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_116'>Florence School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_116' id='input_9_116' class='large gfield_select'  aria-describedby=\"gfield_description_9_116\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='459' >Early Childhood Success Center ANNEX<\/option><option value='460' >Hannah Pamplico High School<\/option><option value='461' >Hannah-Pamplico Elementary and Middle<\/option><\/select><\/div><\/div><div id=\"field_9_117\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_117' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_117'>Florence School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_117' id='input_9_117' class='large gfield_select'  aria-describedby=\"gfield_description_9_117\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='462' >J. C. Lynch Elementary<\/option><option value='463' >J. Paul Truluck Intermediate<\/option><option value='464' >Lake City Early Childhood Center<\/option><option value='465' >Lake City High School<\/option><option value='466' >Main Street Elementary<\/option><option value='467' >Olanta Elementary<\/option><option value='468' >Ronald E. McNair Junior High<\/option><option value='469' >Scranton Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_118\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_118' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_118'>Florence School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_118' id='input_9_118' class='large gfield_select'  aria-describedby=\"gfield_description_9_118\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='470' >Brockington Elementary<\/option><option value='471' >Johnson Middle<\/option><option value='472' >Timmonsville High School<\/option><option value='1275' >Woods Road HeadStart<\/option><\/select><\/div><\/div><div id=\"field_9_119\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_119' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_119'>Florence School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_119' id='input_9_119' class='large gfield_select'  aria-describedby=\"gfield_description_9_119\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='473' >Johnsonville Elementary<\/option><option value='474' >Johnsonville High School<\/option><option value='475' >Johnsonville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_162\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_162' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_162'>Fort Mill School District<\/div><div class='ginput_container ginput_container_select'><select name='input_162' id='input_9_162' class='large gfield_select'  aria-describedby=\"gfield_description_9_162\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1187' >Banks Trail Middle<\/option><option value='1188' >Doby&#039;s Bridge Elementary<\/option><option value='1189' >Fort Mill Elementary<\/option><option value='1190' >Fort Mill High School<\/option><option value='1191' >Fort Mill Middle<\/option><option value='1192' >Gold Hill Elementary<\/option><option value='1193' >Gold Hill Middle<\/option><option value='1194' >Nation Ford High School<\/option><option value='1195' >Orchard Park Elementary-Fort Mill<\/option><option value='1196' >Pleasant Knoll Elementary<\/option><option value='1283' >Pleasant Knoll Middle<\/option><option value='1197' >Riverview Elementary<\/option><option value='1198' >Springfield Elementary<\/option><option value='1199' >Springfield Middle<\/option><option value='1200' >Sugar Creek Elementary<\/option><option value='1201' >Tega Cay Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_120\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_120' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_120'>Georgetown County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_120' id='input_9_120' class='large gfield_select'  aria-describedby=\"gfield_description_9_120\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='476' >Andrews Elementary<\/option><option value='477' >Andrews High School<\/option><option value='478' >Brown&#039;s Ferry Elementary<\/option><option value='479' >Carvers Bay High School<\/option><option value='480' >Carvers Bay Middle<\/option><option value='481' >Coastal Montessori Charter School<\/option><option value='482' >Georgetown High School<\/option><option value='483' >Georgetown Middle<\/option><option value='484' >Kensington Elementary<\/option><option value='485' >Maryville Elementary<\/option><option value='486' >McDonald Elementary<\/option><option value='487' >Plantersville Elementary<\/option><option value='488' >Pleasant Hill Elementary<\/option><option value='489' >Rosemary Middle<\/option><option value='490' >Sampit Elementary<\/option><option value='491' >Waccamaw Elementary<\/option><option value='492' >Waccamaw High  School<\/option><option value='493' >Waccamaw Intermediate<\/option><option value='494' >Waccamaw Middle<\/option><\/select><\/div><\/div><div id=\"field_9_163\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_163' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_163'>GLEAMNS Human Resources Commission, Inc.<\/div><div class='ginput_container ginput_container_select'><select name='input_163' id='input_9_163' class='large gfield_select'  aria-describedby=\"gfield_description_9_163\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1419' >Abbeville Early Head Start &amp; Head Start Center<\/option><option value='1420' >Batesburg Head Start Center<\/option><option value='1421' >Blythewood Head Start Center<\/option><option value='1422' >Edgefield Early Head Start &amp;  Head Start Center<\/option><option value='1423' >Greenwood Early Head Start &amp;  Head Start Center<\/option><option value='1424' >Lexington Head Start Center<\/option><option value='1425' >McCormick Head Start Center<\/option><option value='1426' >North Hodges Head Start Center<\/option><option value='1427' >Pineview  Head Start Center<\/option><option value='1428' >Platt Springs Head Start Center<\/option><option value='1429' >Rikard Head Start Center<\/option><option value='1430' >Saluda Early Head Start &amp; Head Start Center<\/option><option value='1431' >Sanders Head Start Center<\/option><option value='1432' >St. Andrews Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_164\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_164' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_164'>Governor's School for the Arts and Humanities<\/div><div class='ginput_container ginput_container_select'><select name='input_164' id='input_9_164' class='large gfield_select'  aria-describedby=\"gfield_description_9_164\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1254' >SC Governor&#039;s School for the Arts and Humanities<\/option><\/select><\/div><\/div><div id=\"field_9_165\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_165' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_165'>Governor's School for Math and Science<\/div><div class='ginput_container ginput_container_select'><select name='input_165' id='input_9_165' class='large gfield_select'  aria-describedby=\"gfield_description_9_165\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1255' >Governor&#039;s School for Math and Science<\/option><\/select><\/div><\/div><div id=\"field_9_121\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_121' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_121'>Greenville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_121' id='input_9_121' class='large gfield_select'  aria-describedby=\"gfield_description_9_121\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='495' >A.J. Whittenburg Elementary<\/option><option value='496' >Alexander Elementary<\/option><option value='497' >Armstrong Elementary<\/option><option value='498' >Augusta Circle Elementary<\/option><option value='499' >Beck Academy<\/option><option value='500' >Bell&#039;s Crossing Elementary<\/option><option value='501' >Berea Elementary<\/option><option value='502' >Berea High School<\/option><option value='503' >Berea Middle<\/option><option value='504' >Bethel Elementary<\/option><option value='505' >Blue Ridge High School<\/option><option value='506' >Blue Ridge Middle<\/option><option value='507' >Blythe Academy<\/option><option value='508' >Brashier Middle College Charter School<\/option><option value='509' >Brook Glenn Elementary<\/option><option value='510' >Brushy Creek Elementary<\/option><option value='511' >Bryson Elementary<\/option><option value='512' >Bryson Middle<\/option><option value='513' >Buena Vista Elementary<\/option><option value='514' >Carolina Academy<\/option><option value='515' >Chandler Creek Elementary<\/option><option value='516' >Cherrydale Elementary<\/option><option value='517' >Crestview Elementary<\/option><option value='518' >Donaldson Career Center<\/option><option value='519' >Dr. Phinnize J. Fisher Middle<\/option><option value='520' >Duncan Chapel Elementary<\/option><option value='521' >East North Street Academy<\/option><option value='522' >Eastside High School<\/option><option value='523' >Ellen Woodside Elementary<\/option><option value='524' >Enoree Career Center<\/option><option value='525' >Fork Shoals School<\/option><option value='526' >Fountain Inn Elementary<\/option><option value='527' >Gateway Elementary<\/option><option value='528' >Golden Strip Career and Technology Center<\/option><option value='529' >Greenbrier Elementary<\/option><option value='530' >Greenville Middle Academy<\/option><option value='531' >Greenville Senior High Academy<\/option><option value='532' >Greenville Technical Charter High School<\/option><option value='533' >Greer High School<\/option><option value='534' >Greer Middle<\/option><option value='535' >Greer Middle College Charter School<\/option><option value='536' >Grove Elementary<\/option><option value='537' >Heritage Elementary<\/option><option value='538' >Hillcrest High School<\/option><option value='539' >Hillcrest Middle<\/option><option value='540' >Hollis Academy<\/option><option value='541' >Hughes Academy of Science and Technology<\/option><option value='542' >J. Harley Bonds Career Center<\/option><option value='543' >J. L. Mann High Academy<\/option><option value='544' >Lake Forest Elementary<\/option><option value='545' >Lakeview Middle<\/option><option value='546' >Langston Charter Middle<\/option><option value='547' >League Academy<\/option><option value='548' >Legacy Charter School<\/option><option value='549' >Mauldin Elementary<\/option><option value='550' >Mauldin High School<\/option><option value='551' >Mauldin Middle<\/option><option value='552' >Meyer Center for Special Children Charter<\/option><option value='553' >Mitchell Road Elementary<\/option><option value='554' >Monarch Elementary-Greenville<\/option><option value='555' >Monaview Elementary<\/option><option value='556' >Mountain View Elementary<\/option><option value='557' >Northwest Middle<\/option><option value='558' >Northwood Middle<\/option><option value='559' >Oakview Elementary<\/option><option value='560' >Overbrook Child Development Center<\/option><option value='561' >Paris Elementary<\/option><option value='562' >Pelham Road Elementary<\/option><option value='563' >Plain Elementary<\/option><option value='564' >Ralph Chandler Middle<\/option><option value='565' >Riverside High School<\/option><option value='566' >Riverside Middle-Greenville<\/option><option value='567' >Robert E. Cashion Elementary<\/option><option value='568' >Rudolph Gordon Elementary<\/option><option value='569' >Sara Collins Elementary<\/option><option value='570' >Sevier Middle<\/option><option value='571' >Simpsonville Elementary<\/option><option value='572' >Skyland Elementary<\/option><option value='573' >Slater Marietta Elementary<\/option><option value='574' >Southside High School<\/option><option value='575' >Sterling School<\/option><option value='576' >Stone Academy<\/option><option value='577' >Sue Cleveland Elementary<\/option><option value='578' >Summit Drive Elementary<\/option><option value='579' >Tanglewood Middle<\/option><option value='580' >Taylors Elementary<\/option><option value='581' >Thomas E. Kerns Elementary<\/option><option value='582' >Tigerville Elementary<\/option><option value='583' >Travelers Rest High School<\/option><option value='584' >Wade Hampton High School<\/option><option value='585' >Washington Center<\/option><option value='586' >Welcome Elementary<\/option><option value='587' >Westcliffe Elementary<\/option><option value='588' >Woodland Elementary<\/option><option value='589' >Woodmont High School<\/option><option value='590' >Woodmont Middle<\/option><\/select><\/div><\/div><div id=\"field_9_125\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_125' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_125'>Greenwood County Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_125' id='input_9_125' class='large gfield_select'  aria-describedby=\"gfield_description_9_125\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='612' >G Frank Russell Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_122\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_122' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_122'>Greenwood County School District 50<\/div><div class='ginput_container ginput_container_select'><select name='input_122' id='input_9_122' class='large gfield_select'  aria-describedby=\"gfield_description_9_122\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='591' >Brewer Middle<\/option><option value='592' >Eleanor S. Rice Elementary<\/option><option value='593' >Emerald High School<\/option><option value='594' >Greenwood Early Childhood Center<\/option><option value='595' >Greenwood High School<\/option><option value='596' >Hodges Elementary<\/option><option value='597' >Lakeview Elementary<\/option><option value='598' >Mathews Elementary<\/option><option value='599' >Merrywood Elementary<\/option><option value='600' >Northside Middle-Greenwood<\/option><option value='601' >Pinecrest Elementary<\/option><option value='602' >Springfield Elementary<\/option><option value='603' >Westview Middle<\/option><option value='604' >Woodfields Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_123\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_123' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_123'>Greenwood County School District 51<\/div><div class='ginput_container ginput_container_select'><select name='input_123' id='input_9_123' class='large gfield_select'  aria-describedby=\"gfield_description_9_123\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='605' >Ware Shoals Elementary Middle<\/option><option value='606' >Ware Shoals High School<\/option><option value='607' >Ware Shoals Primary<\/option><\/select><\/div><\/div><div id=\"field_9_124\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_124' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_124'>Greenwood County School District 52<\/div><div class='ginput_container ginput_container_select'><select name='input_124' id='input_9_124' class='large gfield_select'  aria-describedby=\"gfield_description_9_124\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='608' >Edgewood Middle<\/option><option value='609' >Ninety Six Elementary<\/option><option value='610' >Ninety Six High School<\/option><option value='611' >Ninety Six Primary<\/option><\/select><\/div><\/div><div id=\"field_9_166\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_166' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_166'>H B Swofford AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_166' id='input_9_166' class='large gfield_select'  aria-describedby=\"gfield_description_9_166\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1090' >H B Swofford Career Center<\/option><\/select><\/div><\/div><div id=\"field_9_126\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_126' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_126'>Hampton County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_126' id='input_9_126' class='large gfield_select'  aria-describedby=\"gfield_description_9_126\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='613' >Ben Hazel Primary<\/option><option value='614' >Brunson Elementary<\/option><option value='615' >Fennell Elementary<\/option><option value='616' >Hampton Elementary<\/option><option value='617' >North District Middle<\/option><option value='618' >Varnville Elementary<\/option><option value='619' >Wade Hampton High School<\/option><\/select><\/div><\/div><div id=\"field_9_127\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_127' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_127'>Hampton County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_127' id='input_9_127' class='large gfield_select'  aria-describedby=\"gfield_description_9_127\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='620' >Estill Elementary<\/option><option value='621' >Estill High School<\/option><option value='622' >Estill Middle<\/option><\/select><\/div><\/div><div id=\"field_9_128\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_128' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_128'>Horry County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_128' id='input_9_128' class='large gfield_select'  aria-describedby=\"gfield_description_9_128\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='623' >Academy For Arts Science Techn<\/option><option value='624' >Academy For Technolgy and Acad<\/option><option value='625' >Academy of Hope Charter<\/option><option value='626' >Aynor Elementary<\/option><option value='627' >Aynor High School<\/option><option value='628' >Aynor Middle<\/option><option value='629' >Black Water Middle<\/option><option value='630' >Bridgewater Academy Charter<\/option><option value='631' >Burgess Elementary<\/option><option value='632' >Carolina Forest Elementary<\/option><option value='633' >Carolina Forest High School<\/option><option value='634' >Conway Elementary<\/option><option value='635' >Conway High School<\/option><option value='636' >Conway Middle<\/option><option value='637' >Daisy Elementary<\/option><option value='638' >Forestbrook Elementary<\/option><option value='639' >Forestbrook Middle<\/option><option value='640' >Green Sea Floyds Elementary<\/option><option value='641' >Green Sea Floyds High School<\/option><option value='642' >HCS Early College High School<\/option><option value='643' >Homewood Elementary<\/option><option value='644' >Kingston Elementary<\/option><option value='645' >Lakewood Elementary<\/option><option value='646' >Loris Elementary<\/option><option value='647' >Loris High School<\/option><option value='648' >Loris Middle<\/option><option value='649' >Midland Elementary<\/option><option value='650' >Myrtle Beach Elementary<\/option><option value='651' >Myrtle Beach High School<\/option><option value='652' >Myrtle Beach Intermediate<\/option><option value='653' >Myrtle Beach Middle<\/option><option value='654' >Myrtle Beach Primary<\/option><option value='655' >North Myrtle Beach High School<\/option><option value='656' >North Myrtle Beach Middle<\/option><option value='657' >Ocean Bay Elementary<\/option><option value='658' >Ocean Bay Middle<\/option><option value='659' >Ocean Drive Elementary<\/option><option value='660' >Palmetto Academy for Learning Motorsports<\/option><option value='661' >Palmetto Academy of Learning and Success Charter<\/option><option value='662' >Palmetto Bays Elementary<\/option><option value='663' >Pee Dee Elementary<\/option><option value='664' >River Oaks Elementary<\/option><option value='665' >Riverside Elementary<\/option><option value='666' >Seaside Elementary<\/option><option value='667' >Socastee Elementary<\/option><option value='668' >Socastee High School<\/option><option value='669' >South Conway Elementary<\/option><option value='670' >St. James Elementary<\/option><option value='671' >St. James High School<\/option><option value='672' >St. James Middle<\/option><option value='673' >Waccamaw Elementary<\/option><option value='674' >Waterway Elementary<\/option><option value='675' >Whittemore Park Middle<\/option><\/select><\/div><\/div><div id=\"field_9_129\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_129' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_129'>Jasper County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_129' id='input_9_129' class='large gfield_select'  aria-describedby=\"gfield_description_9_129\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='676' >Hardeeville Elementary<\/option><option value='677' >Hardeeville-Ridgeland Middle<\/option><option value='678' >Ridgeland Elementary<\/option><option value='679' >Ridgeland-Hardeeville High School<\/option><\/select><\/div><\/div><div id=\"field_9_167\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_167' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_167'>John De La Howe<\/div><div class='ginput_container ginput_container_select'><select name='input_167' id='input_9_167' class='large gfield_select'  aria-describedby=\"gfield_description_9_167\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1236' >John De La Howe School<\/option><\/select><\/div><\/div><div id=\"field_9_168\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_168' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_168'>Juvenile Justice Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_168' id='input_9_168' class='large gfield_select'  aria-describedby=\"gfield_description_9_168\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1242' >Birchwood School<\/option><option value='1243' >Evaluation and Detention Center<\/option><option value='1244' >Willow Lane School<\/option><\/select><\/div><\/div><div id=\"field_9_130\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_130' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_130'>Kershaw County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_130' id='input_9_130' class='large gfield_select'  aria-describedby=\"gfield_description_9_130\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='680' >Applied Technology Education Campus<\/option><option value='681' >Baron Dekalb Elementary<\/option><option value='682' >Bethune Elementary<\/option><option value='683' >Blaney Elementary<\/option><option value='684' >Camden Elementary of the Creative Arts<\/option><option value='685' >Camden High School<\/option><option value='686' >Camden Middle<\/option><option value='687' >Doby&#039;s Mill Elementary<\/option><option value='688' >Jackson School<\/option><option value='689' >Leslie M. Stover Middle<\/option><option value='690' >Lugoff Elementary<\/option><option value='691' >Lugoff-Elgin High School<\/option><option value='692' >Lugoff-Elgin Middle<\/option><option value='693' >Midway Elementary<\/option><option value='694' >Mt. Pisgah Elementary<\/option><option value='695' >North Central High School<\/option><option value='696' >North Central Middle<\/option><option value='697' >Pine Tree Hill Elementary<\/option><option value='698' >Wateree Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_131\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_131' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_131'>Lancaster County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_131' id='input_9_131' class='large gfield_select'  aria-describedby=\"gfield_description_9_131\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='699' >A. R. Rucker Middle<\/option><option value='700' >Andrew Jackson High School<\/option><option value='701' >Andrew Jackson Middle<\/option><option value='702' >Brooklyn Springs Elementary<\/option><option value='703' >Buford Elementary<\/option><option value='704' >Buford High School<\/option><option value='705' >Buford Middle<\/option><option value='728' >Clinton Elementary-Lancaster<\/option><option value='707' >Discovery Charter of Lancaster<\/option><option value='708' >Erwin Elementary<\/option><option value='709' >Harrisburg Elementary<\/option><option value='710' >Heath Springs Elementary<\/option><option value='711' >Indian Land Elementary<\/option><option value='712' >Indian Land High School<\/option><option value='713' >Indian Land Middle<\/option><option value='714' >Kershaw Elementary<\/option><option value='715' >Lancaster High School<\/option><option value='716' >McDonald Green Elementary<\/option><option value='717' >North Elementary<\/option><option value='718' >South Middle<\/option><\/select><\/div><\/div><div id=\"field_9_132\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_132' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_132'>Laurens County School District No. 55\n<\/div><div class='ginput_container ginput_container_select'><select name='input_132' id='input_9_132' class='large gfield_select'  aria-describedby=\"gfield_description_9_132\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='719' >E. B. Morse Elementary<\/option><option value='720' >Ford Elementary<\/option><option value='721' >Gray Court-Owings Elementary-Middle<\/option><option value='722' >Hickory Tavern Elementary-Middle<\/option><option value='723' >Laurens District 55 High School<\/option><option value='724' >Laurens Elementary<\/option><option value='725' >Laurens Middle<\/option><option value='726' >Sanders Middle<\/option><option value='727' >Waterloo Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_133\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_133' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_133'>Laurens County School District 56<\/div><div class='ginput_container ginput_container_select'><select name='input_133' id='input_9_133' class='large gfield_select'  aria-describedby=\"gfield_description_9_133\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='706' >Clinton Elementary-Laurens<\/option><option value='729' >Clinton High School<\/option><option value='730' >Clinton Middle<\/option><option value='731' >Eastside Elementary<\/option><option value='732' >Joanna-Woodson Elementary<\/option><option value='733' >M. S. Bailey Child Development Center<\/option><option value='1295' >Summit Classical Charter School<\/option><option value='1294' >Thornwell Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_134\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_134' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_134'>Lee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_134' id='input_9_134' class='large gfield_select'  aria-describedby=\"gfield_description_9_134\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='734' >Dennis Elementary<\/option><option value='735' >Lee Central High School<\/option><option value='736' >Lee Central Middle<\/option><option value='737' >Lee County Career and Technology Center<\/option><option value='738' >Lower Lee Elementary<\/option><option value='739' >West Lee Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_135\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_135' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_135'>Lexington County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_135' id='input_9_135' class='large gfield_select'  aria-describedby=\"gfield_description_9_135\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1293' >Beechwood Middle<\/option><option value='740' >Carolina Springs Elementary<\/option><option value='741' >Carolina Springs Middle<\/option><option value='1297' >Centerville Elementary-Lexington 1<\/option><option value='742' >Deerfield Elementary<\/option><option value='1265' >East Pointe Academy Charter School<\/option><option value='743' >Forts Pond Elementary<\/option><option value='744' >Gilbert Elementary<\/option><option value='745' >Gilbert High School<\/option><option value='746' >Gilbert Middle<\/option><option value='747' >Gilbert Primary<\/option><option value='748' >Lake Murray Elementary<\/option><option value='1444' >Lakeside Middle School<\/option><option value='749' >Lexington Elementary<\/option><option value='750' >Lexington High School<\/option><option value='751' >Lexington Middle<\/option><option value='752' >Lexington Technology Center<\/option><option value='753' >Meadow Glen Elementary<\/option><option value='754' >Meadow Glen Middle<\/option><option value='755' >Midway Elementary<\/option><option value='756' >New Providence Elementary<\/option><option value='757' >Oak Grove Elementary<\/option><option value='758' >Pelion Elementary<\/option><option value='759' >Pelion High School<\/option><option value='760' >Pelion Middle<\/option><option value='761' >Pleasant Hill Elementary<\/option><option value='762' >Pleasant Hill Middle<\/option><option value='763' >Red Bank Elementary<\/option><option value='764' >River Bluff High School<\/option><option value='765' >Rocky Creek Elementary<\/option><option value='766' >Saxe Gotha Elementary<\/option><option value='1446' >South Lake Elementary<\/option><option value='767' >White Knoll Elementary<\/option><option value='768' >White Knoll High School<\/option><option value='769' >White Knoll Middle<\/option><\/select><\/div><\/div><div id=\"field_9_136\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_136' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_136'>Lexington County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_136' id='input_9_136' class='large gfield_select'  aria-describedby=\"gfield_description_9_136\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='770' >Airport High School<\/option><option value='771' >Brookland Cayce Grammar School No. 1<\/option><option value='772' >Brookland-Cayce Senior High School<\/option><option value='1277' >Cayce Elementary<\/option><option value='774' >Congaree Elementary<\/option><option value='775' >Congaree-Wood Early Childhood Center<\/option><option value='776' >Cyril B. Busbee Creative Arts Academy<\/option><option value='777' >Herbert A. Wood Elementary<\/option><option value='1256' >New Bridge Academy<\/option><option value='778' >Northside Middle-Lexington 2<\/option><option value='779' >Pine Ridge Middle<\/option><option value='780' >Pineview Elementary<\/option><option value='781' >R. Earle Davis-CLOSED<\/option><option value='782' >R. H. Fulmer Middle<\/option><option value='1288' >Riverbank Elementary School<\/option><option value='783' >Saluda River Academy for the Arts<\/option><option value='784' >Springdale Elementary<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_9_137\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_137' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_137'>Lexington County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_137' id='input_9_137' class='large gfield_select'  aria-describedby=\"gfield_description_9_137\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='785' >Batesburg-Leesville Elementary<\/option><option value='786' >Batesburg-Leesville High School<\/option><option value='787' >Batesburg-Leesville Middle<\/option><option value='788' >Batesburg-Leesville Primary<\/option><\/select><\/div><\/div><div id=\"field_9_138\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_138' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_138'>Lexington County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_138' id='input_9_138' class='large gfield_select'  aria-describedby=\"gfield_description_9_138\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='789' >Frances F. Mack Intermediate<\/option><option value='790' >Lexington Four Early Childhood Center<\/option><option value='791' >Sandhills Elementary<\/option><option value='792' >Sandhills Middle<\/option><option value='793' >Sandhills Primary<\/option><option value='794' >Swansea High Freshman Academy<\/option><option value='795' >Swansea High School<\/option><\/select><\/div><\/div><div id=\"field_9_139\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_139' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_139'>Lexington and Richland School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_139' id='input_9_139' class='large gfield_select'  aria-describedby=\"gfield_description_9_139\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='796' >Ballentine Elementary<\/option><option value='797' >Center for Advanced Technical Studies<\/option><option value='798' >Chapin Elementary<\/option><option value='799' >Chapin High School<\/option><option value='800' >Chapin Intermediate<\/option><option value='801' >Chapin Middle<\/option><option value='802' >CrossRoads Intermediate<\/option><option value='803' >Dutch Fork Elementary<\/option><option value='804' >Dutch Fork High School<\/option><option value='805' >Dutch Fork Middle<\/option><option value='806' >H. E. Corley Elementary<\/option><option value='807' >Harbison West Elementary<\/option><option value='808' >Irmo Elementary<\/option><option value='809' >Irmo High School<\/option><option value='810' >Irmo Middle<\/option><option value='811' >Lake Murray Elementary<\/option><option value='812' >Leaphart Elementary<\/option><option value='813' >Nursery Road Elementary<\/option><option value='814' >Oak Pointe Elementary<\/option><option value='1433' >Piney Woods Elementary<\/option><option value='815' >River Springs Elementary<\/option><option value='816' >Seven Oaks Elementary<\/option><option value='817' >Spring Hill High School<\/option><\/select><\/div><\/div><div id=\"field_9_169\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_169' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_169'>Marion County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_169' id='input_9_169' class='large gfield_select'  aria-describedby=\"gfield_description_9_169\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='821' >Academy of Careers and Technology<\/option><option value='822' >Britton&#039;s Neck Elementary<\/option><option value='823' >Creek Bridge High School<\/option><option value='824' >Easterling Primary<\/option><option value='825' >Johnakin Middle<\/option><option value='828' >McCormick Elementary-Marion<\/option><option value='826' >Manning High School<\/option><option value='1287' >Marion High School<\/option><option value='827' >Marion Intermediate<\/option><option value='829' >Mullins Early Childhood Center ANNEX<\/option><option value='830' >Mullins High School<\/option><option value='831' >North Mullins Primary<\/option><option value='832' >Palmetto Middle<\/option><\/select><\/div><\/div><div id=\"field_9_141\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_141' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_141'>Marlboro County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_141' id='input_9_141' class='large gfield_select'  aria-describedby=\"gfield_description_9_141\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='833' >Bennettsville Intermediate<\/option><option value='834' >Bennettsville Primary<\/option><option value='1264' >Blenheim HeadStart<\/option><option value='835' >Blenheim Middle School of Discovery<\/option><option value='836' >Clio Elementary<\/option><option value='837' >Marlboro County High School<\/option><option value='838' >Marlboro School of Discovery<\/option><option value='839' >McColl Elementary-Middle<\/option><option value='840' >Wallace Elementary-Middle<\/option><\/select><\/div><\/div><div id=\"field_9_140\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_140' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_140'>McCormick County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_140' id='input_9_140' class='large gfield_select'  aria-describedby=\"gfield_description_9_140\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='818' >McCormick Elementary-McCormick<\/option><option value='819' >McCormick High School<\/option><option value='820' >McCormick Middle<\/option><\/select><\/div><\/div><div id=\"field_9_190\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_190' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_190'>Movement School<\/div><div class='ginput_container ginput_container_select'><select name='input_190' id='input_9_190' class='large gfield_select'  aria-describedby=\"gfield_description_9_190\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='1451' >Bridge View Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_142\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_142' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_142'>Newberry County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_142' id='input_9_142' class='large gfield_select'  aria-describedby=\"gfield_description_9_142\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='841' >Boundary Street Elementary<\/option><option value='842' >Gallman Elementary<\/option><option value='843' >Little Mountain Elementary<\/option><option value='844' >Mid-Carolina High School<\/option><option value='845' >Mid-Carolina Middle<\/option><option value='846' >Newberry County Career Center<\/option><option value='847' >Newberry Elementary<\/option><option value='848' >Newberry High School<\/option><option value='849' >Newberry Middle<\/option><option value='850' >Pomaria-Garmany Elementary<\/option><option value='851' >Prosperity-Rikard Elementary<\/option><option value='852' >Reuben Elementary<\/option><option value='853' >Whitmire Community High School<\/option><option value='854' >Whitmire Community School (Elementary)<\/option><\/select><\/div><\/div><div id=\"field_9_143\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_143' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_143'>Oconee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_143' id='input_9_143' class='large gfield_select'  aria-describedby=\"gfield_description_9_143\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='855' >Blue Ridge Elementary<\/option><option value='856' >Fair-Oak Elementary<\/option><option value='857' >Fred P. Hamilton Career Center<\/option><option value='858' >James M. Brown Elementary<\/option><option value='859' >Keowee Elementary<\/option><option value='860' >Northside Elementary-Oconee<\/option><option value='861' >Orchard Park Elementary<\/option><option value='862' >Ravenel Elementary<\/option><option value='863' >Seneca High School<\/option><option value='864' >Seneca Middle<\/option><option value='865' >Tamassee-Salem Elementary<\/option><option value='866' >Tamassee-Salem Middle-High School<\/option><option value='867' >Walhalla Elementary<\/option><option value='868' >Walhalla High School<\/option><option value='869' >Walhalla Middle<\/option><option value='870' >West Oak Middle<\/option><option value='871' >West-Oak High School<\/option><option value='872' >Westminster Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_146\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_146' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_146'>Orangeburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_146' id='input_9_146' class='large gfield_select'  aria-describedby=\"gfield_description_9_146\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='887' >Bethune-Bowman Elementary<\/option><option value='888' >Bethune-Bowman Middle-High School<\/option><option value='879' >Branchville High School<\/option><option value='889' >Brookdale Elementary<\/option><option value='880' >Carver Edisto Middle<\/option><option value='890' >Dover Elementary<\/option><option value='1454' >East Lake Elementary School<\/option><option value='881' >Edisto Elementary<\/option><option value='882' >Edisto High<\/option><option value='883' >Edisto Primary<\/option><option value='873' >Elloree Elementary<\/option><option value='884' >Hunter-Kinard-Tyler Elementary<\/option><option value='885' >Hunter-Kinard-Tyler High<\/option><option value='1455' >Lake Marion Middle School<\/option><option value='876' >Lake Marion High<\/option><option value='886' >Lockett Elementary<\/option><option value='891' >Marshall Elementary<\/option><option value='892' >Mellichamp Elementary<\/option><option value='893' >North Middle-High School<\/option><option value='894' >OCSD5 High School for Health Professions<\/option><option value='895' >Orangeburg Consolitated School District Five Technology Center<\/option><option value='896' >Orangeburg Wilkinson High School<\/option><option value='899' >Sheridan Elementary<\/option><option value='900' >Whittaker Elementary<\/option><option value='901' >William J. Clark Middle<\/option><\/select><\/div><\/div><div id=\"field_9_171\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_171' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_171'>Palmetto Unified<\/div><div class='ginput_container ginput_container_select'><select name='input_171' id='input_9_171' class='large gfield_select'  aria-describedby=\"gfield_description_9_171\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1245' >Lee  High School<\/option><option value='1246' >MacDougall High School<\/option><option value='1247' >Manning High School<\/option><option value='1248' >Ridgeland High School<\/option><option value='1249' >Sara Babb High School<\/option><option value='1250' >Trenton High School<\/option><option value='1251' >Turbeville High School<\/option><option value='1252' >Tyger River High School<\/option><option value='1253' >Wateree River High School<\/option><\/select><\/div><\/div><div id=\"field_9_170\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_170' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_170'>Pee Dee Head Starts<\/div><div class='ginput_container ginput_container_select'><select name='input_170' id='input_9_170' class='large gfield_select'  aria-describedby=\"gfield_description_9_170\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1292' >Lake City HS Center<\/option><\/select><\/div><\/div><div id=\"field_9_172\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_172' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_172'>Pickens County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_172' id='input_9_172' class='large gfield_select'  aria-describedby=\"gfield_description_9_172\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='903' >A. R. Lewis Elementary<\/option><option value='904' >Ambler Elementary<\/option><option value='905' >Central Elementary<\/option><option value='906' >Liberty Primary<\/option><option value='907' >Clemson Elementary<\/option><option value='908' >Crosswell Elementary-Pickens<\/option><option value='909' >D. W. Daniel High School<\/option><option value='910' >Dacusville Elementary<\/option><option value='911' >Dacusville Middle<\/option><option value='912' >Easley High School<\/option><option value='913' >East End Elementary<\/option><option value='914' >Forest Acres Elementary<\/option><option value='915' >Hagood Elementary<\/option><option value='916' >Holly Springs Elementary<\/option><option value='917' >Liberty Elementary<\/option><option value='918' >Liberty High School<\/option><option value='919' >Liberty Middle<\/option><option value='920' >McKissick Elementary<\/option><option value='921' >Pickens County Career and Technolgy Center<\/option><option value='922' >Pickens Elementary<\/option><option value='923' >Pickens High School<\/option><option value='924' >Pickens Middle<\/option><option value='925' >R. C. Edwards Middle<\/option><option value='926' >Richard H. Gettys Middle<\/option><option value='927' >Six Mile Elementary<\/option><option value='928' >West End Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_173\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_173' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_173'>R D Anderson Applied Technology Center<\/div><div class='ginput_container ginput_container_select'><select name='input_173' id='input_9_173' class='large gfield_select'  aria-describedby=\"gfield_description_9_173\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1089' >R. D. Anderson Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_174\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_174' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_174'>Richland County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_174' id='input_9_174' class='large gfield_select'  aria-describedby=\"gfield_description_9_174\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='929' >A. C. Flora High School<\/option><option value='930' >A. C. Moore Elementary<\/option><option value='931' >A. J. Lewis Greenview Elementary<\/option><option value='932' >Alcorn Middle<\/option><option value='933' >Annie Burnside Elementary<\/option><option value='934' >Arden Elementary<\/option><option value='935' >Bradley Elementary<\/option><option value='936' >Brennen Elementary<\/option><option value='937' >Brockman Elementary<\/option><option value='938' >Burton Pack Elementary<\/option><option value='939' >C. A. Johnson High School<\/option><option value='940' >Carolina School for Inquiry<\/option><option value='941' >Carver-Lyon Elementary<\/option><option value='942' >Caughman Road Elementary<\/option><option value='943' >Columbia High School<\/option><option value='944' >Crayton Middle<\/option><option value='945' >Dreher High School<\/option><option value='946' >Eau Claire High School<\/option><option value='947' >Edward E. Taylor Elementary<\/option><option value='948' >Forest Heights Elementary<\/option><option value='949' >Gadsden Elementary<\/option><option value='950' >H. B. Rhame Elementary<\/option><option value='951' >Hall Institute<\/option><option value='952' >Hand Middle<\/option><option value='953' >Heyward Gibbes Middle<\/option><option value='954' >Hopkins Elementary<\/option><option value='955' >Hopkins Middle<\/option><option value='956' >Horrell Hill Elementary<\/option><option value='957' >Hyatt Park Elementary<\/option><option value='958' >J. P. Thomas Elementary<\/option><option value='959' >Logan Elementary<\/option><option value='960' >Lower Richland High School<\/option><option value='961' >Meadowfield Elementary<\/option><option value='962' >Mill Creek Elementary<\/option><option value='963' >Pendergrass Fairwold School<\/option><option value='964' >Pine Grove Elementary<\/option><option value='965' >Richland One Charter Middle College<\/option><option value='966' >Rosewood Elementary<\/option><option value='967' >Samuel A. Heyward Career and Tech Center<\/option><option value='968' >Sandel Elementary<\/option><option value='969' >Satchel Ford Elementary<\/option><option value='970' >South Kilbourne Elementary<\/option><option value='971' >Southeast Middle<\/option><option value='972' >St. Andrews Middle<\/option><option value='973' >W. A. Perry Middle<\/option><option value='974' >W. G. Sanders Middle<\/option><option value='975' >W.J. Keenan High School<\/option><option value='976' >Watkins-Nance Elementary<\/option><option value='977' >Webber School<\/option><\/select><\/div><\/div><div id=\"field_9_175\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_175' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_175'>Richland County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_175' id='input_9_175' class='large gfield_select'  aria-describedby=\"gfield_description_9_175\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='978' >Bethel-Hanberry Elementary<\/option><option value='979' >Blythewood High School<\/option><option value='980' >Blythewood Middle School<\/option><option value='981' >Bookman Road Elementary<\/option><option value='982' >Bridge Creek Elementary<\/option><option value='983' >Catawba Trail Elementary<\/option><option value='984' >Dent Middle<\/option><option value='985' >E. L. Wright Middle<\/option><option value='986' >Forest Lake Elementary<\/option><option value='1280' >Jackson Creek Elementary<\/option><option value='987' >Joseph Keels Elementary<\/option><option value='988' >Kelly Mill Middle<\/option><option value='989' >Killian Elementary<\/option><option value='990' >L. B. Nelson Elementary<\/option><option value='991' >L. W. Conder Elementary<\/option><option value='992' >Lake Carolina Elementary<\/option><option value='993' >Lake Carolina Elementary Upper Campus<\/option><option value='994' >Langford Elementary<\/option><option value='995' >Longleaf Middle<\/option><option value='996' >Muller Road Middle<\/option><option value='997' >North Springs Elementary<\/option><option value='998' >Polo Road Elementary<\/option><option value='999' >Pontiac Elementary<\/option><option value='1000' >Rice Creek Elementary<\/option><option value='1001' >Richland Northeast High School<\/option><option value='1002' >Richland Two Charter High School<\/option><option value='1003' >Ridge View High School<\/option><option value='1004' >Round Top Elementary<\/option><option value='1005' >Sandlapper Elementary<\/option><option value='1006' >Spring Valley High School<\/option><option value='1007' >Summit Parkway Middle<\/option><option value='1008' >Westwood High School<\/option><option value='1009' >Windsor Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_176\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_176' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_176'>Rock Hill School District Three of York County<\/div><div class='ginput_container ginput_container_select'><select name='input_176' id='input_9_176' class='large gfield_select'  aria-describedby=\"gfield_description_9_176\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1159' >Applied Technology Center<\/option><option value='1160' >Belleview Elementary<\/option><option value='1161' >Castle Heights Middle<\/option><option value='1162' >Central Child Development Center<\/option><option value='1163' >Dutchman Creek Middle<\/option><option value='1164' >Ebenezer Avenue Elementary<\/option><option value='1165' >Ebinport Elementary<\/option><option value='1166' >Finley Road Elementary<\/option><option value='1167' >Independence Elementary<\/option><option value='1168' >India Hook Elementary<\/option><option value='1169' >Lesslie Elementary<\/option><option value='1170' >Mount Gallant Elementary<\/option><option value='1171' >Mount Holly Elementary<\/option><option value='1172' >Northside Elementary-York 3<\/option><option value='1173' >Northwestern High School<\/option><option value='1174' >Oakdale Elementary<\/option><option value='1175' >Old Pointe Elementary<\/option><option value='1176' >Rawlinson Road Middle<\/option><option value='1177' >Richmond Drive Elementary<\/option><option value='1178' >Rock Hill High School<\/option><option value='1179' >Rosewood Elementary<\/option><option value='1180' >Saluda Trail Middle<\/option><option value='1181' >South Pointe High School<\/option><option value='1182' >Sunset Park Center for Accelerated Studies<\/option><option value='1183' >The Children&#039;s School at Sylvia Circle<\/option><option value='1184' >The Palmetto School at the Children&#039;s Attention Home<\/option><option value='1185' >W. C. Sullivan Middle<\/option><option value='1186' >York Road Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_177\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_177' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_177'>Saluda County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_177' id='input_9_177' class='large gfield_select'  aria-describedby=\"gfield_description_9_177\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1010' >Hollywood Elementary<\/option><option value='1011' >Saluda Elementary<\/option><option value='1012' >Saluda High School<\/option><option value='1013' >Saluda Middle<\/option><option value='1014' >Saluda Primary<\/option><\/select><\/div><\/div><div id=\"field_9_178\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_178' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_178'>SC Public School Charter District<\/div><div class='ginput_container ginput_container_select'><select name='input_178' id='input_9_178' class='large gfield_select'  aria-describedby=\"gfield_description_9_178\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1202' >Bridges Preparatory School<\/option><option value='1203' >Calhoun Falls Charter School<\/option><option value='1204' >Cape Romain Environmental Education Charter<\/option><option value='1205' >Coastal Leadership Academy<\/option><option value='1206' >Cyber Academy of South Carolina<\/option><option value='1207' >East Point Academy<\/option><option value='1208' >Fox Creek High School<\/option><option value='1209' >Garden City Preparatory Academy for Boys<\/option><option value='1210' >Gray Collegiate Academy<\/option><option value='1211' >GREEN Charter School<\/option><option value='1212' >High Point Academy<\/option><option value='1213' >Imagine Columbia Leadership Academy Charter<\/option><option value='1214' >Lead Academy<\/option><option value='1215' >Lowcountry Leadership Charter School<\/option><option value='1216' >Lowcountry Montessori School<\/option><option value='1217' >Midlands Middle College<\/option><option value='1219' >NEXT High School<\/option><option value='1279' >Oceanside Collegiate Academy<\/option><option value='1220' >Palmetto Scholars Academy<\/option><option value='1221' >Pee Dee Math, Science, and Technology Academy<\/option><option value='1222' >Provost Academy South Carolina<\/option><option value='1223' >Quest Leadership Academy<\/option><option value='1224' >Riverwalk Academy<\/option><option value='1225' >Royal Live Oaks Academy of the Arts and Sciences Charter<\/option><option value='1226' >SC Connections Academy<\/option><option value='1227' >SC Science Academy<\/option><option value='1228' >SC Virtual Charter School<\/option><option value='1229' >SC Whitmore School<\/option><option value='1230' >South Carolina Calvert Academy<\/option><option value='1231' >Spartanburg Preparatory School<\/option><option value='1232' >York Preparatory Academy<\/option><option value='1233' >Youth Leadership Academy Charter<\/option><\/select><\/div><\/div><div id=\"field_9_179\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_179' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_179'>SC School for the Deaf and Blind<\/div><div class='ginput_container ginput_container_select'><select name='input_179' id='input_9_179' class='large gfield_select'  aria-describedby=\"gfield_description_9_179\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1237' >Cedar Springs Academy<\/option><option value='1238' >SC School For Blind Elementary-Middle<\/option><option value='1239' >SC School For Deaf Elementary-Middle<\/option><option value='1240' >SC School for the Blind High School<\/option><option value='1241' >SC School for the Deaf High School<\/option><\/select><\/div><\/div><div id=\"field_9_180\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_180' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_180'>Share Community Action Partnership<\/div><div class='ginput_container ginput_container_select'><select name='input_180' id='input_9_180' class='large gfield_select'  aria-describedby=\"gfield_description_9_180\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1399' >BHW Head Start\/Early Head Start Center<\/option><option value='1404' >Children&#039;s Center &quot;B&quot; Head Start Center<\/option><option value='1415' >Clemson  Head Start Center<\/option><option value='1405' >Easley Bridge Road Head Start Center<\/option><option value='1407' >Golden Strip Head Start\/Early Head Start Center<\/option><option value='1412' >Margaret A. Sherred Head Start Center<\/option><option value='1406' >North Franklin Road Head Start Center<\/option><option value='1409' >North Greenville  Head Start Center<\/option><option value='1408' >Parker Head Start\/Early Head Start Center<\/option><option value='1400' >Pendleton Head Start Center<\/option><option value='1416' >Pickens  Head Start Center<\/option><option value='1417' >Reece Mill Road Head Start\/Early Head Start Center<\/option><option value='1411' >Rubye H. Jones Head Start\/Early Head Start Center<\/option><option value='1414' >Seneca  Head Start\/Early Head Start Center<\/option><option value='1418' >Simpson Head  Head Start Center<\/option><option value='1401' >Starr Head Start Center<\/option><option value='1410' >Tommie C. Brooks Early Head Start Center<\/option><option value='1413' >Watkins Road  Head Start\/Early Head Start Center<\/option><option value='1402' >Westside Head Start Center<\/option><option value='1403' >Willis H. Crosby Head Start\/Early Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_159\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_159' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_159'>Spartanburg County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_159' id='input_9_159' class='large gfield_select'  aria-describedby=\"gfield_description_9_159\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='266' >Oakland Elementary-Spartanburg<\/option><option value='1025' >Boiling Springs Elementary<\/option><option value='1026' >Boiling Springs High Ninth Grade Campus<\/option><option value='1027' >Boiling Springs High School<\/option><option value='1028' >Sugar Ridge Elementary<\/option><option value='1029' >Boiling Springs Middle<\/option><option value='1030' >Carlisle-Foster&#039;s Grove Elementary<\/option><option value='1031' >Chesnee Elementary<\/option><option value='1032' >Chesnee High School<\/option><option value='1033' >Chesnee Middle<\/option><option value='1034' >Cooley Springs-Fingerville Elementary<\/option><option value='1035' >James H. Hendrix  Elementary<\/option><option value='1036' >Mayo Elementary<\/option><option value='1038' >Rainbow Lake Middle<\/option><option value='1260' >Shoally Creek Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_160\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_160' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_160'>Spartanburg County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_160' id='input_9_160' class='large gfield_select'  aria-describedby=\"gfield_description_9_160\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1039' >Broome High School<\/option><option value='1040' >Cannons Elementary<\/option><option value='1041' >Cliffdale Middle<\/option><option value='1042' >Cowpens Elementary<\/option><option value='1045' >Pacolet Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_161\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_161' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_161'>Spartanburg County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_161' id='input_9_161' class='large gfield_select'  aria-describedby=\"gfield_description_9_161\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1046' >Woodruff Elementary<\/option><option value='1047' >Woodruff High School<\/option><option value='1048' >Woodruff Middle<\/option><option value='1049' >Woodruff Primary<\/option><\/select><\/div><\/div><div id=\"field_9_155\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_155' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_155'>Spartanburg County School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_155' id='input_9_155' class='large gfield_select'  aria-describedby=\"gfield_description_9_155\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1050' >Abner Creek Academy<\/option><option value='1051' >Beech Springs Intermediate<\/option><option value='1052' >Berry Shoals Intermediate<\/option><option value='1053' >D. R. Hill Middle<\/option><option value='1054' >Duncan Elementary<\/option><option value='1055' >Florence Chapel Middle<\/option><option value='1056' >James Byrnes Freshman Academy<\/option><option value='1057' >James F. Byrnes High School<\/option><option value='1058' >Lyman Elementary<\/option><option value='1059' >Reidville Elementary<\/option><option value='1060' >River Ridge Elementary<\/option><option value='1061' >Wellford Academy of Science and Techology<\/option><\/select><\/div><\/div><div id=\"field_9_158\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_158' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_158'>Spartanburg County School District Six<\/div><div class='ginput_container ginput_container_select'><select name='input_158' id='input_9_158' class='large gfield_select'  aria-describedby=\"gfield_description_9_158\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1062' >Anderson Mill Elementary<\/option><option value='1063' >Arcadia Elementary<\/option><option value='1064' >Dorman High Freshman Campus<\/option><option value='1065' >Dorman High School<\/option><option value='1066' >Fairforest Elementary<\/option><option value='1067' >Fairforest Middle<\/option><option value='1068' >Jesse S. Bobo Elementary<\/option><option value='1069' >L. E. Gable Middle<\/option><option value='1070' >Lone Oak Elementary<\/option><option value='1071' >Pauline Glenn Springs Elementary<\/option><option value='1072' >R. P. Dawkins Middle<\/option><option value='1073' >Roebuck Elementary<\/option><option value='1074' >West View Elementary<\/option><option value='1075' >Woodland Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_157\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_157' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_157'>Spartanburg County School District Seven<\/div><div class='ginput_container ginput_container_select'><select name='input_157' id='input_9_157' class='large gfield_select'  aria-describedby=\"gfield_description_9_157\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1076' >Carver Middle<\/option><option value='1077' >Cleveland Academy of Leadership<\/option><option value='1078' >E. P. Todd School<\/option><option value='1079' >Houston Elementary<\/option><option value='1080' >Jesse Boyd Elementary<\/option><option value='1081' >Mary H. Wright Elementary<\/option><option value='1082' >McCracken Middle<\/option><option value='1083' >Pine Street Elementary<\/option><option value='1084' >Spartanburg Freshman Academy<\/option><option value='1085' >Spartanburg High School<\/option><option value='1086' >Spartanburg School District 7 Early Childhood Center<\/option><option value='1087' >W. Herbert Chapman Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_181\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_181' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_181'>Sumter School District<\/div><div class='ginput_container ginput_container_select'><select name='input_181' id='input_9_181' class='large gfield_select'  aria-describedby=\"gfield_description_9_181\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1092' >Alice Drive Elementary<\/option><option value='1091' >Alice Drive Middle<\/option><option value='1093' >Bates Middle<\/option><option value='1273' >Brewington Alternative<\/option><option value='1094' >Cherryvale Elementary<\/option><option value='1095' >Chestnut Oaks Middle<\/option><option value='1096' >Crestwood High School<\/option><option value='1097' >Crosswell Elementary-Sumter<\/option><option value='1098' >Ebenezer Middle<\/option><option value='1099' >F. J. Delaine Elementary<\/option><option value='1100' >Furman Middle<\/option><option value='1101' >High Hills Elementary<\/option><option value='1102' >Hillcrest Middle<\/option><option value='1103' >Kingsbury  Elementary<\/option><option value='1104' >Lakewood High  School<\/option><option value='1105' >Lemira Elementary<\/option><option value='1106' >Manchester Elementary<\/option><option value='1107' >Mayewood Middle<\/option><option value='1108' >Millwood Elementary<\/option><option value='1109' >Oakland Primary-Sumter<\/option><option value='1110' >Pocalla Springs Elementary<\/option><option value='1111' >R. E. Davis College Preperatory Academy<\/option><option value='1112' >Rafting Creek Elementary<\/option><option value='1113' >Shaw Heights Elementary<\/option><option value='1114' >Sumter Career and Technology Center<\/option><option value='1115' >Sumter High  School<\/option><option value='1116' >Wilder Elementary<\/option><option value='1117' >Willow Drive Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_182\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_182' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_182'>Union County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_182' id='input_9_182' class='large gfield_select'  aria-describedby=\"gfield_description_9_182\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1118' >Buffalo Elementary<\/option><option value='1119' >Foster Park Elementary<\/option><option value='1120' >Jonesville Elementary<\/option><option value='1121' >Jonesville Middle<\/option><option value='1122' >Lockhart School<\/option><option value='1123' >Lockhart School ANNEX<\/option><option value='1124' >Monarch Elementary-Union<\/option><option value='1125' >Sims Middle<\/option><option value='1126' >Union County Career and Technology Center<\/option><option value='1127' >Union County High School<\/option><\/select><\/div><\/div><div id=\"field_9_183\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_183' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_183'>Williamsburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_183' id='input_9_183' class='large gfield_select'  aria-describedby=\"gfield_description_9_183\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1445' >C. E. Murray Elementary School<\/option><option value='1129' >C.E. Murray Middle<\/option><option value='1130' >D.P. Cooper Charter<\/option><option value='1331' >Greeleyville Primary<\/option><option value='1132' >Hemingway Career and Technology Center<\/option><option value='1133' >Hemingway Elementary<\/option><option value='1134' >Hemingway High School<\/option><option value='1135' >Hemingway MB Lee Middle<\/option><option value='1136' >Kenneth Gardner Leadership Academy<\/option><option value='1137' >Kingstree High School<\/option><option value='1138' >Kingstree Middle Magnet<\/option><option value='1139' >W.M. Anderson Primary<\/option><option value='1140' >Williamsburg Co. Magnet School<\/option><\/select><\/div><\/div><div id=\"field_9_184\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_184' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_184'>Williamsburg Tech<\/div><div class='ginput_container ginput_container_select'><select name='input_184' id='input_9_184' class='large gfield_select'  aria-describedby=\"gfield_description_9_184\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1234' >Wmsbg Tec Voc Adult Ed Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_90\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_90' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_90'>Williston School District (Barnwell County 29)<\/div><div class='ginput_container ginput_container_select'><select name='input_90' id='input_9_90' class='large gfield_select'  aria-describedby=\"gfield_description_9_90\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='118' >Kelly Edwards Elementary<\/option><option value='119' >Williston-Elko High School<\/option><option value='120' >Williston-Elko Middle<\/option><\/select><\/div><\/div><div id=\"field_9_186\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_186' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_186'>York School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_186' id='input_9_186' class='large gfield_select'  aria-describedby=\"gfield_description_9_186\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1141' >Cotton Belt Elementary<\/option><option value='1142' >Floyd D. Johnson Technology Ctr<\/option><option value='1143' >Harold C. Johnson Elementary<\/option><option value='1144' >Hickory Grove-Sharon Elementary<\/option><option value='1145' >Hunter Street Elementary<\/option><option value='1146' >Jefferson Elementary-York 1<\/option><option value='1147' >York Comprehensive High School<\/option><option value='1148' >York Intermediate<\/option><option value='1149' >York Middle<\/option><\/select><\/div><\/div><div id=\"field_9_185\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_185' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_185'>York County School District Two\n<\/div><div class='ginput_container ginput_container_select'><select name='input_185' id='input_9_185' class='large gfield_select'  aria-describedby=\"gfield_description_9_185\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1150' >Bethany Elementary<\/option><option value='1151' >Bethel Elementary<\/option><option value='1284' >Blue Eagle Academy<\/option><option value='1152' >Clover High School<\/option><option value='1153' >Clover Middle<\/option><option value='1282' >Clover Ninth Grade Campus<\/option><option value='1154' >Crowders Creek Elem<\/option><option value='1155' >Griggs Road Elementary<\/option><option value='1156' >Kinard Elementary<\/option><option value='1157' >Larne Elementary<\/option><option value='1289' >Oakridge Elementary<\/option><option value='1158' >Oakridge Middle<\/option><\/select><\/div><\/div><div id=\"field_9_50\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n del Estudiante<\/h3><\/div><fieldset id=\"field_9_2\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name' id='input_9_2'>\n                            \n                            <span id='input_9_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_9_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_3' >Primeiro<\/label>\n                                                <\/span>\n                            <span id='input_9_2_4_container' class='name_middle' >\n                                                    <input type='text' name='input_2.4' id='input_9_2_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_2_4' >Meio<\/label>\n                                                <\/span>\n                            <span id='input_9_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_9_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_6' >Sobrenome<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_9_3\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Sexo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_3'>\n\t\t\t<div class='gchoice gchoice_9_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Male'  id='choice_9_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_0' id='label_9_3_0'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Female'  id='choice_9_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_1' id='label_9_3_1'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_10\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de Nacimiento del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_10' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_10_1_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_10_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_10_2_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_10_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_10_3_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_10_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_9_188\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_188' >Grado<\/label><div class='ginput_container ginput_container_text'><input name='input_188' id='input_9_188' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_189\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_189' >Maestra Tutora<\/label><div class='ginput_container ginput_container_text'><input name='input_189' id='input_9_189' type='text' value='' class='large'  aria-describedby=\"gfield_description_9_189\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_189'>Maestra tutora \/ \"Homeroom Teacher\"<\/div><\/div><div id=\"field_9_48\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_48' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_48' id='input_9_48' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_11\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_11' >Telefono de Casa<\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_9_11' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_75\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de correo electronico pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_9_75'>La Direccion de correo electronico debe ser valida ya que recibir\u00e1 una copia de la informaci\u00f3n enviada en el mismo<\/div><div class='ginput_complex ginput_container ginput_container_email' id='input_9_75_container'>\n                                <span id='input_9_75_1_container' class='ginput_left'>\n                                    <input class='' type='email' name='input_75' id='input_9_75' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75' >ingrese correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <span id='input_9_75_2_container' class='ginput_right'>\n                                    <input class='' type='email' name='input_75_2' id='input_9_75_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75_2' >Confirmar correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_9_5\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direcci\u00f3n del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_9_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_9_5_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_5_1' id='input_9_5_1_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_9_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_9_5_2' value=''   placeholder='Street 2'  aria-required='false'   \/>\n                                        <label for='input_9_5_2' id='input_9_5_2_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_9_5_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_5_3' id='input_9_5_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_5_4_container' >\n                                        <select name='input_5.4' id='input_9_5_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_5_4' id='input_9_5_4_label' class='hidden_sub_label screen-reader-text'>Provincia<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_9_5_5' value=''   placeholder='ZIP Code' aria-required='true'    \/>\n                                    <label for='input_9_5_5' id='input_9_5_5_label' class='hidden_sub_label screen-reader-text'>C\u00f3digo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_9_5_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_54' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_8\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Preguntas M\u00e9dicas<\/h3><\/div><div id=\"field_9_15\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_15' >Doctor del ni\u00f1o<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_9_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_13\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_13' >Dentista de ni\u00f1os<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_9_13' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_14\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de ultima limpieza dental<\/legend><div id='input_9_14' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_14_1_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_14_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_14_2_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_14_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_14_3_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_14_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><fieldset id=\"field_9_16\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfSu hijo tiene alergias?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_16'>\n\t\t\t<div class='gchoice gchoice_9_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Yes'  id='choice_9_16_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_16\"   \/>\n\t\t\t\t\t<label for='choice_9_16_0' id='label_9_16_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='No'  id='choice_9_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_16_1' id='label_9_16_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_9_16'>(incluyendo alimentos, medicamentos y\/o l\u00e1tex?)<\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_17\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_17' >En caso afirmativo, enumere<\/label><div class='gfield_description' id='gfield_description_9_17'>Por favor enum\u00e9relos aqu\u00ed. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_9_17' class='textarea medium'  aria-describedby=\"gfield_description_9_17\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_18\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez su hijo tuvo un reemplazo artificial de articulaci\u00f3n?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_18'>\n\t\t\t<div class='gchoice gchoice_9_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Yes'  id='choice_9_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_0' id='label_9_18_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='No'  id='choice_9_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_1' id='label_9_18_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_20\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez le han diagnosticado a su hijo fiebre reum\u00e1tica?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_20'>\n\t\t\t<div class='gchoice gchoice_9_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_9_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_0' id='label_9_20_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_9_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_1' id='label_9_20_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_21\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfTiene su hijo anemia de c\u00e9lulas falciformes o rasgo drepanoc\u00edtico?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_21'>\n\t\t\t<div class='gchoice gchoice_9_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_9_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_0' id='label_9_21_0'>Ninguno<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Trait'  id='choice_9_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_1' id='label_9_21_1'>rasgo falciforme<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Anemia'  id='choice_9_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_2' id='label_9_21_2'>anemia falciforme<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_25\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_25' >Problemas de Salud<\/label><div class='gfield_description' id='gfield_description_9_25'>Por favor utilice el siguiente espacio para enumerar cualquier otro problema grave de salud que su hijo haya tenido o tenga ahora.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_9_25' class='textarea medium'  aria-describedby=\"gfield_description_9_25\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_24\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_24' >Lista de Medicamentos<\/label><div class='gfield_description' id='gfield_description_9_24'>Haga una lista de todos los medicamentos, medicamentos de venta libre o suplementos herbales que su hijo est\u00e9 tomando en este momento.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_9_24' class='textarea medium'  aria-describedby=\"gfield_description_9_24\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_55' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_55' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_26\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informacion de pago<\/h3><div class='gsection_description' id='gfield_description_9_26'>DEBE verificar y completar y firmar en la parte inferior<\/div><\/div><fieldset id=\"field_9_72\" class=\"gfield gfield--width-third field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label'  >Informacion de pago<\/legend><div class='gfield_description' id='gfield_description_9_72'>Elige uno.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_72\"   \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0'>Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid and Insurance'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1'>Seguro Privado y Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Private Insurance'  id='choice_9_72_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_2' id='label_9_72_2'>Seguro Privado<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Self-pay\/no insurance'  id='choice_9_72_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_3' id='label_9_72_3'>No tengo seguro\/Soy responsable del pago<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 8;\"><\/div><div id=\"field_9_71\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_71' >Numero de MEDICAID<\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_9_71' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_71\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_71'>N\u00famero individual de 10 d\u00edgitos del NI\u00d1O(A) - NO EL # DE PLAN.<\/div><\/div><div id=\"field_9_61\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado y Medicaid<\/h3><\/div><fieldset id=\"field_9_58\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian que tiene seguro<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_58'>\n                            \n                            <span id='input_9_58_3_container' class='name_first' >\n                                                    <input type='text' name='input_58.3' id='input_9_58_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_58_6_container' class='name_last' >\n                                                    <input type='text' name='input_58.6' id='input_9_58_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_63\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_63' >Nombre de la seguro compania<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_9_63' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_65\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_65' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_65' id='input_9_65' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_66\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado<\/h3><\/div><div id=\"field_9_148\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_148' >Nombre de la compania para la cual trabaja el pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_9_148' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_67\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de Padre o Guardian asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_67' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_67_1_container' >\n                                        <input type='text' name='input_67.1' id='input_9_67_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_67_1' id='input_9_67_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_67_3_container' >\n                                    <input type='text' name='input_67.3' id='input_9_67_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_67_3' id='input_9_67_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_67_4_container' >\n                                        <select name='input_67.4' id='input_9_67_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_67_4' id='input_9_67_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_67_5_container' >\n                                    <input type='text' name='input_67.5' id='input_9_67_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_67_5' id='input_9_67_5_label' class='hidden_sub_label screen-reader-text'>Codigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_67.6' id='input_9_67_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_78\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_78' >N\u00famero de seguridad social<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_9_78' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_35\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre de la empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_35' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_35_1_container' >\n                                        <input type='text' name='input_35.1' id='input_9_35_1' value=''   placeholder='Street' aria-required='true'    \/>\n                                        <label for='input_9_35_1' id='input_9_35_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_35_3_container' >\n                                    <input type='text' name='input_35.3' id='input_9_35_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_35_3' id='input_9_35_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_35_4_container' >\n                                        <select name='input_35.4' id='input_9_35_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_35_4' id='input_9_35_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_35_5_container' >\n                                    <input type='text' name='input_35.5' id='input_9_35_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_35_5' id='input_9_35_5_label' class='hidden_sub_label screen-reader-text'>Condigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_35.6' id='input_9_35_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_147\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_147' >Numero de Seguro<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_9_147' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_79\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_79' >Identificaci\u00f3n # del grupo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_9_79' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_69\" class=\"gfield gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de nacimiento de padre o guardian que esta asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_69' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_69_1_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_69_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_69_2_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_69_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_69_3_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_69_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_37\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_37' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_37' id='input_9_37' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_80\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_80' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_80' id='input_9_80' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_80\"  \/><\/div><div class='gfield_description' id='gfield_description_9_80'>Vuelva a confirmar su n\u00famero de tel\u00e9fono celular; nos pondremos en contacto con usted antes del servicio.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_74' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_74' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_70\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent Section<\/h3><\/div><div id=\"field_9_44\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Parent Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_44'>I agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022\u00a0Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_150\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Financial Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_150'>I understand if my child is not eligible for Medicaid or private insurance coverage, I am financially responsible and agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022 Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_38\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent<\/h3><div class='gsection_description' id='gfield_description_9_38'><b>Printed name is considered legal signature.<\/b>\n\n\nSolicito y autorizo a HPS, a sus odont\u00f3logos contratantes y al personal, debidamente autorizado como Doctores en Odontolog\u00eda o higienistas dentales con licencia, a realizar cualquier procedimiento de diagn\u00f3stico, procedimientos preventivos o procedimientos de tratamiento para mi hijo. <br>Entiendo que los servicios preventivos no reemplazan un examen realizado por un dentista con licencia. Entiendo que las fotos pueden tomarse con fines educativos. <br>Adem\u00e1s, entiendo que si mi hijo no est\u00e1 inscrito en Medicaid, soy financieramente responsable ante HPS por los servicios prestados. <br>Autorizo el pago de Medicaid o beneficios de seguro directamente a HPS y sus dentistas asociados. Solicito y autorizo la divulgaci\u00f3n de cualquier informaci\u00f3n en este formulario o adquirida en el transcurso del tratamiento para fines de pago, referencia, y para todo el personal escolar apropiado y SC ORS y SC DHEC, seg\u00fan lo considere necesario por HPS. La firma da permiso para que el informe se env\u00ede por correo electr\u00f3nico o mensaje de texto. <br><b>El nombre impreso del padre o guardian se considera firma.<\/b><\/div><\/div><fieldset id=\"field_9_39\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_39'>\n                            \n                            <span id='input_9_39_3_container' class='name_first' >\n                                                    <input type='text' name='input_39.3' id='input_9_39_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_39_6_container' class='name_last' >\n                                                    <input type='text' name='input_39.6' id='input_9_39_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_41\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_41' >Firma impresa<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_9_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_42\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_42' >Relacion hacia el ni\u00f1o(a)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_9_42' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button button' value='Previous'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' value='WyJ7XCI3MlwiOltcIjdlMDY1ZTAyYjU1YjBmOTcxNDUxN2MyYzZhNGEyNzMzXCIsXCJmMTEyNDUwMjlmOTk5ZDZhOTVmYThlMDA1ZWVkMWZkM1wiLFwiMWRkOWM3MDczY2VhODVlYTM0NDU5YWFiYjVkZjQ0ZTdcIixcIjhiZDBiMzgzZWZjZGY1Njg3NTUwMzE0ZGJkMTE2MjM4XCJdfSIsIjI2YjE2ZmRiOThhZTJlODM2ZWFmNmJjMDNiNWI0YzU3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Consentimiento para Servicios<\/h2>\n                            <span class='gform_description'>Este formulario nos da permiso para tratar a su hijo. Los datos se mantienen confidenciales y se usan solo para el tratamiento y la facturaci\u00f3n, de acuerdo con las leyes estatales y federales. Si la informaci\u00f3n cambia antes del tratamiento, comun\u00edquese con nosotros.<\/span>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/es\/wp-json\/wp\/v2\/pages\/1224#gf_9' novalidate><div id='gf_page_steps_9' class='gf_page_steps'><div id='gf_step_9_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Secci\u00f3n de informaci\u00f3n del estudiante<\/span><\/div><div id='gf_step_9_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Secci\u00f3n M\u00e9dica<\/span><\/div><div id='gf_step_9_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Secci\u00f3n de pago<\/span><\/div><div id='gf_step_9_4' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Firmar y Consentimiento<\/span><\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_9_1' class='gform_page' >\n                                    <div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_9\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n de la Escuela<\/h3><\/div><div id=\"field_9_46\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_46' >Distrito escolar<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_46' id='input_9_46' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County School District<\/option><option value='2' >Aiken County Public Schools<\/option><option value='3' >Allendale County Schools<\/option><option value='10' >Anderson 1 &amp; 2 AVC<\/option><option value='9' >Anderson Alternative School District<\/option><option value='4' >Anderson School District One<\/option><option value='5' >Anderson School District Two<\/option><option value='6' >Anderson School District Three<\/option><option value='7' >Anderson County School District 4<\/option><option value='8' >Anderson School District Five<\/option><option value='11' >Bamberg School District<\/option><option value='16' >Barnwell County AVC<\/option><option value='15' >Barnwell School District 45<\/option><option value='17' >Beaufort County School District<\/option><option value='18' >Beaufort-Jasper Career Center<\/option><option value='19' >Berkeley County School District<\/option><option value='13' >Blackville-Hilda Public Schools<\/option><option value='20' >Calhoun County Public Schools<\/option><option value='21' >Charleston County School District<\/option><option value='105' >Charter Institute at Erskine<\/option><option value='22' >Cherokee County School District<\/option><option value='23' >Chester County School District<\/option><option value='24' >Chesterfield County School District<\/option><option value='25' >Clarendon County School District One<\/option><option value='26' >Clarendon County School District Two<\/option><option value='27' >Clarendon County School District Three<\/option><option value='29' >Colleton County School District<\/option><option value='72' >Cope Area Career Center<\/option><option value='84' >Daniel Morgan Vocational Center<\/option><option value='30' >Darlington County School District<\/option><option value='33' >Dillon County Applied Tech Center<\/option><option value='31' >Dillon School District Three<\/option><option value='32' >Dillon School District Four<\/option><option value='36' >Dorchester County Career School<\/option><option value='34' >Dorchester County School District Two<\/option><option value='35' >Dorchester County School District Four<\/option><option value='37' >Edgefield County School District<\/option><option value='28' >F E Dubose Vocational Center<\/option><option value='38' >Fairfield County School District<\/option><option value='96' >Felton Laboratory School<\/option><option value='39' >Florence School District One<\/option><option value='40' >Florence School District Two<\/option><option value='41' >Florence School District Three<\/option><option value='42' >Florence School District Four<\/option><option value='43' >Florence School District Five<\/option><option value='93' >Fort Mill School District<\/option><option value='44' >Georgetown County School District<\/option><option value='108' >GLEAMNS Human Resources Commission, Inc.<\/option><option value='102' >Governor&#039;s School for Math and Science<\/option><option value='101' >Governor&#039;s School for the Arts and Humanities<\/option><option value='45' >Greenville County School District<\/option><option value='49' >Greenwood County Career Center<\/option><option value='46' >Greenwood County School District 50<\/option><option value='47' >Greenwood County School District 51<\/option><option value='48' >Greenwood County School District 52<\/option><option value='86' >H B Swofford AVC<\/option><option value='50' >Hampton County School District One<\/option><option value='51' >Hampton County School District Two<\/option><option value='52' >Horry County Schools<\/option><option value='53' >Jasper County School District<\/option><option value='97' >John De La Howe<\/option><option value='99' >Juvenile Justice Schools<\/option><option value='54' >Kershaw County School District<\/option><option value='55' >Lancaster County School District<\/option><option value='56' >Laurens County School District No. 55<\/option><option value='57' >Laurens County School District 56<\/option><option value='58' >Lee County School District<\/option><option value='63' >Lexington and Richland School District Five<\/option><option value='59' >Lexington County School District One<\/option><option value='60' >Lexington County School District Two<\/option><option value='61' >Lexington County School District Three<\/option><option value='62' >Lexington County School District Four<\/option><option value='103' >Marion County School District<\/option><option value='66' >Marlboro County School District<\/option><option value='64' >McCormick County School District<\/option><option value='110' >Movement School<\/option><option value='67' >Newberry County School District<\/option><option value='68' >Oconee County School District<\/option><option value='71' >Orangeburg County School District<\/option><option value='100' >Palmetto Unified<\/option><option value='104' >Pee Dee Head Starts<\/option><option value='73' >Pickens County School District<\/option><option value='85' >R D Anderson Applied Technology Center<\/option><option value='74' >Richland County School District One<\/option><option value='75' >Richland County School District Two<\/option><option value='92' >Rock Hill School District Three of York County<\/option><option value='76' >Saluda County School District One<\/option><option value='94' >SC Public School Charter District<\/option><option value='98' >SC School for the Deaf and Blind<\/option><option value='107' >Share Community Action Partnership<\/option><option value='77' >Spartanburg County School District One<\/option><option value='78' >Spartanburg County School District Two<\/option><option value='79' >Spartanburg County School District Three<\/option><option value='80' >Spartanburg County School District Four<\/option><option value='81' >Spartanburg County School District Five<\/option><option value='82' >Spartanburg County School District Six<\/option><option value='83' >Spartanburg County School District Seven<\/option><option value='87' >Sumter School District<\/option><option value='88' >Union County School District<\/option><option value='89' >Williamsburg County School District<\/option><option value='95' >Williamsburg Tech<\/option><option value='14' >Williston School District 29<\/option><option value='90' >York School District One<\/option><option value='91' >York County School District Two<\/option><\/select><\/div><\/div><div id=\"field_9_51\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_51' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_51'>Abbeville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_51' id='input_9_51' class='large gfield_select'  aria-describedby=\"gfield_description_9_51\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County Career Center<\/option><option value='2' >Abbeville High School<\/option><option value='3' >Cherokee Trail Elementary<\/option><option value='4' >Diamond Hill Elementary<\/option><option value='5' >Dixie High School<\/option><option value='6' >John C. Calhoun Elementary<\/option><option value='7' >Long Cane Primary<\/option><option value='8' >Westwood Elementary<\/option><option value='9' >Wright Middle<\/option><\/select><\/div><\/div><div id=\"field_9_52\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_52' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_52'>Aiken County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_52' id='input_9_52' class='large gfield_select'  aria-describedby=\"gfield_description_9_52\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='10' >Aiken County Career Center<\/option><option value='11' >Aiken High School<\/option><option value='12' >Aiken Middle<\/option><option value='13' >Aiken Performing Arts Academy Charter<\/option><option value='14' >Belvedere Elementary<\/option><option value='15' >Busbee Corbett Elementary Middle<\/option><option value='16' >Byrd Elementary<\/option><option value='17' >Chukker Creek Elementary<\/option><option value='18' >Clearwater Elementary<\/option><option value='19' >East Aiken School of the Arts<\/option><option value='20' >Gloverville Elementary<\/option><option value='21' >Greendale Elementary<\/option><option value='22' >Hammond Hill Elementary<\/option><option value='23' >Horse Creek Academy<\/option><option value='24' >J. D. Lever Elementary<\/option><option value='25' >Jackson Middle<\/option><option value='27' >Langley-Bath-Clearwater Middle<\/option><option value='28' >Leavelle McCampbell Middle<\/option><option value='29' >Lloyd-Kennedy Charter<\/option><option value='30' >M. B. Kennedy Middle<\/option><option value='31' >Midland Valley High School<\/option><option value='32' >Millbrook Elementary<\/option><option value='33' >Mossy Creek Elementary<\/option><option value='34' >New Ellenton Middle<\/option><option value='35' >North Aiken Elementary<\/option><option value='36' >North Augusta Elementary<\/option><option value='37' >North Augusta High School<\/option><option value='38' >North Augusta Middle<\/option><option value='39' >Oakwood-Windsor Elementary<\/option><option value='40' >Paul Knox Middle<\/option><option value='41' >Redcliffe Elementary<\/option><option value='42' >Ridge Spring Monetta Elementary<\/option><option value='43' >Ridge Spring-Monetta Middle High School<\/option><option value='44' >Schofield Middle<\/option><option value='45' >Silver Bluff High School<\/option><option value='46' >South Aiken High School<\/option><option value='47' >Wagener-Salley High School<\/option><option value='48' >Warrenville Elementary<\/option><option value='324' >Jefferson Elementary-Aiken<\/option><\/select><\/div><\/div><div id=\"field_9_53\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_53' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_53'>Allendale County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_53' id='input_9_53' class='large gfield_select'  aria-describedby=\"gfield_description_9_53\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='49' >Allendale Elementary<\/option><option value='50' >Allendale Fairfax High School<\/option><option value='51' >Allendale-Fairfax Middle<\/option><option value='52' >Fairfax Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_81\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_81' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_81'>Anderson School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_81' id='input_9_81' class='large gfield_select'  aria-describedby=\"gfield_description_9_81\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='53' >Cedar Grove Elementary<\/option><option value='54' >Concrete Primary<\/option><option value='55' >Hunt Meadows Elementary<\/option><option value='56' >Palmetto Elementary<\/option><option value='57' >Palmetto High School<\/option><option value='58' >Palmetto Middle<\/option><option value='59' >Powdersville Elementary<\/option><option value='60' >Powdersville High School<\/option><option value='61' >Powdersville Middle<\/option><option value='62' >Spearman Elementary<\/option><option value='63' >West Pelzer Elementary<\/option><option value='64' >Wren Elementary<\/option><option value='65' >Wren High School<\/option><option value='66' >Wren Middle<\/option><\/select><\/div><\/div><div id=\"field_9_82\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_82' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_82'>Anderson School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_82' id='input_9_82' class='large gfield_select'  aria-describedby=\"gfield_description_9_82\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='67' >Belton Elementary<\/option><option value='68' >Belton Honea Path High School<\/option><option value='69' >Belton Middle<\/option><option value='70' >Honea Path Elementary<\/option><option value='71' >Honea Path Middle<\/option><option value='72' >Marshall Primary<\/option><option value='73' >Wright Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_83\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_83' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_83'>Anderson School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_83' id='input_9_83' class='large gfield_select'  aria-describedby=\"gfield_description_9_83\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='74' >Crescent High School<\/option><option value='75' >Flat Rock Elementary<\/option><option value='76' >Iva Elementary<\/option><option value='77' >Starr Elementary<\/option><option value='78' >Starr-Iva Middle<\/option><\/select><\/div><\/div><div id=\"field_9_84\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_84' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_84'>Anderson County School District 4<\/div><div class='ginput_container ginput_container_select'><select name='input_84' id='input_9_84' class='large gfield_select'  aria-describedby=\"gfield_description_9_84\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='79' >La France Elementary<\/option><option value='80' >Mt. Lebanon Elementary<\/option><option value='81' >Pendleton Elementary<\/option><option value='82' >Pendleton High School<\/option><option value='83' >Riverside Middle-Anderson<\/option><option value='84' >Townville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_85\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_85' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_85'>Anderson School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_85' id='input_9_85' class='large gfield_select'  aria-describedby=\"gfield_description_9_85\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='85' >Anderson  Five Charter School<\/option><option value='86' >Anderson Five Career Campus<\/option><option value='1291' >Anderson Institute of Technology<\/option><option value='87' >Calhoun Academy of the Arts<\/option><option value='88' >Centerville Elementary-Anderson 5<\/option><option value='89' >Concord Elementary<\/option><option value='90' >Glenview Middle<\/option><option value='91' >Homeland Park Primary<\/option><option value='92' >Lakeside Middle<\/option><option value='93' >McCants Middle<\/option><option value='94' >McLees Elementary<\/option><option value='95' >Midway Elementary School of Science and Engineering<\/option><option value='96' >Nevitt Forest Elementary<\/option><option value='97' >New Prospect Elementary<\/option><option value='98' >North Pointe Elementary<\/option><option value='99' >Robert Anderson Middle<\/option><option value='100' >South Fant School of Early Education<\/option><option value='101' >Southwood Academy of the Arts<\/option><option value='102' >T. L. Hanna High School<\/option><option value='103' >Varennes Elementary<\/option><option value='104' >West Market School of Early Education<\/option><option value='105' >Westside High School<\/option><option value='106' >Whitehall Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_86\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_86' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_86'>Anderson 1 & 2 AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_86' id='input_9_86' class='large gfield_select'  aria-describedby=\"gfield_description_9_86\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='108' >Career Tec Ctr Anderson1&amp;2<\/option><\/select><\/div><\/div><div id=\"field_9_187\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_187' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_187'>Renaissance Academy<\/div><div class='ginput_container ginput_container_select'><select name='input_187' id='input_9_187' class='large gfield_select'  aria-describedby=\"gfield_description_9_187\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='107' >Renaissance Academy<\/option><\/select><\/div><\/div><div id=\"field_9_87\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_87' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_87'>Bamberg School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_87' id='input_9_87' class='large gfield_select'  aria-describedby=\"gfield_description_9_87\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='109' >Bamberg-Ehrhardt High School<\/option><option value='110' >Bamberg-Ehrhardt Middle<\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><option value='111' >Richard Carroll Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_88\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_88' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_88'>Bamberg School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_88' id='input_9_88' class='large gfield_select'  aria-describedby=\"gfield_description_9_88\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><\/select><\/div><\/div><div id=\"field_9_91\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_91' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_91'>Barnwell School District 45<\/div><div class='ginput_container ginput_container_select'><select name='input_91' id='input_9_91' class='large gfield_select'  aria-describedby=\"gfield_description_9_91\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='121' >Barnwell Elementary<\/option><option value='122' >Barnwell High School<\/option><option value='123' >Barnwell Primary<\/option><option value='124' >Guinyard-Butler Middle<\/option><\/select><\/div><\/div><div id=\"field_9_92\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_92' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_92'>Barnwell County AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_92' id='input_9_92' class='large gfield_select'  aria-describedby=\"gfield_description_9_92\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='125' >Barnwell County Career Centertr<\/option><\/select><\/div><\/div><div id=\"field_9_93\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_93' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_93'>Beaufort County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_93' id='input_9_93' class='large gfield_select'  aria-describedby=\"gfield_description_9_93\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='126' >Battery Creek High School<\/option><option value='127' >Beaufort Elementary<\/option><option value='128' >Beaufort High School<\/option><option value='129' >Beaufort Middle<\/option><option value='130' >Bluffton Elementary<\/option><option value='131' >Bluffton High School<\/option><option value='132' >Bluffton Middle<\/option><option value='133' >Broad River Elementary<\/option><option value='134' >Coosa Elementary<\/option><option value='135' >Daufuskie Elem. ANNEX<\/option><option value='136' >H. E. McCracken Middle<\/option><option value='137' >Hilton Head Island Early Childhood Center<\/option><option value='138' >Hilton Head Island Elementary<\/option><option value='139' >Hilton Head Island Elementary School for the Creative Arts<\/option><option value='140' >Hilton Head Island High School<\/option><option value='141' >Hilton Head Island Middle<\/option><option value='142' >Joseph S. Shanklin Elementary<\/option><option value='143' >Lady&#039;s Island Elementary<\/option><option value='144' >Lady&#039;s Island Middle<\/option><option value='145' >Michael C. Riley Elementary<\/option><option value='146' >Mossy Oaks Elementary<\/option><option value='147' >Okatie Elementary<\/option><option value='148' >Port Royal Elementary<\/option><option value='149' >Pritchardville Elementary<\/option><option value='150' >Red Cedar Elementary<\/option><option value='151' >Right Choice  School<\/option><option value='152' >River Ridge Academy<\/option><option value='153' >Riverview Charter School<\/option><option value='154' >Robert Smalls International Academy<\/option><option value='155' >St. Helena Elementary<\/option><option value='156' >Whale Branch Early College High School<\/option><option value='157' >Whale Branch Elementary<\/option><option value='158' >Whale Branch Middle<\/option><\/select><\/div><\/div><div id=\"field_9_95\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_95' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_95'>Beaufort-Jasper Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_95' id='input_9_95' class='large gfield_select'  aria-describedby=\"gfield_description_9_95\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='159' >Beaufort-Jasper Academy For Ex<\/option><\/select><\/div><\/div><div id=\"field_9_94\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_94' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_94'>Berkeley County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_94' id='input_9_94' class='large gfield_select'  aria-describedby=\"gfield_description_9_94\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='160' >Berkeley County Middle College High School<\/option><option value='161' >Berkeley Elementary<\/option><option value='162' >Berkeley High School<\/option><option value='163' >Berkeley Intermediate<\/option><option value='164' >Berkeley Middle<\/option><option value='165' >Boulder Bluff Elementary<\/option><option value='1285' >Bowen&#039;s Corner Elementary<\/option><option value='166' >Cainhoy Elementary Middle<\/option><option value='167' >Cane Bay Elementary<\/option><option value='168' >Cane Bay High School<\/option><option value='169' >Cane Bay Middle<\/option><option value='1443' >Carolyn Lewis School<\/option><option value='170' >College Park Elementary<\/option><option value='171' >College Park Middle<\/option><option value='172' >Cross Elementary<\/option><option value='173' >Cross High School<\/option><option value='174' >Daniel Island School<\/option><option value='175' >Devon Forest Elementary<\/option><option value='1286' >Foxbank Elementary<\/option><option value='176' >Goose Creek High School<\/option><option value='177' >Goose Creek Elementary<\/option><option value='178' >Hanahan Elementary<\/option><option value='179' >Hanahan High School<\/option><option value='180' >Hanahan Middle<\/option><option value='181' >Henry E. Bonner Elementary<\/option><option value='182' >Howe Hall AIMS Elementary<\/option><option value='183' >J. K. Gourdin Elementary<\/option><option value='184' >Macedonia Middle<\/option><option value='185' >Marrington Elementary<\/option><option value='186' >Marrington Middle School of the Arts<\/option><option value='191' >Mount Holly Elementary (formerly Sedgefield Intermediate)<\/option><option value='163' >Moncks Corner Elementary<\/option><option value='187' >Nexton Elementary<\/option><option value='1268' >Philip Simmons Elementary<\/option><option value='1269' >Phillip Simmons Middle<\/option><option value='188' >Sangaree Elementary<\/option><option value='189' >Sangaree Intermediate<\/option><option value='190' >Sangaree Middle<\/option><option value='192' >Sedgefield Middle<\/option><option value='193' >St. Stephen Elementary<\/option><option value='194' >St. Stephen Middle<\/option><option value='195' >Stratford High School<\/option><option value='196' >Timberland High  School<\/option><option value='197' >Westview Elementary<\/option><option value='198' >Westview Middle<\/option><option value='199' >Westview Primary<\/option><option value='200' >Whitesville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_89\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_89' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_89'>Blackville-Hilda Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_89' id='input_9_89' class='large gfield_select'  aria-describedby=\"gfield_description_9_89\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='115' >Blackville-Hilda High School<\/option><option value='116' >Blackville-Hilda Junior High<\/option><option value='117' >Macedonia Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_96\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_96' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_96'>Calhoun County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_96' id='input_9_96' class='large gfield_select'  aria-describedby=\"gfield_description_9_96\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='201' >Calhoun County High School<\/option><option value='202' >Sandy Run School<\/option><option value='203' >St. Matthews K-8 School<\/option><\/select><\/div><\/div><div id=\"field_9_97\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_97' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_97'>Charleston County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_97' id='input_9_97' class='large gfield_select'  aria-describedby=\"gfield_description_9_97\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='204' >A. C. Corcoran Elementary<\/option><option value='205' >Academic Magnet High School<\/option><option value='206' >Allegro Charter School of Music<\/option><option value='207' >Angel Oak Elementary<\/option><option value='208' >Ashley River Creative Arts Elementary<\/option><option value='209' >Baptist Hill High School<\/option><option value='210' >Belle Hall Elementary<\/option><option value='211' >Buist Academy<\/option><option value='212' >Burke High School<\/option><option value='213' >C.E. Williams Middle School<\/option><option value='235' >Camp Middle<\/option><option value='1276' >Cape Romain Environmental Charter School<\/option><option value='1278' >Carolina Park Elementary School<\/option><option value='214' >Carolina Voyager Charter<\/option><option value='215' >Charles Pinckney Elementary<\/option><option value='216' >Charleston Charter School for Math and Science<\/option><option value='217' >Charleston Development Academy Public Charter School<\/option><option value='218' >Charleston Progressive Academy<\/option><option value='219' >Charleston School Of The Arts<\/option><option value='220' >Chicora Elementary School<\/option><option value='1272' >Daniel Jenkins Academy<\/option><option value='221' >Drayton Hall Elementary School<\/option><option value='222' >E.B. Ellington Elementary School<\/option><option value='223' >East Cooper Center for Advanced Studies<\/option><option value='224' >Edith L. Frierson Elementary<\/option><option value='225' >Edmund A. Burns Elementary<\/option><option value='226' >Fort Johnson Middle<\/option><option value='227' >Garrett Academy of Technology<\/option><option value='228' >Greg Mathis Charter High School<\/option><option value='229' >Harbor View Elementary<\/option><option value='230' >Haut Gap Middle<\/option><option value='231' >Hunley Park Elementary<\/option><option value='232' >James B. Edwards Elementary<\/option><option value='233' >James Island Charter High School<\/option><option value='234' >James Island Elementary<\/option><option value='236' >James Simons Montessori School<\/option><option value='237' >Jane Edwards Elementary<\/option><option value='238' >Jennie Moore Elementary<\/option><option value='239' >Jerry Zucker Middle School of Science<\/option><option value='240' >Ladson Elementary<\/option><option value='241' >Laing Middle School of Science and Technology<\/option><option value='242' >Lambs Elementary School<\/option><option value='243' >Laurel Hill Primary<\/option><option value='1267' >Liberty Hill Academy<\/option><option value='244' >Lincoln High School<\/option><option value='245' >Malcolm C. Hursey Elementary<\/option><option value='246' >Mamie Whitesides Elementary<\/option><option value='247' >Mary Ford Early Learning &amp; Family Center<\/option><option value='248' >Matilda Dunston Elementary<\/option><option value='1270' >Meeting Street Academy<\/option><option value='249' >Meeting Street Elementary at Brentwood<\/option><option value='250' >Memminger School of Global Studies<\/option><option value='251' >Midland Park Primary<\/option><option value='252' >Military Magnet Academy<\/option><option value='253' >Minnie Hughes Elementary<\/option><option value='254' >Mitchell Elementary<\/option><option value='255' >Montessori Community School<\/option><option value='256' >Morningside Middle<\/option><option value='257' >Morningside Middle ANNEX<\/option><option value='258' >Moultrie Middle<\/option><option value='259' >Mt. Pleasant Academy<\/option><option value='260' >Mt. Zion Elementary<\/option><option value='261' >Murray LaSaine Elementary<\/option><option value='262' >North Charleston Creative Arts Elementary<\/option><option value='263' >North Charleston Elementary<\/option><option value='264' >North Charleston High School<\/option><option value='265' >Northwoods Middle<\/option><option value='1037' >Oakland Elementary-Charleston<\/option><option value='267' >Orange Grove Elementary Charter<\/option><option value='268' >Pattison&#039;s Academy for Comprehensive Education<\/option><option value='269' >Pepperhill Elementary<\/option><option value='270' >Pinehurst Elementary<\/option><option value='271' >R. B. Stall High School<\/option><option value='272' >Sanders-Clyde Elementary<\/option><option value='1261' >Septima Clarke Alternative<\/option><option value='273' >Simmons Pinckney Middle<\/option><option value='274' >Springfield Elementary<\/option><option value='275' >St. Andrew&#039;s School of Math and Science<\/option><option value='276' >St. James Santee Elementary<\/option><option value='277' >St. John&#039;s High School<\/option><option value='278' >Stiles Point Elementary<\/option><option value='279' >Stono Park Elementary<\/option><option value='280' >Sullivan&#039;s Island Elementary<\/option><option value='281' >Thomas C. Cario Middle<\/option><option value='282' >W. B. Goodwin Elementary<\/option><option value='283' >Wando High School<\/option><option value='284' >West Ashley High School<\/option><option value='285' >West Ashley Middle<\/option><option value='1271' >West Ashley Advanced Study Magnet<\/option><\/select><\/div><\/div><div id=\"field_9_151\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_151' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_151'>Charter Institute at Erskine<\/div><div class='ginput_container ginput_container_select'><select name='input_151' id='input_9_151' class='large gfield_select'  aria-describedby=\"gfield_description_9_151\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1299' >Belton Preparatory Academy<\/option><option value='1300' >Berkeley Preparatory Academy<\/option><option value='1301' >Brashier Middle College Charter School<\/option><option value='1302' >Calhoun Falls Charter School<\/option><option value='1303' >Cherokee Charter Academy<\/option><option value='1304' >Clear Dot Charter School<\/option><option value='1305' >Coastal Leadership Academy<\/option><option value='1306' >Cyber Academy of SC<\/option><option value='1307' >Gates School<\/option><option value='1308' >Gray Collegiate Academy<\/option><option value='1309' >Horse Creek Academy<\/option><option value='1310' >Legion Collegiate Academy<\/option><option value='1311' >Lowcountry Leadership Charter School<\/option><option value='1312' >Lowcountry Connections Academy<\/option><option value='1313' >Mevers School of Excellence<\/option><option value='1218' >Midlands STEM Institute<\/option><option value='1316' >Oceanside Collegiate Academy<\/option><option value='1317' >Odyssey Online Learning<\/option><option value='1318' >Royal Live Oaks Academy<\/option><option value='1319' >South Carolina Connections Academy<\/option><option value='1320' >SC Preparatory Academy<\/option><option value='1321' >South Carolina Virtual Charter School<\/option><option value='1322' >Summit Classical School<\/option><option value='1315' >The Montessori School of Camden<\/option><option value='1323' >Thornwell Charter School<\/option><option value='1324' >Virtus Academy of South Carolina<\/option><\/select><\/div><\/div><div id=\"field_9_98\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_98' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_98'>Cherokee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_98' id='input_9_98' class='large gfield_select'  aria-describedby=\"gfield_description_9_98\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='286' >Alma Elementary<\/option><option value='287' >B. D. Lee Elementary<\/option><option value='288' >Blacksburg Elementary<\/option><option value='289' >Blacksburg High School<\/option><option value='290' >Blacksburg Middle<\/option><option value='291' >Blacksburg Primary<\/option><option value='292' >Cherokee Technology Center<\/option><option value='293' >Corinth Elementary<\/option><option value='294' >Draytonville Elementary<\/option><option value='295' >Gaffney High School<\/option><option value='296' >Gaffney Middle<\/option><option value='297' >Goucher Elementary<\/option><option value='298' >Granard Middle<\/option><option value='299' >Grassy Pond Elementary<\/option><option value='300' >John E. Ewing Middle<\/option><option value='301' >Limestone-Central Elementary<\/option><option value='302' >Luther L. Vaughan  Elementary<\/option><option value='303' >Mary Bramlett Elementary<\/option><option value='304' >Northwest Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_99\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_99' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_99'>Chester County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_99' id='input_9_99' class='large gfield_select'  aria-describedby=\"gfield_description_9_99\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='305' >Academy for Teaching and Learning  K-8<\/option><option value='306' >Chester County Career Center<\/option><option value='307' >Chester Middle<\/option><option value='308' >Chester Park Elementary of Inquiry<\/option><option value='309' >Chester Park Elementary School for the Arts<\/option><option value='310' >Chester Park Elementary School of Literacy and Technology<\/option><option value='311' >Chester Senior High School<\/option><option value='312' >Great Falls Elementary<\/option><option value='313' >Great Falls High School<\/option><option value='314' >Lewisville Elementary<\/option><option value='315' >Lewisville High School<\/option><option value='316' >Lewisville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_100\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_100' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_100'>Chesterfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_100' id='input_9_100' class='large gfield_select'  aria-describedby=\"gfield_description_9_100\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='317' >Central High School<\/option><option value='1274' >Cheraw Headstart<\/option><option value='318' >Cheraw High School<\/option><option value='319' >Cheraw Intermediate<\/option><option value='320' >Cheraw Primary<\/option><option value='321' >Chesterfield High School<\/option><option value='322' >Chesterfield-Ruby Middle<\/option><option value='323' >Edwards Elementary<\/option><option value='26' >Jefferson Elementary-Chesterfield<\/option><option value='325' >Long Middle<\/option><option value='326' >McBee Elementary<\/option><option value='1262' >McBee HeadStart<\/option><option value='327' >McBee High School<\/option><option value='328' >New Heights Middle<\/option><option value='329' >Pageland Elementary<\/option><option value='330' >Petersburg Primary<\/option><option value='331' >Plainview Elementary<\/option><option value='332' >Ruby Elementary<\/option><option value='1263' >Ruby HeadStart<\/option><option value='1296' >Pageland Headstart<\/option><\/select><\/div><\/div><div id=\"field_9_101\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_101' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_101'>Clarendon County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_101' id='input_9_101' class='large gfield_select'  aria-describedby=\"gfield_description_9_101\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='333' >Scott&#039;s Branch High School<\/option><option value='334' >Scott&#039;s Branch Middle<\/option><option value='335' >St. Paul Elementary<\/option><option value='336' >Summerton Early Childhood Center<\/option><\/select><\/div><\/div><div id=\"field_9_102\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_102' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_102'>Clarendon County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_102' id='input_9_102' class='large gfield_select'  aria-describedby=\"gfield_description_9_102\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='337' >Manning Early Childhood Center<\/option><option value='338' >Manning Elementary<\/option><option value='339' >Manning High School<\/option><option value='340' >Manning Junior High<\/option><option value='341' >Manning Primary<\/option><option value='342' >Phoenix Charter High School<\/option><\/select><\/div><\/div><div id=\"field_9_103\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_103' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_103'>Clarendon County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_103' id='input_9_103' class='large gfield_select'  aria-describedby=\"gfield_description_9_103\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='343' >East Clarendon Middle-High School<\/option><option value='344' >Walker-Gamble Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_105\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_105' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_105'>Colleton County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_105' id='input_9_105' class='large gfield_select'  aria-describedby=\"gfield_description_9_105\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='346' >Bells Elementary<\/option><option value='347' >Black Street Early Childhood Center<\/option><option value='348' >Colleton County High School<\/option><option value='349' >Colleton County Middle<\/option><option value='350' >Cottageville Elementary<\/option><option value='351' >Forest Hills Elementary<\/option><option value='352' >Hendersonville Elementary<\/option><option value='353' >Northside Elementary-Colleton<\/option><option value='354' >Thunderbolt Career and Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_152\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_152' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_152'>Cope Area Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_152' id='input_9_152' class='large gfield_select'  aria-describedby=\"gfield_description_9_152\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='902' >Cope Area Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_153\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_153' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_153'>Daniel Morgan Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_153' id='input_9_153' class='large gfield_select'  aria-describedby=\"gfield_description_9_153\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1088' >Daniel Morgan Technolgy Center<\/option><\/select><\/div><\/div><div id=\"field_9_106\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_106' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_106'>Darlington County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_106' id='input_9_106' class='large gfield_select'  aria-describedby=\"gfield_description_9_106\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='355' >Brockington Elementary<\/option><option value='356' >Brunson-Dargan Elementary<\/option><option value='357' >Cain Elementary<\/option><option value='358' >Carolina Elementary<\/option><option value='359' >Darlington County Institute Of<\/option><option value='360' >Darlington High School<\/option><option value='361' >Darlington Middle<\/option><option value='362' >Hartsville High School<\/option><option value='363' >Hartsville Middle<\/option><option value='364' >Lamar Elementary<\/option><option value='365' >Lamar High School<\/option><option value='366' >Mayo High School for Math, Science, and Technology<\/option><option value='367' >North Hartsville Elementary<\/option><option value='368' >Pate Elementary<\/option><option value='369' >Rosenwald Elementary-Middle<\/option><option value='370' >Southside Early Childhood Education Center<\/option><option value='371' >Spaulding Elementary<\/option><option value='372' >Spaulding Middle<\/option><option value='373' >St. Johns Elementary<\/option><option value='374' >Thornwell School for the Arts<\/option><option value='375' >Washington St. Elementary<\/option><option value='376' >West Hartsville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_109\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_109' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_109'>Dillon County Applied Tech Center<\/div><div class='ginput_container ginput_container_select'><select name='input_109' id='input_9_109' class='large gfield_select'  aria-describedby=\"gfield_description_9_109\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='388' >Dillon County Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_107\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_107' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_107'>Dillon School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_107' id='input_9_107' class='large gfield_select'  aria-describedby=\"gfield_description_9_107\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='377' >Latta Elementary<\/option><option value='378' >Latta High School<\/option><option value='379' >Latta Middle<\/option><\/select><\/div><\/div><div id=\"field_9_108\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_108' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_108'>Dillon School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_108' id='input_9_108' class='large gfield_select'  aria-describedby=\"gfield_description_9_108\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='380' >Dillon High School<\/option><option value='381' >Dillon Middle<\/option><option value='382' >East Elementary<\/option><option value='383' >Gordon Elementary<\/option><option value='384' >Lake View Elementary<\/option><option value='385' >Lake View High School<\/option><option value='386' >South Elementary<\/option><option value='387' >Stewart Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_154\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_154' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_154'>Spartanburg County District One<\/div><div class='ginput_container ginput_container_select'><select name='input_154' id='input_9_154' class='large gfield_select'  aria-describedby=\"gfield_description_9_154\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1015' >Campobello-Gramling School<\/option><option value='1016' >Chapman High School<\/option><option value='1017' >Holly Springs-Motlow Elementary<\/option><option value='1018' >Inman Elementary<\/option><option value='1019' >Inman Intermediate<\/option><option value='1020' >Landrum High School<\/option><option value='1021' >Landrum Middle<\/option><option value='1022' >New Prospect Elementary<\/option><option value='1023' >O. P. Earle Elementary<\/option><option value='1024' >T. E. Mabry Middle<\/option><\/select><\/div><\/div><div id=\"field_9_112\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_112' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_112'>Dorchester County Career School<\/div><div class='ginput_container ginput_container_select'><select name='input_112' id='input_9_112' class='large gfield_select'  aria-describedby=\"gfield_description_9_112\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='416' >Dorchester County Career &amp; Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_110\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_110' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_110'>Dorchester County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_110' id='input_9_110' class='large gfield_select'  aria-describedby=\"gfield_description_9_110\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='389' >Alston Middle<\/option><option value='390' >Ashley Ridge High School<\/option><option value='391' >Beech Hill Elementary<\/option><option value='392' >Charles B. DuBose Middle<\/option><option value='393' >Eagle Nest Elementary<\/option><option value='394' >Flowertown Elementary<\/option><option value='395' >Fort Dorchester Elementary<\/option><option value='396' >Fort Dorchester High School<\/option><option value='397' >Gregg Middle<\/option><option value='398' >James H. Spann Elementary<\/option><option value='399' >Joseph R. Pye Elementary<\/option><option value='400' >Knightsville Elementary<\/option><option value='401' >Newington Elementary<\/option><option value='402' >Oakbrook Elementary<\/option><option value='403' >Oakbrook Middle<\/option><option value='404' >River Oaks Middle<\/option><option value='405' >Rollings Middle School of the Arts<\/option><option value='406' >Summerville Elementary<\/option><option value='407' >Summerville High School<\/option><option value='408' >William M. Reeves Elementary<\/option><option value='409' >Windsor Hill Arts Infused Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_111\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_111' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_111'>Dorchester County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_111' id='input_9_111' class='large gfield_select'  aria-describedby=\"gfield_description_9_111\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='410' >Clay Hill Elementary<\/option><option value='411' >Harleyville Elementary<\/option><option value='414' >Williams Memorial Elementary<\/option><option value='415' >Woodland High School<\/option><option value='1449' >Woodland Middle<\/option><\/select><\/div><\/div><div id=\"field_9_113\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_113' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_113'>Edgefield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_113' id='input_9_113' class='large gfield_select'  aria-describedby=\"gfield_description_9_113\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='417' >Douglas Elementary<\/option><option value='418' >Johnston Elementary<\/option><option value='419' >Johnston-Edgefield-Trenton Middle<\/option><option value='420' >Merriwether Elementary<\/option><option value='421' >Merriwether Middle<\/option><option value='422' >Strom Thurmond Career Center<\/option><option value='423' >Strom Thurmond High School<\/option><option value='424' >W. E. Parker Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_104\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_104' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_104'>F E Dubose Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_104' id='input_9_104' class='large gfield_select'  aria-describedby=\"gfield_description_9_104\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='345' >F E Dubose Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_114\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_114' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_114'>Fairfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_114' id='input_9_114' class='large gfield_select'  aria-describedby=\"gfield_description_9_114\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='425' >Fairfield Career and Technology Center<\/option><option value='426' >Fairfield Central High School<\/option><option value='427' >Fairfield Elementary<\/option><option value='428' >Fairfield Magnet for Math and Science<\/option><option value='429' >Fairfield Middle<\/option><option value='430' >Geiger Elementary<\/option><option value='431' >Kelly Miller Elementary<\/option><option value='432' >McCrorey-Liston School of Technology<\/option><\/select><\/div><\/div><div id=\"field_9_156\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_156' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_156'>Felton Laboratory School<\/div><div class='ginput_container ginput_container_select'><select name='input_156' id='input_9_156' class='large gfield_select'  aria-describedby=\"gfield_description_9_156\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1235' >Felton Laboratory Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_115\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_115' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_115'>Florence School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_115' id='input_9_115' class='large gfield_select'  aria-describedby=\"gfield_description_9_115\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='433' >Alfred Rush Academy<\/option><option value='434' >Beck Learning Center<\/option><option value='435' >Briggs Elementary<\/option><option value='436' >Carver Elementary<\/option><option value='437' >Child Development Center at Woods Road<\/option><option value='438' >Delmae Elementary<\/option><option value='439' >Dewey-Carter Elementary<\/option><option value='440' >Florence Career Center<\/option><option value='441' >Greenwood Elementary<\/option><option value='442' >Henry L. Sneed Middle<\/option><option value='443' >Henry Timrod Elementary<\/option><option value='444' >John W. Moore Middle<\/option><option value='445' >Lucy T. Davis Elementary<\/option><option value='446' >McLaurin Elementary<\/option><option value='447' >North Vista Elementary<\/option><option value='448' >Palmetto Youth Academy Charter<\/option><option value='449' >Poynor Center<\/option><option value='450' >Royall Elementary<\/option><option value='451' >Savannah Grove Elementary<\/option><option value='452' >South Florence High School<\/option><option value='453' >Southside Middle<\/option><option value='454' >Theodore Lester Elementary<\/option><option value='455' >Wallace Gregg Elementary<\/option><option value='456' >West Florence High School<\/option><option value='457' >Williams Middle<\/option><option value='458' >Wilson High School<\/option><\/select><\/div><\/div><div id=\"field_9_116\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_116' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_116'>Florence School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_116' id='input_9_116' class='large gfield_select'  aria-describedby=\"gfield_description_9_116\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='459' >Early Childhood Success Center ANNEX<\/option><option value='460' >Hannah Pamplico High School<\/option><option value='461' >Hannah-Pamplico Elementary and Middle<\/option><\/select><\/div><\/div><div id=\"field_9_117\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_117' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_117'>Florence School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_117' id='input_9_117' class='large gfield_select'  aria-describedby=\"gfield_description_9_117\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='462' >J. C. Lynch Elementary<\/option><option value='463' >J. Paul Truluck Intermediate<\/option><option value='464' >Lake City Early Childhood Center<\/option><option value='465' >Lake City High School<\/option><option value='466' >Main Street Elementary<\/option><option value='467' >Olanta Elementary<\/option><option value='468' >Ronald E. McNair Junior High<\/option><option value='469' >Scranton Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_118\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_118' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_118'>Florence School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_118' id='input_9_118' class='large gfield_select'  aria-describedby=\"gfield_description_9_118\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='470' >Brockington Elementary<\/option><option value='471' >Johnson Middle<\/option><option value='472' >Timmonsville High School<\/option><option value='1275' >Woods Road HeadStart<\/option><\/select><\/div><\/div><div id=\"field_9_119\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_119' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_119'>Florence School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_119' id='input_9_119' class='large gfield_select'  aria-describedby=\"gfield_description_9_119\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='473' >Johnsonville Elementary<\/option><option value='474' >Johnsonville High School<\/option><option value='475' >Johnsonville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_162\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_162' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_162'>Fort Mill School District<\/div><div class='ginput_container ginput_container_select'><select name='input_162' id='input_9_162' class='large gfield_select'  aria-describedby=\"gfield_description_9_162\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1187' >Banks Trail Middle<\/option><option value='1188' >Doby&#039;s Bridge Elementary<\/option><option value='1189' >Fort Mill Elementary<\/option><option value='1190' >Fort Mill High School<\/option><option value='1191' >Fort Mill Middle<\/option><option value='1192' >Gold Hill Elementary<\/option><option value='1193' >Gold Hill Middle<\/option><option value='1194' >Nation Ford High School<\/option><option value='1195' >Orchard Park Elementary-Fort Mill<\/option><option value='1196' >Pleasant Knoll Elementary<\/option><option value='1283' >Pleasant Knoll Middle<\/option><option value='1197' >Riverview Elementary<\/option><option value='1198' >Springfield Elementary<\/option><option value='1199' >Springfield Middle<\/option><option value='1200' >Sugar Creek Elementary<\/option><option value='1201' >Tega Cay Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_120\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_120' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_120'>Georgetown County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_120' id='input_9_120' class='large gfield_select'  aria-describedby=\"gfield_description_9_120\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='476' >Andrews Elementary<\/option><option value='477' >Andrews High School<\/option><option value='478' >Brown&#039;s Ferry Elementary<\/option><option value='479' >Carvers Bay High School<\/option><option value='480' >Carvers Bay Middle<\/option><option value='481' >Coastal Montessori Charter School<\/option><option value='482' >Georgetown High School<\/option><option value='483' >Georgetown Middle<\/option><option value='484' >Kensington Elementary<\/option><option value='485' >Maryville Elementary<\/option><option value='486' >McDonald Elementary<\/option><option value='487' >Plantersville Elementary<\/option><option value='488' >Pleasant Hill Elementary<\/option><option value='489' >Rosemary Middle<\/option><option value='490' >Sampit Elementary<\/option><option value='491' >Waccamaw Elementary<\/option><option value='492' >Waccamaw High  School<\/option><option value='493' >Waccamaw Intermediate<\/option><option value='494' >Waccamaw Middle<\/option><\/select><\/div><\/div><div id=\"field_9_163\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_163' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_163'>GLEAMNS Human Resources Commission, Inc.<\/div><div class='ginput_container ginput_container_select'><select name='input_163' id='input_9_163' class='large gfield_select'  aria-describedby=\"gfield_description_9_163\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1419' >Abbeville Early Head Start &amp; Head Start Center<\/option><option value='1420' >Batesburg Head Start Center<\/option><option value='1421' >Blythewood Head Start Center<\/option><option value='1422' >Edgefield Early Head Start &amp;  Head Start Center<\/option><option value='1423' >Greenwood Early Head Start &amp;  Head Start Center<\/option><option value='1424' >Lexington Head Start Center<\/option><option value='1425' >McCormick Head Start Center<\/option><option value='1426' >North Hodges Head Start Center<\/option><option value='1427' >Pineview  Head Start Center<\/option><option value='1428' >Platt Springs Head Start Center<\/option><option value='1429' >Rikard Head Start Center<\/option><option value='1430' >Saluda Early Head Start &amp; Head Start Center<\/option><option value='1431' >Sanders Head Start Center<\/option><option value='1432' >St. Andrews Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_164\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_164' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_164'>Governor's School for the Arts and Humanities<\/div><div class='ginput_container ginput_container_select'><select name='input_164' id='input_9_164' class='large gfield_select'  aria-describedby=\"gfield_description_9_164\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1254' >SC Governor&#039;s School for the Arts and Humanities<\/option><\/select><\/div><\/div><div id=\"field_9_165\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_165' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_165'>Governor's School for Math and Science<\/div><div class='ginput_container ginput_container_select'><select name='input_165' id='input_9_165' class='large gfield_select'  aria-describedby=\"gfield_description_9_165\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1255' >Governor&#039;s School for Math and Science<\/option><\/select><\/div><\/div><div id=\"field_9_121\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_121' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_121'>Greenville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_121' id='input_9_121' class='large gfield_select'  aria-describedby=\"gfield_description_9_121\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='495' >A.J. Whittenburg Elementary<\/option><option value='496' >Alexander Elementary<\/option><option value='497' >Armstrong Elementary<\/option><option value='498' >Augusta Circle Elementary<\/option><option value='499' >Beck Academy<\/option><option value='500' >Bell&#039;s Crossing Elementary<\/option><option value='501' >Berea Elementary<\/option><option value='502' >Berea High School<\/option><option value='503' >Berea Middle<\/option><option value='504' >Bethel Elementary<\/option><option value='505' >Blue Ridge High School<\/option><option value='506' >Blue Ridge Middle<\/option><option value='507' >Blythe Academy<\/option><option value='508' >Brashier Middle College Charter School<\/option><option value='509' >Brook Glenn Elementary<\/option><option value='510' >Brushy Creek Elementary<\/option><option value='511' >Bryson Elementary<\/option><option value='512' >Bryson Middle<\/option><option value='513' >Buena Vista Elementary<\/option><option value='514' >Carolina Academy<\/option><option value='515' >Chandler Creek Elementary<\/option><option value='516' >Cherrydale Elementary<\/option><option value='517' >Crestview Elementary<\/option><option value='518' >Donaldson Career Center<\/option><option value='519' >Dr. Phinnize J. Fisher Middle<\/option><option value='520' >Duncan Chapel Elementary<\/option><option value='521' >East North Street Academy<\/option><option value='522' >Eastside High School<\/option><option value='523' >Ellen Woodside Elementary<\/option><option value='524' >Enoree Career Center<\/option><option value='525' >Fork Shoals School<\/option><option value='526' >Fountain Inn Elementary<\/option><option value='527' >Gateway Elementary<\/option><option value='528' >Golden Strip Career and Technology Center<\/option><option value='529' >Greenbrier Elementary<\/option><option value='530' >Greenville Middle Academy<\/option><option value='531' >Greenville Senior High Academy<\/option><option value='532' >Greenville Technical Charter High School<\/option><option value='533' >Greer High School<\/option><option value='534' >Greer Middle<\/option><option value='535' >Greer Middle College Charter School<\/option><option value='536' >Grove Elementary<\/option><option value='537' >Heritage Elementary<\/option><option value='538' >Hillcrest High School<\/option><option value='539' >Hillcrest Middle<\/option><option value='540' >Hollis Academy<\/option><option value='541' >Hughes Academy of Science and Technology<\/option><option value='542' >J. Harley Bonds Career Center<\/option><option value='543' >J. L. Mann High Academy<\/option><option value='544' >Lake Forest Elementary<\/option><option value='545' >Lakeview Middle<\/option><option value='546' >Langston Charter Middle<\/option><option value='547' >League Academy<\/option><option value='548' >Legacy Charter School<\/option><option value='549' >Mauldin Elementary<\/option><option value='550' >Mauldin High School<\/option><option value='551' >Mauldin Middle<\/option><option value='552' >Meyer Center for Special Children Charter<\/option><option value='553' >Mitchell Road Elementary<\/option><option value='554' >Monarch Elementary-Greenville<\/option><option value='555' >Monaview Elementary<\/option><option value='556' >Mountain View Elementary<\/option><option value='557' >Northwest Middle<\/option><option value='558' >Northwood Middle<\/option><option value='559' >Oakview Elementary<\/option><option value='560' >Overbrook Child Development Center<\/option><option value='561' >Paris Elementary<\/option><option value='562' >Pelham Road Elementary<\/option><option value='563' >Plain Elementary<\/option><option value='564' >Ralph Chandler Middle<\/option><option value='565' >Riverside High School<\/option><option value='566' >Riverside Middle-Greenville<\/option><option value='567' >Robert E. Cashion Elementary<\/option><option value='568' >Rudolph Gordon Elementary<\/option><option value='569' >Sara Collins Elementary<\/option><option value='570' >Sevier Middle<\/option><option value='571' >Simpsonville Elementary<\/option><option value='572' >Skyland Elementary<\/option><option value='573' >Slater Marietta Elementary<\/option><option value='574' >Southside High School<\/option><option value='575' >Sterling School<\/option><option value='576' >Stone Academy<\/option><option value='577' >Sue Cleveland Elementary<\/option><option value='578' >Summit Drive Elementary<\/option><option value='579' >Tanglewood Middle<\/option><option value='580' >Taylors Elementary<\/option><option value='581' >Thomas E. Kerns Elementary<\/option><option value='582' >Tigerville Elementary<\/option><option value='583' >Travelers Rest High School<\/option><option value='584' >Wade Hampton High School<\/option><option value='585' >Washington Center<\/option><option value='586' >Welcome Elementary<\/option><option value='587' >Westcliffe Elementary<\/option><option value='588' >Woodland Elementary<\/option><option value='589' >Woodmont High School<\/option><option value='590' >Woodmont Middle<\/option><\/select><\/div><\/div><div id=\"field_9_125\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_125' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_125'>Greenwood County Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_125' id='input_9_125' class='large gfield_select'  aria-describedby=\"gfield_description_9_125\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='612' >G Frank Russell Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_122\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_122' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_122'>Greenwood County School District 50<\/div><div class='ginput_container ginput_container_select'><select name='input_122' id='input_9_122' class='large gfield_select'  aria-describedby=\"gfield_description_9_122\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='591' >Brewer Middle<\/option><option value='592' >Eleanor S. Rice Elementary<\/option><option value='593' >Emerald High School<\/option><option value='594' >Greenwood Early Childhood Center<\/option><option value='595' >Greenwood High School<\/option><option value='596' >Hodges Elementary<\/option><option value='597' >Lakeview Elementary<\/option><option value='598' >Mathews Elementary<\/option><option value='599' >Merrywood Elementary<\/option><option value='600' >Northside Middle-Greenwood<\/option><option value='601' >Pinecrest Elementary<\/option><option value='602' >Springfield Elementary<\/option><option value='603' >Westview Middle<\/option><option value='604' >Woodfields Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_123\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_123' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_123'>Greenwood County School District 51<\/div><div class='ginput_container ginput_container_select'><select name='input_123' id='input_9_123' class='large gfield_select'  aria-describedby=\"gfield_description_9_123\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='605' >Ware Shoals Elementary Middle<\/option><option value='606' >Ware Shoals High School<\/option><option value='607' >Ware Shoals Primary<\/option><\/select><\/div><\/div><div id=\"field_9_124\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_124' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_124'>Greenwood County School District 52<\/div><div class='ginput_container ginput_container_select'><select name='input_124' id='input_9_124' class='large gfield_select'  aria-describedby=\"gfield_description_9_124\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='608' >Edgewood Middle<\/option><option value='609' >Ninety Six Elementary<\/option><option value='610' >Ninety Six High School<\/option><option value='611' >Ninety Six Primary<\/option><\/select><\/div><\/div><div id=\"field_9_166\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_166' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_166'>H B Swofford AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_166' id='input_9_166' class='large gfield_select'  aria-describedby=\"gfield_description_9_166\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1090' >H B Swofford Career Center<\/option><\/select><\/div><\/div><div id=\"field_9_126\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_126' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_126'>Hampton County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_126' id='input_9_126' class='large gfield_select'  aria-describedby=\"gfield_description_9_126\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='613' >Ben Hazel Primary<\/option><option value='614' >Brunson Elementary<\/option><option value='615' >Fennell Elementary<\/option><option value='616' >Hampton Elementary<\/option><option value='617' >North District Middle<\/option><option value='618' >Varnville Elementary<\/option><option value='619' >Wade Hampton High School<\/option><\/select><\/div><\/div><div id=\"field_9_127\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_127' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_127'>Hampton County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_127' id='input_9_127' class='large gfield_select'  aria-describedby=\"gfield_description_9_127\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='620' >Estill Elementary<\/option><option value='621' >Estill High School<\/option><option value='622' >Estill Middle<\/option><\/select><\/div><\/div><div id=\"field_9_128\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_128' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_128'>Horry County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_128' id='input_9_128' class='large gfield_select'  aria-describedby=\"gfield_description_9_128\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='623' >Academy For Arts Science Techn<\/option><option value='624' >Academy For Technolgy and Acad<\/option><option value='625' >Academy of Hope Charter<\/option><option value='626' >Aynor Elementary<\/option><option value='627' >Aynor High School<\/option><option value='628' >Aynor Middle<\/option><option value='629' >Black Water Middle<\/option><option value='630' >Bridgewater Academy Charter<\/option><option value='631' >Burgess Elementary<\/option><option value='632' >Carolina Forest Elementary<\/option><option value='633' >Carolina Forest High School<\/option><option value='634' >Conway Elementary<\/option><option value='635' >Conway High School<\/option><option value='636' >Conway Middle<\/option><option value='637' >Daisy Elementary<\/option><option value='638' >Forestbrook Elementary<\/option><option value='639' >Forestbrook Middle<\/option><option value='640' >Green Sea Floyds Elementary<\/option><option value='641' >Green Sea Floyds High School<\/option><option value='642' >HCS Early College High School<\/option><option value='643' >Homewood Elementary<\/option><option value='644' >Kingston Elementary<\/option><option value='645' >Lakewood Elementary<\/option><option value='646' >Loris Elementary<\/option><option value='647' >Loris High School<\/option><option value='648' >Loris Middle<\/option><option value='649' >Midland Elementary<\/option><option value='650' >Myrtle Beach Elementary<\/option><option value='651' >Myrtle Beach High School<\/option><option value='652' >Myrtle Beach Intermediate<\/option><option value='653' >Myrtle Beach Middle<\/option><option value='654' >Myrtle Beach Primary<\/option><option value='655' >North Myrtle Beach High School<\/option><option value='656' >North Myrtle Beach Middle<\/option><option value='657' >Ocean Bay Elementary<\/option><option value='658' >Ocean Bay Middle<\/option><option value='659' >Ocean Drive Elementary<\/option><option value='660' >Palmetto Academy for Learning Motorsports<\/option><option value='661' >Palmetto Academy of Learning and Success Charter<\/option><option value='662' >Palmetto Bays Elementary<\/option><option value='663' >Pee Dee Elementary<\/option><option value='664' >River Oaks Elementary<\/option><option value='665' >Riverside Elementary<\/option><option value='666' >Seaside Elementary<\/option><option value='667' >Socastee Elementary<\/option><option value='668' >Socastee High School<\/option><option value='669' >South Conway Elementary<\/option><option value='670' >St. James Elementary<\/option><option value='671' >St. James High School<\/option><option value='672' >St. James Middle<\/option><option value='673' >Waccamaw Elementary<\/option><option value='674' >Waterway Elementary<\/option><option value='675' >Whittemore Park Middle<\/option><\/select><\/div><\/div><div id=\"field_9_129\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_129' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_129'>Jasper County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_129' id='input_9_129' class='large gfield_select'  aria-describedby=\"gfield_description_9_129\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='676' >Hardeeville Elementary<\/option><option value='677' >Hardeeville-Ridgeland Middle<\/option><option value='678' >Ridgeland Elementary<\/option><option value='679' >Ridgeland-Hardeeville High School<\/option><\/select><\/div><\/div><div id=\"field_9_167\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_167' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_167'>John De La Howe<\/div><div class='ginput_container ginput_container_select'><select name='input_167' id='input_9_167' class='large gfield_select'  aria-describedby=\"gfield_description_9_167\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1236' >John De La Howe School<\/option><\/select><\/div><\/div><div id=\"field_9_168\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_168' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_168'>Juvenile Justice Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_168' id='input_9_168' class='large gfield_select'  aria-describedby=\"gfield_description_9_168\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1242' >Birchwood School<\/option><option value='1243' >Evaluation and Detention Center<\/option><option value='1244' >Willow Lane School<\/option><\/select><\/div><\/div><div id=\"field_9_130\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_130' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_130'>Kershaw County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_130' id='input_9_130' class='large gfield_select'  aria-describedby=\"gfield_description_9_130\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='680' >Applied Technology Education Campus<\/option><option value='681' >Baron Dekalb Elementary<\/option><option value='682' >Bethune Elementary<\/option><option value='683' >Blaney Elementary<\/option><option value='684' >Camden Elementary of the Creative Arts<\/option><option value='685' >Camden High School<\/option><option value='686' >Camden Middle<\/option><option value='687' >Doby&#039;s Mill Elementary<\/option><option value='688' >Jackson School<\/option><option value='689' >Leslie M. Stover Middle<\/option><option value='690' >Lugoff Elementary<\/option><option value='691' >Lugoff-Elgin High School<\/option><option value='692' >Lugoff-Elgin Middle<\/option><option value='693' >Midway Elementary<\/option><option value='694' >Mt. Pisgah Elementary<\/option><option value='695' >North Central High School<\/option><option value='696' >North Central Middle<\/option><option value='697' >Pine Tree Hill Elementary<\/option><option value='698' >Wateree Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_131\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_131' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_131'>Lancaster County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_131' id='input_9_131' class='large gfield_select'  aria-describedby=\"gfield_description_9_131\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='699' >A. R. Rucker Middle<\/option><option value='700' >Andrew Jackson High School<\/option><option value='701' >Andrew Jackson Middle<\/option><option value='702' >Brooklyn Springs Elementary<\/option><option value='703' >Buford Elementary<\/option><option value='704' >Buford High School<\/option><option value='705' >Buford Middle<\/option><option value='728' >Clinton Elementary-Lancaster<\/option><option value='707' >Discovery Charter of Lancaster<\/option><option value='708' >Erwin Elementary<\/option><option value='709' >Harrisburg Elementary<\/option><option value='710' >Heath Springs Elementary<\/option><option value='711' >Indian Land Elementary<\/option><option value='712' >Indian Land High School<\/option><option value='713' >Indian Land Middle<\/option><option value='714' >Kershaw Elementary<\/option><option value='715' >Lancaster High School<\/option><option value='716' >McDonald Green Elementary<\/option><option value='717' >North Elementary<\/option><option value='718' >South Middle<\/option><\/select><\/div><\/div><div id=\"field_9_132\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_132' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_132'>Laurens County School District No. 55\n<\/div><div class='ginput_container ginput_container_select'><select name='input_132' id='input_9_132' class='large gfield_select'  aria-describedby=\"gfield_description_9_132\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='719' >E. B. Morse Elementary<\/option><option value='720' >Ford Elementary<\/option><option value='721' >Gray Court-Owings Elementary-Middle<\/option><option value='722' >Hickory Tavern Elementary-Middle<\/option><option value='723' >Laurens District 55 High School<\/option><option value='724' >Laurens Elementary<\/option><option value='725' >Laurens Middle<\/option><option value='726' >Sanders Middle<\/option><option value='727' >Waterloo Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_133\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_133' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_133'>Laurens County School District 56<\/div><div class='ginput_container ginput_container_select'><select name='input_133' id='input_9_133' class='large gfield_select'  aria-describedby=\"gfield_description_9_133\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='706' >Clinton Elementary-Laurens<\/option><option value='729' >Clinton High School<\/option><option value='730' >Clinton Middle<\/option><option value='731' >Eastside Elementary<\/option><option value='732' >Joanna-Woodson Elementary<\/option><option value='733' >M. S. Bailey Child Development Center<\/option><option value='1295' >Summit Classical Charter School<\/option><option value='1294' >Thornwell Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_134\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_134' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_134'>Lee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_134' id='input_9_134' class='large gfield_select'  aria-describedby=\"gfield_description_9_134\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='734' >Dennis Elementary<\/option><option value='735' >Lee Central High School<\/option><option value='736' >Lee Central Middle<\/option><option value='737' >Lee County Career and Technology Center<\/option><option value='738' >Lower Lee Elementary<\/option><option value='739' >West Lee Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_135\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_135' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_135'>Lexington County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_135' id='input_9_135' class='large gfield_select'  aria-describedby=\"gfield_description_9_135\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1293' >Beechwood Middle<\/option><option value='740' >Carolina Springs Elementary<\/option><option value='741' >Carolina Springs Middle<\/option><option value='1297' >Centerville Elementary-Lexington 1<\/option><option value='742' >Deerfield Elementary<\/option><option value='1265' >East Pointe Academy Charter School<\/option><option value='743' >Forts Pond Elementary<\/option><option value='744' >Gilbert Elementary<\/option><option value='745' >Gilbert High School<\/option><option value='746' >Gilbert Middle<\/option><option value='747' >Gilbert Primary<\/option><option value='748' >Lake Murray Elementary<\/option><option value='1444' >Lakeside Middle School<\/option><option value='749' >Lexington Elementary<\/option><option value='750' >Lexington High School<\/option><option value='751' >Lexington Middle<\/option><option value='752' >Lexington Technology Center<\/option><option value='753' >Meadow Glen Elementary<\/option><option value='754' >Meadow Glen Middle<\/option><option value='755' >Midway Elementary<\/option><option value='756' >New Providence Elementary<\/option><option value='757' >Oak Grove Elementary<\/option><option value='758' >Pelion Elementary<\/option><option value='759' >Pelion High School<\/option><option value='760' >Pelion Middle<\/option><option value='761' >Pleasant Hill Elementary<\/option><option value='762' >Pleasant Hill Middle<\/option><option value='763' >Red Bank Elementary<\/option><option value='764' >River Bluff High School<\/option><option value='765' >Rocky Creek Elementary<\/option><option value='766' >Saxe Gotha Elementary<\/option><option value='1446' >South Lake Elementary<\/option><option value='767' >White Knoll Elementary<\/option><option value='768' >White Knoll High School<\/option><option value='769' >White Knoll Middle<\/option><\/select><\/div><\/div><div id=\"field_9_136\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_136' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_136'>Lexington County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_136' id='input_9_136' class='large gfield_select'  aria-describedby=\"gfield_description_9_136\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='770' >Airport High School<\/option><option value='771' >Brookland Cayce Grammar School No. 1<\/option><option value='772' >Brookland-Cayce Senior High School<\/option><option value='1277' >Cayce Elementary<\/option><option value='774' >Congaree Elementary<\/option><option value='775' >Congaree-Wood Early Childhood Center<\/option><option value='776' >Cyril B. Busbee Creative Arts Academy<\/option><option value='777' >Herbert A. Wood Elementary<\/option><option value='1256' >New Bridge Academy<\/option><option value='778' >Northside Middle-Lexington 2<\/option><option value='779' >Pine Ridge Middle<\/option><option value='780' >Pineview Elementary<\/option><option value='781' >R. Earle Davis-CLOSED<\/option><option value='782' >R. H. Fulmer Middle<\/option><option value='1288' >Riverbank Elementary School<\/option><option value='783' >Saluda River Academy for the Arts<\/option><option value='784' >Springdale Elementary<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_9_137\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_137' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_137'>Lexington County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_137' id='input_9_137' class='large gfield_select'  aria-describedby=\"gfield_description_9_137\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='785' >Batesburg-Leesville Elementary<\/option><option value='786' >Batesburg-Leesville High School<\/option><option value='787' >Batesburg-Leesville Middle<\/option><option value='788' >Batesburg-Leesville Primary<\/option><\/select><\/div><\/div><div id=\"field_9_138\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_138' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_138'>Lexington County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_138' id='input_9_138' class='large gfield_select'  aria-describedby=\"gfield_description_9_138\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='789' >Frances F. Mack Intermediate<\/option><option value='790' >Lexington Four Early Childhood Center<\/option><option value='791' >Sandhills Elementary<\/option><option value='792' >Sandhills Middle<\/option><option value='793' >Sandhills Primary<\/option><option value='794' >Swansea High Freshman Academy<\/option><option value='795' >Swansea High School<\/option><\/select><\/div><\/div><div id=\"field_9_139\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_139' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_139'>Lexington and Richland School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_139' id='input_9_139' class='large gfield_select'  aria-describedby=\"gfield_description_9_139\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='796' >Ballentine Elementary<\/option><option value='797' >Center for Advanced Technical Studies<\/option><option value='798' >Chapin Elementary<\/option><option value='799' >Chapin High School<\/option><option value='800' >Chapin Intermediate<\/option><option value='801' >Chapin Middle<\/option><option value='802' >CrossRoads Intermediate<\/option><option value='803' >Dutch Fork Elementary<\/option><option value='804' >Dutch Fork High School<\/option><option value='805' >Dutch Fork Middle<\/option><option value='806' >H. E. Corley Elementary<\/option><option value='807' >Harbison West Elementary<\/option><option value='808' >Irmo Elementary<\/option><option value='809' >Irmo High School<\/option><option value='810' >Irmo Middle<\/option><option value='811' >Lake Murray Elementary<\/option><option value='812' >Leaphart Elementary<\/option><option value='813' >Nursery Road Elementary<\/option><option value='814' >Oak Pointe Elementary<\/option><option value='1433' >Piney Woods Elementary<\/option><option value='815' >River Springs Elementary<\/option><option value='816' >Seven Oaks Elementary<\/option><option value='817' >Spring Hill High School<\/option><\/select><\/div><\/div><div id=\"field_9_169\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_169' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_169'>Marion County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_169' id='input_9_169' class='large gfield_select'  aria-describedby=\"gfield_description_9_169\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='821' >Academy of Careers and Technology<\/option><option value='822' >Britton&#039;s Neck Elementary<\/option><option value='823' >Creek Bridge High School<\/option><option value='824' >Easterling Primary<\/option><option value='825' >Johnakin Middle<\/option><option value='828' >McCormick Elementary-Marion<\/option><option value='826' >Manning High School<\/option><option value='1287' >Marion High School<\/option><option value='827' >Marion Intermediate<\/option><option value='829' >Mullins Early Childhood Center ANNEX<\/option><option value='830' >Mullins High School<\/option><option value='831' >North Mullins Primary<\/option><option value='832' >Palmetto Middle<\/option><\/select><\/div><\/div><div id=\"field_9_141\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_141' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_141'>Marlboro County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_141' id='input_9_141' class='large gfield_select'  aria-describedby=\"gfield_description_9_141\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='833' >Bennettsville Intermediate<\/option><option value='834' >Bennettsville Primary<\/option><option value='1264' >Blenheim HeadStart<\/option><option value='835' >Blenheim Middle School of Discovery<\/option><option value='836' >Clio Elementary<\/option><option value='837' >Marlboro County High School<\/option><option value='838' >Marlboro School of Discovery<\/option><option value='839' >McColl Elementary-Middle<\/option><option value='840' >Wallace Elementary-Middle<\/option><\/select><\/div><\/div><div id=\"field_9_140\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_140' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_140'>McCormick County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_140' id='input_9_140' class='large gfield_select'  aria-describedby=\"gfield_description_9_140\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='818' >McCormick Elementary-McCormick<\/option><option value='819' >McCormick High School<\/option><option value='820' >McCormick Middle<\/option><\/select><\/div><\/div><div id=\"field_9_190\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_190' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_190'>Movement School<\/div><div class='ginput_container ginput_container_select'><select name='input_190' id='input_9_190' class='large gfield_select'  aria-describedby=\"gfield_description_9_190\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='1451' >Bridge View Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_142\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_142' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_142'>Newberry County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_142' id='input_9_142' class='large gfield_select'  aria-describedby=\"gfield_description_9_142\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='841' >Boundary Street Elementary<\/option><option value='842' >Gallman Elementary<\/option><option value='843' >Little Mountain Elementary<\/option><option value='844' >Mid-Carolina High School<\/option><option value='845' >Mid-Carolina Middle<\/option><option value='846' >Newberry County Career Center<\/option><option value='847' >Newberry Elementary<\/option><option value='848' >Newberry High School<\/option><option value='849' >Newberry Middle<\/option><option value='850' >Pomaria-Garmany Elementary<\/option><option value='851' >Prosperity-Rikard Elementary<\/option><option value='852' >Reuben Elementary<\/option><option value='853' >Whitmire Community High School<\/option><option value='854' >Whitmire Community School (Elementary)<\/option><\/select><\/div><\/div><div id=\"field_9_143\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_143' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_143'>Oconee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_143' id='input_9_143' class='large gfield_select'  aria-describedby=\"gfield_description_9_143\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='855' >Blue Ridge Elementary<\/option><option value='856' >Fair-Oak Elementary<\/option><option value='857' >Fred P. Hamilton Career Center<\/option><option value='858' >James M. Brown Elementary<\/option><option value='859' >Keowee Elementary<\/option><option value='860' >Northside Elementary-Oconee<\/option><option value='861' >Orchard Park Elementary<\/option><option value='862' >Ravenel Elementary<\/option><option value='863' >Seneca High School<\/option><option value='864' >Seneca Middle<\/option><option value='865' >Tamassee-Salem Elementary<\/option><option value='866' >Tamassee-Salem Middle-High School<\/option><option value='867' >Walhalla Elementary<\/option><option value='868' >Walhalla High School<\/option><option value='869' >Walhalla Middle<\/option><option value='870' >West Oak Middle<\/option><option value='871' >West-Oak High School<\/option><option value='872' >Westminster Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_146\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_146' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_146'>Orangeburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_146' id='input_9_146' class='large gfield_select'  aria-describedby=\"gfield_description_9_146\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='887' >Bethune-Bowman Elementary<\/option><option value='888' >Bethune-Bowman Middle-High School<\/option><option value='879' >Branchville High School<\/option><option value='889' >Brookdale Elementary<\/option><option value='880' >Carver Edisto Middle<\/option><option value='890' >Dover Elementary<\/option><option value='1454' >East Lake Elementary School<\/option><option value='881' >Edisto Elementary<\/option><option value='882' >Edisto High<\/option><option value='883' >Edisto Primary<\/option><option value='873' >Elloree Elementary<\/option><option value='884' >Hunter-Kinard-Tyler Elementary<\/option><option value='885' >Hunter-Kinard-Tyler High<\/option><option value='1455' >Lake Marion Middle School<\/option><option value='876' >Lake Marion High<\/option><option value='886' >Lockett Elementary<\/option><option value='891' >Marshall Elementary<\/option><option value='892' >Mellichamp Elementary<\/option><option value='893' >North Middle-High School<\/option><option value='894' >OCSD5 High School for Health Professions<\/option><option value='895' >Orangeburg Consolitated School District Five Technology Center<\/option><option value='896' >Orangeburg Wilkinson High School<\/option><option value='899' >Sheridan Elementary<\/option><option value='900' >Whittaker Elementary<\/option><option value='901' >William J. Clark Middle<\/option><\/select><\/div><\/div><div id=\"field_9_171\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_171' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_171'>Palmetto Unified<\/div><div class='ginput_container ginput_container_select'><select name='input_171' id='input_9_171' class='large gfield_select'  aria-describedby=\"gfield_description_9_171\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1245' >Lee  High School<\/option><option value='1246' >MacDougall High School<\/option><option value='1247' >Manning High School<\/option><option value='1248' >Ridgeland High School<\/option><option value='1249' >Sara Babb High School<\/option><option value='1250' >Trenton High School<\/option><option value='1251' >Turbeville High School<\/option><option value='1252' >Tyger River High School<\/option><option value='1253' >Wateree River High School<\/option><\/select><\/div><\/div><div id=\"field_9_170\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_170' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_170'>Pee Dee Head Starts<\/div><div class='ginput_container ginput_container_select'><select name='input_170' id='input_9_170' class='large gfield_select'  aria-describedby=\"gfield_description_9_170\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1292' >Lake City HS Center<\/option><\/select><\/div><\/div><div id=\"field_9_172\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_172' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_172'>Pickens County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_172' id='input_9_172' class='large gfield_select'  aria-describedby=\"gfield_description_9_172\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='903' >A. R. Lewis Elementary<\/option><option value='904' >Ambler Elementary<\/option><option value='905' >Central Elementary<\/option><option value='906' >Liberty Primary<\/option><option value='907' >Clemson Elementary<\/option><option value='908' >Crosswell Elementary-Pickens<\/option><option value='909' >D. W. Daniel High School<\/option><option value='910' >Dacusville Elementary<\/option><option value='911' >Dacusville Middle<\/option><option value='912' >Easley High School<\/option><option value='913' >East End Elementary<\/option><option value='914' >Forest Acres Elementary<\/option><option value='915' >Hagood Elementary<\/option><option value='916' >Holly Springs Elementary<\/option><option value='917' >Liberty Elementary<\/option><option value='918' >Liberty High School<\/option><option value='919' >Liberty Middle<\/option><option value='920' >McKissick Elementary<\/option><option value='921' >Pickens County Career and Technolgy Center<\/option><option value='922' >Pickens Elementary<\/option><option value='923' >Pickens High School<\/option><option value='924' >Pickens Middle<\/option><option value='925' >R. C. Edwards Middle<\/option><option value='926' >Richard H. Gettys Middle<\/option><option value='927' >Six Mile Elementary<\/option><option value='928' >West End Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_173\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_173' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_173'>R D Anderson Applied Technology Center<\/div><div class='ginput_container ginput_container_select'><select name='input_173' id='input_9_173' class='large gfield_select'  aria-describedby=\"gfield_description_9_173\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1089' >R. D. Anderson Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_174\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_174' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_174'>Richland County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_174' id='input_9_174' class='large gfield_select'  aria-describedby=\"gfield_description_9_174\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='929' >A. C. Flora High School<\/option><option value='930' >A. C. Moore Elementary<\/option><option value='931' >A. J. Lewis Greenview Elementary<\/option><option value='932' >Alcorn Middle<\/option><option value='933' >Annie Burnside Elementary<\/option><option value='934' >Arden Elementary<\/option><option value='935' >Bradley Elementary<\/option><option value='936' >Brennen Elementary<\/option><option value='937' >Brockman Elementary<\/option><option value='938' >Burton Pack Elementary<\/option><option value='939' >C. A. Johnson High School<\/option><option value='940' >Carolina School for Inquiry<\/option><option value='941' >Carver-Lyon Elementary<\/option><option value='942' >Caughman Road Elementary<\/option><option value='943' >Columbia High School<\/option><option value='944' >Crayton Middle<\/option><option value='945' >Dreher High School<\/option><option value='946' >Eau Claire High School<\/option><option value='947' >Edward E. Taylor Elementary<\/option><option value='948' >Forest Heights Elementary<\/option><option value='949' >Gadsden Elementary<\/option><option value='950' >H. B. Rhame Elementary<\/option><option value='951' >Hall Institute<\/option><option value='952' >Hand Middle<\/option><option value='953' >Heyward Gibbes Middle<\/option><option value='954' >Hopkins Elementary<\/option><option value='955' >Hopkins Middle<\/option><option value='956' >Horrell Hill Elementary<\/option><option value='957' >Hyatt Park Elementary<\/option><option value='958' >J. P. Thomas Elementary<\/option><option value='959' >Logan Elementary<\/option><option value='960' >Lower Richland High School<\/option><option value='961' >Meadowfield Elementary<\/option><option value='962' >Mill Creek Elementary<\/option><option value='963' >Pendergrass Fairwold School<\/option><option value='964' >Pine Grove Elementary<\/option><option value='965' >Richland One Charter Middle College<\/option><option value='966' >Rosewood Elementary<\/option><option value='967' >Samuel A. Heyward Career and Tech Center<\/option><option value='968' >Sandel Elementary<\/option><option value='969' >Satchel Ford Elementary<\/option><option value='970' >South Kilbourne Elementary<\/option><option value='971' >Southeast Middle<\/option><option value='972' >St. Andrews Middle<\/option><option value='973' >W. A. Perry Middle<\/option><option value='974' >W. G. Sanders Middle<\/option><option value='975' >W.J. Keenan High School<\/option><option value='976' >Watkins-Nance Elementary<\/option><option value='977' >Webber School<\/option><\/select><\/div><\/div><div id=\"field_9_175\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_175' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_175'>Richland County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_175' id='input_9_175' class='large gfield_select'  aria-describedby=\"gfield_description_9_175\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='978' >Bethel-Hanberry Elementary<\/option><option value='979' >Blythewood High School<\/option><option value='980' >Blythewood Middle School<\/option><option value='981' >Bookman Road Elementary<\/option><option value='982' >Bridge Creek Elementary<\/option><option value='983' >Catawba Trail Elementary<\/option><option value='984' >Dent Middle<\/option><option value='985' >E. L. Wright Middle<\/option><option value='986' >Forest Lake Elementary<\/option><option value='1280' >Jackson Creek Elementary<\/option><option value='987' >Joseph Keels Elementary<\/option><option value='988' >Kelly Mill Middle<\/option><option value='989' >Killian Elementary<\/option><option value='990' >L. B. Nelson Elementary<\/option><option value='991' >L. W. Conder Elementary<\/option><option value='992' >Lake Carolina Elementary<\/option><option value='993' >Lake Carolina Elementary Upper Campus<\/option><option value='994' >Langford Elementary<\/option><option value='995' >Longleaf Middle<\/option><option value='996' >Muller Road Middle<\/option><option value='997' >North Springs Elementary<\/option><option value='998' >Polo Road Elementary<\/option><option value='999' >Pontiac Elementary<\/option><option value='1000' >Rice Creek Elementary<\/option><option value='1001' >Richland Northeast High School<\/option><option value='1002' >Richland Two Charter High School<\/option><option value='1003' >Ridge View High School<\/option><option value='1004' >Round Top Elementary<\/option><option value='1005' >Sandlapper Elementary<\/option><option value='1006' >Spring Valley High School<\/option><option value='1007' >Summit Parkway Middle<\/option><option value='1008' >Westwood High School<\/option><option value='1009' >Windsor Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_176\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_176' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_176'>Rock Hill School District Three of York County<\/div><div class='ginput_container ginput_container_select'><select name='input_176' id='input_9_176' class='large gfield_select'  aria-describedby=\"gfield_description_9_176\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1159' >Applied Technology Center<\/option><option value='1160' >Belleview Elementary<\/option><option value='1161' >Castle Heights Middle<\/option><option value='1162' >Central Child Development Center<\/option><option value='1163' >Dutchman Creek Middle<\/option><option value='1164' >Ebenezer Avenue Elementary<\/option><option value='1165' >Ebinport Elementary<\/option><option value='1166' >Finley Road Elementary<\/option><option value='1167' >Independence Elementary<\/option><option value='1168' >India Hook Elementary<\/option><option value='1169' >Lesslie Elementary<\/option><option value='1170' >Mount Gallant Elementary<\/option><option value='1171' >Mount Holly Elementary<\/option><option value='1172' >Northside Elementary-York 3<\/option><option value='1173' >Northwestern High School<\/option><option value='1174' >Oakdale Elementary<\/option><option value='1175' >Old Pointe Elementary<\/option><option value='1176' >Rawlinson Road Middle<\/option><option value='1177' >Richmond Drive Elementary<\/option><option value='1178' >Rock Hill High School<\/option><option value='1179' >Rosewood Elementary<\/option><option value='1180' >Saluda Trail Middle<\/option><option value='1181' >South Pointe High School<\/option><option value='1182' >Sunset Park Center for Accelerated Studies<\/option><option value='1183' >The Children&#039;s School at Sylvia Circle<\/option><option value='1184' >The Palmetto School at the Children&#039;s Attention Home<\/option><option value='1185' >W. C. Sullivan Middle<\/option><option value='1186' >York Road Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_177\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_177' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_177'>Saluda County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_177' id='input_9_177' class='large gfield_select'  aria-describedby=\"gfield_description_9_177\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1010' >Hollywood Elementary<\/option><option value='1011' >Saluda Elementary<\/option><option value='1012' >Saluda High School<\/option><option value='1013' >Saluda Middle<\/option><option value='1014' >Saluda Primary<\/option><\/select><\/div><\/div><div id=\"field_9_178\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_178' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_178'>SC Public School Charter District<\/div><div class='ginput_container ginput_container_select'><select name='input_178' id='input_9_178' class='large gfield_select'  aria-describedby=\"gfield_description_9_178\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1202' >Bridges Preparatory School<\/option><option value='1203' >Calhoun Falls Charter School<\/option><option value='1204' >Cape Romain Environmental Education Charter<\/option><option value='1205' >Coastal Leadership Academy<\/option><option value='1206' >Cyber Academy of South Carolina<\/option><option value='1207' >East Point Academy<\/option><option value='1208' >Fox Creek High School<\/option><option value='1209' >Garden City Preparatory Academy for Boys<\/option><option value='1210' >Gray Collegiate Academy<\/option><option value='1211' >GREEN Charter School<\/option><option value='1212' >High Point Academy<\/option><option value='1213' >Imagine Columbia Leadership Academy Charter<\/option><option value='1214' >Lead Academy<\/option><option value='1215' >Lowcountry Leadership Charter School<\/option><option value='1216' >Lowcountry Montessori School<\/option><option value='1217' >Midlands Middle College<\/option><option value='1219' >NEXT High School<\/option><option value='1279' >Oceanside Collegiate Academy<\/option><option value='1220' >Palmetto Scholars Academy<\/option><option value='1221' >Pee Dee Math, Science, and Technology Academy<\/option><option value='1222' >Provost Academy South Carolina<\/option><option value='1223' >Quest Leadership Academy<\/option><option value='1224' >Riverwalk Academy<\/option><option value='1225' >Royal Live Oaks Academy of the Arts and Sciences Charter<\/option><option value='1226' >SC Connections Academy<\/option><option value='1227' >SC Science Academy<\/option><option value='1228' >SC Virtual Charter School<\/option><option value='1229' >SC Whitmore School<\/option><option value='1230' >South Carolina Calvert Academy<\/option><option value='1231' >Spartanburg Preparatory School<\/option><option value='1232' >York Preparatory Academy<\/option><option value='1233' >Youth Leadership Academy Charter<\/option><\/select><\/div><\/div><div id=\"field_9_179\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_179' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_179'>SC School for the Deaf and Blind<\/div><div class='ginput_container ginput_container_select'><select name='input_179' id='input_9_179' class='large gfield_select'  aria-describedby=\"gfield_description_9_179\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1237' >Cedar Springs Academy<\/option><option value='1238' >SC School For Blind Elementary-Middle<\/option><option value='1239' >SC School For Deaf Elementary-Middle<\/option><option value='1240' >SC School for the Blind High School<\/option><option value='1241' >SC School for the Deaf High School<\/option><\/select><\/div><\/div><div id=\"field_9_180\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_180' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_180'>Share Community Action Partnership<\/div><div class='ginput_container ginput_container_select'><select name='input_180' id='input_9_180' class='large gfield_select'  aria-describedby=\"gfield_description_9_180\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1399' >BHW Head Start\/Early Head Start Center<\/option><option value='1404' >Children&#039;s Center &quot;B&quot; Head Start Center<\/option><option value='1415' >Clemson  Head Start Center<\/option><option value='1405' >Easley Bridge Road Head Start Center<\/option><option value='1407' >Golden Strip Head Start\/Early Head Start Center<\/option><option value='1412' >Margaret A. Sherred Head Start Center<\/option><option value='1406' >North Franklin Road Head Start Center<\/option><option value='1409' >North Greenville  Head Start Center<\/option><option value='1408' >Parker Head Start\/Early Head Start Center<\/option><option value='1400' >Pendleton Head Start Center<\/option><option value='1416' >Pickens  Head Start Center<\/option><option value='1417' >Reece Mill Road Head Start\/Early Head Start Center<\/option><option value='1411' >Rubye H. Jones Head Start\/Early Head Start Center<\/option><option value='1414' >Seneca  Head Start\/Early Head Start Center<\/option><option value='1418' >Simpson Head  Head Start Center<\/option><option value='1401' >Starr Head Start Center<\/option><option value='1410' >Tommie C. Brooks Early Head Start Center<\/option><option value='1413' >Watkins Road  Head Start\/Early Head Start Center<\/option><option value='1402' >Westside Head Start Center<\/option><option value='1403' >Willis H. Crosby Head Start\/Early Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_159\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_159' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_159'>Spartanburg County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_159' id='input_9_159' class='large gfield_select'  aria-describedby=\"gfield_description_9_159\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='266' >Oakland Elementary-Spartanburg<\/option><option value='1025' >Boiling Springs Elementary<\/option><option value='1026' >Boiling Springs High Ninth Grade Campus<\/option><option value='1027' >Boiling Springs High School<\/option><option value='1028' >Sugar Ridge Elementary<\/option><option value='1029' >Boiling Springs Middle<\/option><option value='1030' >Carlisle-Foster&#039;s Grove Elementary<\/option><option value='1031' >Chesnee Elementary<\/option><option value='1032' >Chesnee High School<\/option><option value='1033' >Chesnee Middle<\/option><option value='1034' >Cooley Springs-Fingerville Elementary<\/option><option value='1035' >James H. Hendrix  Elementary<\/option><option value='1036' >Mayo Elementary<\/option><option value='1038' >Rainbow Lake Middle<\/option><option value='1260' >Shoally Creek Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_160\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_160' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_160'>Spartanburg County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_160' id='input_9_160' class='large gfield_select'  aria-describedby=\"gfield_description_9_160\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1039' >Broome High School<\/option><option value='1040' >Cannons Elementary<\/option><option value='1041' >Cliffdale Middle<\/option><option value='1042' >Cowpens Elementary<\/option><option value='1045' >Pacolet Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_161\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_161' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_161'>Spartanburg County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_161' id='input_9_161' class='large gfield_select'  aria-describedby=\"gfield_description_9_161\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1046' >Woodruff Elementary<\/option><option value='1047' >Woodruff High School<\/option><option value='1048' >Woodruff Middle<\/option><option value='1049' >Woodruff Primary<\/option><\/select><\/div><\/div><div id=\"field_9_155\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_155' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_155'>Spartanburg County School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_155' id='input_9_155' class='large gfield_select'  aria-describedby=\"gfield_description_9_155\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1050' >Abner Creek Academy<\/option><option value='1051' >Beech Springs Intermediate<\/option><option value='1052' >Berry Shoals Intermediate<\/option><option value='1053' >D. R. Hill Middle<\/option><option value='1054' >Duncan Elementary<\/option><option value='1055' >Florence Chapel Middle<\/option><option value='1056' >James Byrnes Freshman Academy<\/option><option value='1057' >James F. Byrnes High School<\/option><option value='1058' >Lyman Elementary<\/option><option value='1059' >Reidville Elementary<\/option><option value='1060' >River Ridge Elementary<\/option><option value='1061' >Wellford Academy of Science and Techology<\/option><\/select><\/div><\/div><div id=\"field_9_158\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_158' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_158'>Spartanburg County School District Six<\/div><div class='ginput_container ginput_container_select'><select name='input_158' id='input_9_158' class='large gfield_select'  aria-describedby=\"gfield_description_9_158\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1062' >Anderson Mill Elementary<\/option><option value='1063' >Arcadia Elementary<\/option><option value='1064' >Dorman High Freshman Campus<\/option><option value='1065' >Dorman High School<\/option><option value='1066' >Fairforest Elementary<\/option><option value='1067' >Fairforest Middle<\/option><option value='1068' >Jesse S. Bobo Elementary<\/option><option value='1069' >L. E. Gable Middle<\/option><option value='1070' >Lone Oak Elementary<\/option><option value='1071' >Pauline Glenn Springs Elementary<\/option><option value='1072' >R. P. Dawkins Middle<\/option><option value='1073' >Roebuck Elementary<\/option><option value='1074' >West View Elementary<\/option><option value='1075' >Woodland Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_157\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_157' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_157'>Spartanburg County School District Seven<\/div><div class='ginput_container ginput_container_select'><select name='input_157' id='input_9_157' class='large gfield_select'  aria-describedby=\"gfield_description_9_157\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1076' >Carver Middle<\/option><option value='1077' >Cleveland Academy of Leadership<\/option><option value='1078' >E. P. Todd School<\/option><option value='1079' >Houston Elementary<\/option><option value='1080' >Jesse Boyd Elementary<\/option><option value='1081' >Mary H. Wright Elementary<\/option><option value='1082' >McCracken Middle<\/option><option value='1083' >Pine Street Elementary<\/option><option value='1084' >Spartanburg Freshman Academy<\/option><option value='1085' >Spartanburg High School<\/option><option value='1086' >Spartanburg School District 7 Early Childhood Center<\/option><option value='1087' >W. Herbert Chapman Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_181\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_181' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_181'>Sumter School District<\/div><div class='ginput_container ginput_container_select'><select name='input_181' id='input_9_181' class='large gfield_select'  aria-describedby=\"gfield_description_9_181\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1092' >Alice Drive Elementary<\/option><option value='1091' >Alice Drive Middle<\/option><option value='1093' >Bates Middle<\/option><option value='1273' >Brewington Alternative<\/option><option value='1094' >Cherryvale Elementary<\/option><option value='1095' >Chestnut Oaks Middle<\/option><option value='1096' >Crestwood High School<\/option><option value='1097' >Crosswell Elementary-Sumter<\/option><option value='1098' >Ebenezer Middle<\/option><option value='1099' >F. J. Delaine Elementary<\/option><option value='1100' >Furman Middle<\/option><option value='1101' >High Hills Elementary<\/option><option value='1102' >Hillcrest Middle<\/option><option value='1103' >Kingsbury  Elementary<\/option><option value='1104' >Lakewood High  School<\/option><option value='1105' >Lemira Elementary<\/option><option value='1106' >Manchester Elementary<\/option><option value='1107' >Mayewood Middle<\/option><option value='1108' >Millwood Elementary<\/option><option value='1109' >Oakland Primary-Sumter<\/option><option value='1110' >Pocalla Springs Elementary<\/option><option value='1111' >R. E. Davis College Preperatory Academy<\/option><option value='1112' >Rafting Creek Elementary<\/option><option value='1113' >Shaw Heights Elementary<\/option><option value='1114' >Sumter Career and Technology Center<\/option><option value='1115' >Sumter High  School<\/option><option value='1116' >Wilder Elementary<\/option><option value='1117' >Willow Drive Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_182\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_182' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_182'>Union County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_182' id='input_9_182' class='large gfield_select'  aria-describedby=\"gfield_description_9_182\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1118' >Buffalo Elementary<\/option><option value='1119' >Foster Park Elementary<\/option><option value='1120' >Jonesville Elementary<\/option><option value='1121' >Jonesville Middle<\/option><option value='1122' >Lockhart School<\/option><option value='1123' >Lockhart School ANNEX<\/option><option value='1124' >Monarch Elementary-Union<\/option><option value='1125' >Sims Middle<\/option><option value='1126' >Union County Career and Technology Center<\/option><option value='1127' >Union County High School<\/option><\/select><\/div><\/div><div id=\"field_9_183\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_183' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_183'>Williamsburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_183' id='input_9_183' class='large gfield_select'  aria-describedby=\"gfield_description_9_183\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1445' >C. E. Murray Elementary School<\/option><option value='1129' >C.E. Murray Middle<\/option><option value='1130' >D.P. Cooper Charter<\/option><option value='1331' >Greeleyville Primary<\/option><option value='1132' >Hemingway Career and Technology Center<\/option><option value='1133' >Hemingway Elementary<\/option><option value='1134' >Hemingway High School<\/option><option value='1135' >Hemingway MB Lee Middle<\/option><option value='1136' >Kenneth Gardner Leadership Academy<\/option><option value='1137' >Kingstree High School<\/option><option value='1138' >Kingstree Middle Magnet<\/option><option value='1139' >W.M. Anderson Primary<\/option><option value='1140' >Williamsburg Co. Magnet School<\/option><\/select><\/div><\/div><div id=\"field_9_184\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_184' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_184'>Williamsburg Tech<\/div><div class='ginput_container ginput_container_select'><select name='input_184' id='input_9_184' class='large gfield_select'  aria-describedby=\"gfield_description_9_184\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1234' >Wmsbg Tec Voc Adult Ed Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_90\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_90' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_90'>Williston School District (Barnwell County 29)<\/div><div class='ginput_container ginput_container_select'><select name='input_90' id='input_9_90' class='large gfield_select'  aria-describedby=\"gfield_description_9_90\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='118' >Kelly Edwards Elementary<\/option><option value='119' >Williston-Elko High School<\/option><option value='120' >Williston-Elko Middle<\/option><\/select><\/div><\/div><div id=\"field_9_186\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_186' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_186'>York School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_186' id='input_9_186' class='large gfield_select'  aria-describedby=\"gfield_description_9_186\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1141' >Cotton Belt Elementary<\/option><option value='1142' >Floyd D. Johnson Technology Ctr<\/option><option value='1143' >Harold C. Johnson Elementary<\/option><option value='1144' >Hickory Grove-Sharon Elementary<\/option><option value='1145' >Hunter Street Elementary<\/option><option value='1146' >Jefferson Elementary-York 1<\/option><option value='1147' >York Comprehensive High School<\/option><option value='1148' >York Intermediate<\/option><option value='1149' >York Middle<\/option><\/select><\/div><\/div><div id=\"field_9_185\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_185' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_185'>York County School District Two\n<\/div><div class='ginput_container ginput_container_select'><select name='input_185' id='input_9_185' class='large gfield_select'  aria-describedby=\"gfield_description_9_185\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1150' >Bethany Elementary<\/option><option value='1151' >Bethel Elementary<\/option><option value='1284' >Blue Eagle Academy<\/option><option value='1152' >Clover High School<\/option><option value='1153' >Clover Middle<\/option><option value='1282' >Clover Ninth Grade Campus<\/option><option value='1154' >Crowders Creek Elem<\/option><option value='1155' >Griggs Road Elementary<\/option><option value='1156' >Kinard Elementary<\/option><option value='1157' >Larne Elementary<\/option><option value='1289' >Oakridge Elementary<\/option><option value='1158' >Oakridge Middle<\/option><\/select><\/div><\/div><div id=\"field_9_50\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n del Estudiante<\/h3><\/div><fieldset id=\"field_9_2\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name' id='input_9_2'>\n                            \n                            <span id='input_9_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_9_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_3' >Primeiro<\/label>\n                                                <\/span>\n                            <span id='input_9_2_4_container' class='name_middle' >\n                                                    <input type='text' name='input_2.4' id='input_9_2_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_2_4' >Meio<\/label>\n                                                <\/span>\n                            <span id='input_9_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_9_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_6' >Sobrenome<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_9_3\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Sexo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_3'>\n\t\t\t<div class='gchoice gchoice_9_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Male'  id='choice_9_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_0' id='label_9_3_0'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Female'  id='choice_9_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_1' id='label_9_3_1'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_10\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de Nacimiento del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_10' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_10_1_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_10_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_10_2_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_10_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_10_3_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_10_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_9_188\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_188' >Grado<\/label><div class='ginput_container ginput_container_text'><input name='input_188' id='input_9_188' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_189\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_189' >Maestra Tutora<\/label><div class='ginput_container ginput_container_text'><input name='input_189' id='input_9_189' type='text' value='' class='large'  aria-describedby=\"gfield_description_9_189\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_189'>Maestra tutora \/ \"Homeroom Teacher\"<\/div><\/div><div id=\"field_9_48\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_48' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_48' id='input_9_48' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_11\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_11' >Telefono de Casa<\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_9_11' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_75\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de correo electronico pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_9_75'>La Direccion de correo electronico debe ser valida ya que recibir\u00e1 una copia de la informaci\u00f3n enviada en el mismo<\/div><div class='ginput_complex ginput_container ginput_container_email' id='input_9_75_container'>\n                                <span id='input_9_75_1_container' class='ginput_left'>\n                                    <input class='' type='email' name='input_75' id='input_9_75' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75' >ingrese correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <span id='input_9_75_2_container' class='ginput_right'>\n                                    <input class='' type='email' name='input_75_2' id='input_9_75_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75_2' >Confirmar correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_9_5\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direcci\u00f3n del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_9_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_9_5_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_5_1' id='input_9_5_1_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_9_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_9_5_2' value=''   placeholder='Street 2'  aria-required='false'   \/>\n                                        <label for='input_9_5_2' id='input_9_5_2_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_9_5_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_5_3' id='input_9_5_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_5_4_container' >\n                                        <select name='input_5.4' id='input_9_5_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_5_4' id='input_9_5_4_label' class='hidden_sub_label screen-reader-text'>Provincia<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_9_5_5' value=''   placeholder='ZIP Code' aria-required='true'    \/>\n                                    <label for='input_9_5_5' id='input_9_5_5_label' class='hidden_sub_label screen-reader-text'>C\u00f3digo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_9_5_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_54' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_8\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Preguntas M\u00e9dicas<\/h3><\/div><div id=\"field_9_15\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_15' >Doctor del ni\u00f1o<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_9_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_13\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_13' >Dentista de ni\u00f1os<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_9_13' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_14\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de ultima limpieza dental<\/legend><div id='input_9_14' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_14_1_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_14_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_14_2_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_14_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_14_3_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_14_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><fieldset id=\"field_9_16\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfSu hijo tiene alergias?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_16'>\n\t\t\t<div class='gchoice gchoice_9_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Yes'  id='choice_9_16_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_16\"   \/>\n\t\t\t\t\t<label for='choice_9_16_0' id='label_9_16_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='No'  id='choice_9_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_16_1' id='label_9_16_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_9_16'>(incluyendo alimentos, medicamentos y\/o l\u00e1tex?)<\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_17\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_17' >En caso afirmativo, enumere<\/label><div class='gfield_description' id='gfield_description_9_17'>Por favor enum\u00e9relos aqu\u00ed. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_9_17' class='textarea medium'  aria-describedby=\"gfield_description_9_17\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_18\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez su hijo tuvo un reemplazo artificial de articulaci\u00f3n?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_18'>\n\t\t\t<div class='gchoice gchoice_9_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Yes'  id='choice_9_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_0' id='label_9_18_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='No'  id='choice_9_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_1' id='label_9_18_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_20\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez le han diagnosticado a su hijo fiebre reum\u00e1tica?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_20'>\n\t\t\t<div class='gchoice gchoice_9_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_9_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_0' id='label_9_20_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_9_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_1' id='label_9_20_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_21\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfTiene su hijo anemia de c\u00e9lulas falciformes o rasgo drepanoc\u00edtico?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_21'>\n\t\t\t<div class='gchoice gchoice_9_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_9_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_0' id='label_9_21_0'>Ninguno<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Trait'  id='choice_9_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_1' id='label_9_21_1'>rasgo falciforme<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Anemia'  id='choice_9_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_2' id='label_9_21_2'>anemia falciforme<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_25\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_25' >Problemas de Salud<\/label><div class='gfield_description' id='gfield_description_9_25'>Por favor utilice el siguiente espacio para enumerar cualquier otro problema grave de salud que su hijo haya tenido o tenga ahora.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_9_25' class='textarea medium'  aria-describedby=\"gfield_description_9_25\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_24\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_24' >Lista de Medicamentos<\/label><div class='gfield_description' id='gfield_description_9_24'>Haga una lista de todos los medicamentos, medicamentos de venta libre o suplementos herbales que su hijo est\u00e9 tomando en este momento.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_9_24' class='textarea medium'  aria-describedby=\"gfield_description_9_24\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_55' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_55' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_26\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informacion de pago<\/h3><div class='gsection_description' id='gfield_description_9_26'>DEBE verificar y completar y firmar en la parte inferior<\/div><\/div><fieldset id=\"field_9_72\" class=\"gfield gfield--width-third field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label'  >Informacion de pago<\/legend><div class='gfield_description' id='gfield_description_9_72'>Elige uno.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_72\"   \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0'>Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid and Insurance'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1'>Seguro Privado y Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Private Insurance'  id='choice_9_72_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_2' id='label_9_72_2'>Seguro Privado<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Self-pay\/no insurance'  id='choice_9_72_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_3' id='label_9_72_3'>No tengo seguro\/Soy responsable del pago<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 8;\"><\/div><div id=\"field_9_71\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_71' >Numero de MEDICAID<\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_9_71' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_71\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_71'>N\u00famero individual de 10 d\u00edgitos del NI\u00d1O(A) - NO EL # DE PLAN.<\/div><\/div><div id=\"field_9_61\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado y Medicaid<\/h3><\/div><fieldset id=\"field_9_58\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian que tiene seguro<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_58'>\n                            \n                            <span id='input_9_58_3_container' class='name_first' >\n                                                    <input type='text' name='input_58.3' id='input_9_58_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_58_6_container' class='name_last' >\n                                                    <input type='text' name='input_58.6' id='input_9_58_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_63\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_63' >Nombre de la seguro compania<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_9_63' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_65\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_65' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_65' id='input_9_65' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_66\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado<\/h3><\/div><div id=\"field_9_148\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_148' >Nombre de la compania para la cual trabaja el pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_9_148' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_67\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de Padre o Guardian asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_67' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_67_1_container' >\n                                        <input type='text' name='input_67.1' id='input_9_67_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_67_1' id='input_9_67_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_67_3_container' >\n                                    <input type='text' name='input_67.3' id='input_9_67_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_67_3' id='input_9_67_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_67_4_container' >\n                                        <select name='input_67.4' id='input_9_67_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_67_4' id='input_9_67_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_67_5_container' >\n                                    <input type='text' name='input_67.5' id='input_9_67_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_67_5' id='input_9_67_5_label' class='hidden_sub_label screen-reader-text'>Codigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_67.6' id='input_9_67_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_78\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_78' >N\u00famero de seguridad social<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_9_78' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_35\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre de la empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_35' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_35_1_container' >\n                                        <input type='text' name='input_35.1' id='input_9_35_1' value=''   placeholder='Street' aria-required='true'    \/>\n                                        <label for='input_9_35_1' id='input_9_35_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_35_3_container' >\n                                    <input type='text' name='input_35.3' id='input_9_35_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_35_3' id='input_9_35_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_35_4_container' >\n                                        <select name='input_35.4' id='input_9_35_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_35_4' id='input_9_35_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_35_5_container' >\n                                    <input type='text' name='input_35.5' id='input_9_35_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_35_5' id='input_9_35_5_label' class='hidden_sub_label screen-reader-text'>Condigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_35.6' id='input_9_35_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_147\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_147' >Numero de Seguro<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_9_147' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_79\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_79' >Identificaci\u00f3n # del grupo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_9_79' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_69\" class=\"gfield gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de nacimiento de padre o guardian que esta asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_69' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_69_1_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_69_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_69_2_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_69_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_69_3_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_69_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_37\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_37' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_37' id='input_9_37' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_80\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_80' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_80' id='input_9_80' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_80\"  \/><\/div><div class='gfield_description' id='gfield_description_9_80'>Vuelva a confirmar su n\u00famero de tel\u00e9fono celular; nos pondremos en contacto con usted antes del servicio.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_74' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_74' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_70\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent Section<\/h3><\/div><div id=\"field_9_44\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Parent Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_44'>I agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022\u00a0Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_150\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Financial Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_150'>I understand if my child is not eligible for Medicaid or private insurance coverage, I am financially responsible and agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022 Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_38\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent<\/h3><div class='gsection_description' id='gfield_description_9_38'><b>Printed name is considered legal signature.<\/b>\n\n\nSolicito y autorizo a HPS, a sus odont\u00f3logos contratantes y al personal, debidamente autorizado como Doctores en Odontolog\u00eda o higienistas dentales con licencia, a realizar cualquier procedimiento de diagn\u00f3stico, procedimientos preventivos o procedimientos de tratamiento para mi hijo. <br>Entiendo que los servicios preventivos no reemplazan un examen realizado por un dentista con licencia. Entiendo que las fotos pueden tomarse con fines educativos. <br>Adem\u00e1s, entiendo que si mi hijo no est\u00e1 inscrito en Medicaid, soy financieramente responsable ante HPS por los servicios prestados. <br>Autorizo el pago de Medicaid o beneficios de seguro directamente a HPS y sus dentistas asociados. Solicito y autorizo la divulgaci\u00f3n de cualquier informaci\u00f3n en este formulario o adquirida en el transcurso del tratamiento para fines de pago, referencia, y para todo el personal escolar apropiado y SC ORS y SC DHEC, seg\u00fan lo considere necesario por HPS. La firma da permiso para que el informe se env\u00ede por correo electr\u00f3nico o mensaje de texto. <br><b>El nombre impreso del padre o guardian se considera firma.<\/b><\/div><\/div><fieldset id=\"field_9_39\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_39'>\n                            \n                            <span id='input_9_39_3_container' class='name_first' >\n                                                    <input type='text' name='input_39.3' id='input_9_39_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_39_6_container' class='name_last' >\n                                                    <input type='text' name='input_39.6' id='input_9_39_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_41\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_41' >Firma impresa<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_9_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_42\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_42' >Relacion hacia el ni\u00f1o(a)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_9_42' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button button' value='Previous'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' value='WyJ7XCI3MlwiOltcIjdlMDY1ZTAyYjU1YjBmOTcxNDUxN2MyYzZhNGEyNzMzXCIsXCJmMTEyNDUwMjlmOTk5ZDZhOTVmYThlMDA1ZWVkMWZkM1wiLFwiMWRkOWM3MDczY2VhODVlYTM0NDU5YWFiYjVkZjQ0ZTdcIixcIjhiZDBiMzgzZWZjZGY1Njg3NTUwMzE0ZGJkMTE2MjM4XCJdfSIsIjI2YjE2ZmRiOThhZTJlODM2ZWFmNmJjMDNiNWI0YzU3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_9' style='display:none'><div id='gf_9' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Consentimiento para Servicios<\/h2>\n                            <span class='gform_description'>Este formulario nos da permiso para tratar a su hijo. Los datos se mantienen confidenciales y se usan solo para el tratamiento y la facturaci\u00f3n, de acuerdo con las leyes estatales y federales. Si la informaci\u00f3n cambia antes del tratamiento, comun\u00edquese con nosotros.<\/span>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/es\/wp-json\/wp\/v2\/pages\/1224#gf_9' novalidate><div id='gf_page_steps_9' class='gf_page_steps'><div id='gf_step_9_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Secci\u00f3n de informaci\u00f3n del estudiante<\/span><\/div><div id='gf_step_9_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Secci\u00f3n M\u00e9dica<\/span><\/div><div id='gf_step_9_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Secci\u00f3n de pago<\/span><\/div><div id='gf_step_9_4' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Firmar y Consentimiento<\/span><\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_9_1' class='gform_page' >\n                                    <div class='gform_page_fields'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_9\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n de la Escuela<\/h3><\/div><div id=\"field_9_46\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_46' >Distrito escolar<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_46' id='input_9_46' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County School District<\/option><option value='2' >Aiken County Public Schools<\/option><option value='3' >Allendale County Schools<\/option><option value='10' >Anderson 1 &amp; 2 AVC<\/option><option value='9' >Anderson Alternative School District<\/option><option value='4' >Anderson School District One<\/option><option value='5' >Anderson School District Two<\/option><option value='6' >Anderson School District Three<\/option><option value='7' >Anderson County School District 4<\/option><option value='8' >Anderson School District Five<\/option><option value='11' >Bamberg School District<\/option><option value='16' >Barnwell County AVC<\/option><option value='15' >Barnwell School District 45<\/option><option value='17' >Beaufort County School District<\/option><option value='18' >Beaufort-Jasper Career Center<\/option><option value='19' >Berkeley County School District<\/option><option value='13' >Blackville-Hilda Public Schools<\/option><option value='20' >Calhoun County Public Schools<\/option><option value='21' >Charleston County School District<\/option><option value='105' >Charter Institute at Erskine<\/option><option value='22' >Cherokee County School District<\/option><option value='23' >Chester County School District<\/option><option value='24' >Chesterfield County School District<\/option><option value='25' >Clarendon County School District One<\/option><option value='26' >Clarendon County School District Two<\/option><option value='27' >Clarendon County School District Three<\/option><option value='29' >Colleton County School District<\/option><option value='72' >Cope Area Career Center<\/option><option value='84' >Daniel Morgan Vocational Center<\/option><option value='30' >Darlington County School District<\/option><option value='33' >Dillon County Applied Tech Center<\/option><option value='31' >Dillon School District Three<\/option><option value='32' >Dillon School District Four<\/option><option value='36' >Dorchester County Career School<\/option><option value='34' >Dorchester County School District Two<\/option><option value='35' >Dorchester County School District Four<\/option><option value='37' >Edgefield County School District<\/option><option value='28' >F E Dubose Vocational Center<\/option><option value='38' >Fairfield County School District<\/option><option value='96' >Felton Laboratory School<\/option><option value='39' >Florence School District One<\/option><option value='40' >Florence School District Two<\/option><option value='41' >Florence School District Three<\/option><option value='42' >Florence School District Four<\/option><option value='43' >Florence School District Five<\/option><option value='93' >Fort Mill School District<\/option><option value='44' >Georgetown County School District<\/option><option value='108' >GLEAMNS Human Resources Commission, Inc.<\/option><option value='102' >Governor&#039;s School for Math and Science<\/option><option value='101' >Governor&#039;s School for the Arts and Humanities<\/option><option value='45' >Greenville County School District<\/option><option value='49' >Greenwood County Career Center<\/option><option value='46' >Greenwood County School District 50<\/option><option value='47' >Greenwood County School District 51<\/option><option value='48' >Greenwood County School District 52<\/option><option value='86' >H B Swofford AVC<\/option><option value='50' >Hampton County School District One<\/option><option value='51' >Hampton County School District Two<\/option><option value='52' >Horry County Schools<\/option><option value='53' >Jasper County School District<\/option><option value='97' >John De La Howe<\/option><option value='99' >Juvenile Justice Schools<\/option><option value='54' >Kershaw County School District<\/option><option value='55' >Lancaster County School District<\/option><option value='56' >Laurens County School District No. 55<\/option><option value='57' >Laurens County School District 56<\/option><option value='58' >Lee County School District<\/option><option value='63' >Lexington and Richland School District Five<\/option><option value='59' >Lexington County School District One<\/option><option value='60' >Lexington County School District Two<\/option><option value='61' >Lexington County School District Three<\/option><option value='62' >Lexington County School District Four<\/option><option value='103' >Marion County School District<\/option><option value='66' >Marlboro County School District<\/option><option value='64' >McCormick County School District<\/option><option value='110' >Movement School<\/option><option value='67' >Newberry County School District<\/option><option value='68' >Oconee County School District<\/option><option value='71' >Orangeburg County School District<\/option><option value='100' >Palmetto Unified<\/option><option value='104' >Pee Dee Head Starts<\/option><option value='73' >Pickens County School District<\/option><option value='85' >R D Anderson Applied Technology Center<\/option><option value='74' >Richland County School District One<\/option><option value='75' >Richland County School District Two<\/option><option value='92' >Rock Hill School District Three of York County<\/option><option value='76' >Saluda County School District One<\/option><option value='94' >SC Public School Charter District<\/option><option value='98' >SC School for the Deaf and Blind<\/option><option value='107' >Share Community Action Partnership<\/option><option value='77' >Spartanburg County School District One<\/option><option value='78' >Spartanburg County School District Two<\/option><option value='79' >Spartanburg County School District Three<\/option><option value='80' >Spartanburg County School District Four<\/option><option value='81' >Spartanburg County School District Five<\/option><option value='82' >Spartanburg County School District Six<\/option><option value='83' >Spartanburg County School District Seven<\/option><option value='87' >Sumter School District<\/option><option value='88' >Union County School District<\/option><option value='89' >Williamsburg County School District<\/option><option value='95' >Williamsburg Tech<\/option><option value='14' >Williston School District 29<\/option><option value='90' >York School District One<\/option><option value='91' >York County School District Two<\/option><\/select><\/div><\/div><div id=\"field_9_51\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_51' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_51'>Abbeville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_51' id='input_9_51' class='large gfield_select'  aria-describedby=\"gfield_description_9_51\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1' >Abbeville County Career Center<\/option><option value='2' >Abbeville High School<\/option><option value='3' >Cherokee Trail Elementary<\/option><option value='4' >Diamond Hill Elementary<\/option><option value='5' >Dixie High School<\/option><option value='6' >John C. Calhoun Elementary<\/option><option value='7' >Long Cane Primary<\/option><option value='8' >Westwood Elementary<\/option><option value='9' >Wright Middle<\/option><\/select><\/div><\/div><div id=\"field_9_52\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_52' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_52'>Aiken County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_52' id='input_9_52' class='large gfield_select'  aria-describedby=\"gfield_description_9_52\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='10' >Aiken County Career Center<\/option><option value='11' >Aiken High School<\/option><option value='12' >Aiken Middle<\/option><option value='13' >Aiken Performing Arts Academy Charter<\/option><option value='14' >Belvedere Elementary<\/option><option value='15' >Busbee Corbett Elementary Middle<\/option><option value='16' >Byrd Elementary<\/option><option value='17' >Chukker Creek Elementary<\/option><option value='18' >Clearwater Elementary<\/option><option value='19' >East Aiken School of the Arts<\/option><option value='20' >Gloverville Elementary<\/option><option value='21' >Greendale Elementary<\/option><option value='22' >Hammond Hill Elementary<\/option><option value='23' >Horse Creek Academy<\/option><option value='24' >J. D. Lever Elementary<\/option><option value='25' >Jackson Middle<\/option><option value='27' >Langley-Bath-Clearwater Middle<\/option><option value='28' >Leavelle McCampbell Middle<\/option><option value='29' >Lloyd-Kennedy Charter<\/option><option value='30' >M. B. Kennedy Middle<\/option><option value='31' >Midland Valley High School<\/option><option value='32' >Millbrook Elementary<\/option><option value='33' >Mossy Creek Elementary<\/option><option value='34' >New Ellenton Middle<\/option><option value='35' >North Aiken Elementary<\/option><option value='36' >North Augusta Elementary<\/option><option value='37' >North Augusta High School<\/option><option value='38' >North Augusta Middle<\/option><option value='39' >Oakwood-Windsor Elementary<\/option><option value='40' >Paul Knox Middle<\/option><option value='41' >Redcliffe Elementary<\/option><option value='42' >Ridge Spring Monetta Elementary<\/option><option value='43' >Ridge Spring-Monetta Middle High School<\/option><option value='44' >Schofield Middle<\/option><option value='45' >Silver Bluff High School<\/option><option value='46' >South Aiken High School<\/option><option value='47' >Wagener-Salley High School<\/option><option value='48' >Warrenville Elementary<\/option><option value='324' >Jefferson Elementary-Aiken<\/option><\/select><\/div><\/div><div id=\"field_9_53\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_53' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_53'>Allendale County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_53' id='input_9_53' class='large gfield_select'  aria-describedby=\"gfield_description_9_53\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='49' >Allendale Elementary<\/option><option value='50' >Allendale Fairfax High School<\/option><option value='51' >Allendale-Fairfax Middle<\/option><option value='52' >Fairfax Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_81\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_81' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_81'>Anderson School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_81' id='input_9_81' class='large gfield_select'  aria-describedby=\"gfield_description_9_81\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='53' >Cedar Grove Elementary<\/option><option value='54' >Concrete Primary<\/option><option value='55' >Hunt Meadows Elementary<\/option><option value='56' >Palmetto Elementary<\/option><option value='57' >Palmetto High School<\/option><option value='58' >Palmetto Middle<\/option><option value='59' >Powdersville Elementary<\/option><option value='60' >Powdersville High School<\/option><option value='61' >Powdersville Middle<\/option><option value='62' >Spearman Elementary<\/option><option value='63' >West Pelzer Elementary<\/option><option value='64' >Wren Elementary<\/option><option value='65' >Wren High School<\/option><option value='66' >Wren Middle<\/option><\/select><\/div><\/div><div id=\"field_9_82\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_82' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_82'>Anderson School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_82' id='input_9_82' class='large gfield_select'  aria-describedby=\"gfield_description_9_82\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='67' >Belton Elementary<\/option><option value='68' >Belton Honea Path High School<\/option><option value='69' >Belton Middle<\/option><option value='70' >Honea Path Elementary<\/option><option value='71' >Honea Path Middle<\/option><option value='72' >Marshall Primary<\/option><option value='73' >Wright Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_83\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_83' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_83'>Anderson School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_83' id='input_9_83' class='large gfield_select'  aria-describedby=\"gfield_description_9_83\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='74' >Crescent High School<\/option><option value='75' >Flat Rock Elementary<\/option><option value='76' >Iva Elementary<\/option><option value='77' >Starr Elementary<\/option><option value='78' >Starr-Iva Middle<\/option><\/select><\/div><\/div><div id=\"field_9_84\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_84' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_84'>Anderson County School District 4<\/div><div class='ginput_container ginput_container_select'><select name='input_84' id='input_9_84' class='large gfield_select'  aria-describedby=\"gfield_description_9_84\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='79' >La France Elementary<\/option><option value='80' >Mt. Lebanon Elementary<\/option><option value='81' >Pendleton Elementary<\/option><option value='82' >Pendleton High School<\/option><option value='83' >Riverside Middle-Anderson<\/option><option value='84' >Townville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_85\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_85' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_85'>Anderson School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_85' id='input_9_85' class='large gfield_select'  aria-describedby=\"gfield_description_9_85\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='85' >Anderson  Five Charter School<\/option><option value='86' >Anderson Five Career Campus<\/option><option value='1291' >Anderson Institute of Technology<\/option><option value='87' >Calhoun Academy of the Arts<\/option><option value='88' >Centerville Elementary-Anderson 5<\/option><option value='89' >Concord Elementary<\/option><option value='90' >Glenview Middle<\/option><option value='91' >Homeland Park Primary<\/option><option value='92' >Lakeside Middle<\/option><option value='93' >McCants Middle<\/option><option value='94' >McLees Elementary<\/option><option value='95' >Midway Elementary School of Science and Engineering<\/option><option value='96' >Nevitt Forest Elementary<\/option><option value='97' >New Prospect Elementary<\/option><option value='98' >North Pointe Elementary<\/option><option value='99' >Robert Anderson Middle<\/option><option value='100' >South Fant School of Early Education<\/option><option value='101' >Southwood Academy of the Arts<\/option><option value='102' >T. L. Hanna High School<\/option><option value='103' >Varennes Elementary<\/option><option value='104' >West Market School of Early Education<\/option><option value='105' >Westside High School<\/option><option value='106' >Whitehall Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_86\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_86' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_86'>Anderson 1 & 2 AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_86' id='input_9_86' class='large gfield_select'  aria-describedby=\"gfield_description_9_86\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='108' >Career Tec Ctr Anderson1&amp;2<\/option><\/select><\/div><\/div><div id=\"field_9_187\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_187' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_187'>Renaissance Academy<\/div><div class='ginput_container ginput_container_select'><select name='input_187' id='input_9_187' class='large gfield_select'  aria-describedby=\"gfield_description_9_187\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='107' >Renaissance Academy<\/option><\/select><\/div><\/div><div id=\"field_9_87\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_87' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_87'>Bamberg School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_87' id='input_9_87' class='large gfield_select'  aria-describedby=\"gfield_description_9_87\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='109' >Bamberg-Ehrhardt High School<\/option><option value='110' >Bamberg-Ehrhardt Middle<\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><option value='111' >Richard Carroll Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_88\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_88' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_88'>Bamberg School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_88' id='input_9_88' class='large gfield_select'  aria-describedby=\"gfield_description_9_88\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='112' >Denmark Olar High School<\/option><option value='113' >Denmark-Olar Elementary<\/option><option value='114' >Denmark-Olar Middle<\/option><\/select><\/div><\/div><div id=\"field_9_91\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_91' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_91'>Barnwell School District 45<\/div><div class='ginput_container ginput_container_select'><select name='input_91' id='input_9_91' class='large gfield_select'  aria-describedby=\"gfield_description_9_91\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='121' >Barnwell Elementary<\/option><option value='122' >Barnwell High School<\/option><option value='123' >Barnwell Primary<\/option><option value='124' >Guinyard-Butler Middle<\/option><\/select><\/div><\/div><div id=\"field_9_92\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_92' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_92'>Barnwell County AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_92' id='input_9_92' class='large gfield_select'  aria-describedby=\"gfield_description_9_92\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='125' >Barnwell County Career Centertr<\/option><\/select><\/div><\/div><div id=\"field_9_93\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_93' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_93'>Beaufort County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_93' id='input_9_93' class='large gfield_select'  aria-describedby=\"gfield_description_9_93\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='126' >Battery Creek High School<\/option><option value='127' >Beaufort Elementary<\/option><option value='128' >Beaufort High School<\/option><option value='129' >Beaufort Middle<\/option><option value='130' >Bluffton Elementary<\/option><option value='131' >Bluffton High School<\/option><option value='132' >Bluffton Middle<\/option><option value='133' >Broad River Elementary<\/option><option value='134' >Coosa Elementary<\/option><option value='135' >Daufuskie Elem. ANNEX<\/option><option value='136' >H. E. McCracken Middle<\/option><option value='137' >Hilton Head Island Early Childhood Center<\/option><option value='138' >Hilton Head Island Elementary<\/option><option value='139' >Hilton Head Island Elementary School for the Creative Arts<\/option><option value='140' >Hilton Head Island High School<\/option><option value='141' >Hilton Head Island Middle<\/option><option value='142' >Joseph S. Shanklin Elementary<\/option><option value='143' >Lady&#039;s Island Elementary<\/option><option value='144' >Lady&#039;s Island Middle<\/option><option value='145' >Michael C. Riley Elementary<\/option><option value='146' >Mossy Oaks Elementary<\/option><option value='147' >Okatie Elementary<\/option><option value='148' >Port Royal Elementary<\/option><option value='149' >Pritchardville Elementary<\/option><option value='150' >Red Cedar Elementary<\/option><option value='151' >Right Choice  School<\/option><option value='152' >River Ridge Academy<\/option><option value='153' >Riverview Charter School<\/option><option value='154' >Robert Smalls International Academy<\/option><option value='155' >St. Helena Elementary<\/option><option value='156' >Whale Branch Early College High School<\/option><option value='157' >Whale Branch Elementary<\/option><option value='158' >Whale Branch Middle<\/option><\/select><\/div><\/div><div id=\"field_9_95\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_95' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_95'>Beaufort-Jasper Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_95' id='input_9_95' class='large gfield_select'  aria-describedby=\"gfield_description_9_95\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='159' >Beaufort-Jasper Academy For Ex<\/option><\/select><\/div><\/div><div id=\"field_9_94\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_94' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_94'>Berkeley County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_94' id='input_9_94' class='large gfield_select'  aria-describedby=\"gfield_description_9_94\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='160' >Berkeley County Middle College High School<\/option><option value='161' >Berkeley Elementary<\/option><option value='162' >Berkeley High School<\/option><option value='163' >Berkeley Intermediate<\/option><option value='164' >Berkeley Middle<\/option><option value='165' >Boulder Bluff Elementary<\/option><option value='1285' >Bowen&#039;s Corner Elementary<\/option><option value='166' >Cainhoy Elementary Middle<\/option><option value='167' >Cane Bay Elementary<\/option><option value='168' >Cane Bay High School<\/option><option value='169' >Cane Bay Middle<\/option><option value='1443' >Carolyn Lewis School<\/option><option value='170' >College Park Elementary<\/option><option value='171' >College Park Middle<\/option><option value='172' >Cross Elementary<\/option><option value='173' >Cross High School<\/option><option value='174' >Daniel Island School<\/option><option value='175' >Devon Forest Elementary<\/option><option value='1286' >Foxbank Elementary<\/option><option value='176' >Goose Creek High School<\/option><option value='177' >Goose Creek Elementary<\/option><option value='178' >Hanahan Elementary<\/option><option value='179' >Hanahan High School<\/option><option value='180' >Hanahan Middle<\/option><option value='181' >Henry E. Bonner Elementary<\/option><option value='182' >Howe Hall AIMS Elementary<\/option><option value='183' >J. K. Gourdin Elementary<\/option><option value='184' >Macedonia Middle<\/option><option value='185' >Marrington Elementary<\/option><option value='186' >Marrington Middle School of the Arts<\/option><option value='191' >Mount Holly Elementary (formerly Sedgefield Intermediate)<\/option><option value='163' >Moncks Corner Elementary<\/option><option value='187' >Nexton Elementary<\/option><option value='1268' >Philip Simmons Elementary<\/option><option value='1269' >Phillip Simmons Middle<\/option><option value='188' >Sangaree Elementary<\/option><option value='189' >Sangaree Intermediate<\/option><option value='190' >Sangaree Middle<\/option><option value='192' >Sedgefield Middle<\/option><option value='193' >St. Stephen Elementary<\/option><option value='194' >St. Stephen Middle<\/option><option value='195' >Stratford High School<\/option><option value='196' >Timberland High  School<\/option><option value='197' >Westview Elementary<\/option><option value='198' >Westview Middle<\/option><option value='199' >Westview Primary<\/option><option value='200' >Whitesville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_89\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_89' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_89'>Blackville-Hilda Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_89' id='input_9_89' class='large gfield_select'  aria-describedby=\"gfield_description_9_89\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='115' >Blackville-Hilda High School<\/option><option value='116' >Blackville-Hilda Junior High<\/option><option value='117' >Macedonia Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_96\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_96' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_96'>Calhoun County Public Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_96' id='input_9_96' class='large gfield_select'  aria-describedby=\"gfield_description_9_96\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='201' >Calhoun County High School<\/option><option value='202' >Sandy Run School<\/option><option value='203' >St. Matthews K-8 School<\/option><\/select><\/div><\/div><div id=\"field_9_97\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_97' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_97'>Charleston County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_97' id='input_9_97' class='large gfield_select'  aria-describedby=\"gfield_description_9_97\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='204' >A. C. Corcoran Elementary<\/option><option value='205' >Academic Magnet High School<\/option><option value='206' >Allegro Charter School of Music<\/option><option value='207' >Angel Oak Elementary<\/option><option value='208' >Ashley River Creative Arts Elementary<\/option><option value='209' >Baptist Hill High School<\/option><option value='210' >Belle Hall Elementary<\/option><option value='211' >Buist Academy<\/option><option value='212' >Burke High School<\/option><option value='213' >C.E. Williams Middle School<\/option><option value='235' >Camp Middle<\/option><option value='1276' >Cape Romain Environmental Charter School<\/option><option value='1278' >Carolina Park Elementary School<\/option><option value='214' >Carolina Voyager Charter<\/option><option value='215' >Charles Pinckney Elementary<\/option><option value='216' >Charleston Charter School for Math and Science<\/option><option value='217' >Charleston Development Academy Public Charter School<\/option><option value='218' >Charleston Progressive Academy<\/option><option value='219' >Charleston School Of The Arts<\/option><option value='220' >Chicora Elementary School<\/option><option value='1272' >Daniel Jenkins Academy<\/option><option value='221' >Drayton Hall Elementary School<\/option><option value='222' >E.B. Ellington Elementary School<\/option><option value='223' >East Cooper Center for Advanced Studies<\/option><option value='224' >Edith L. Frierson Elementary<\/option><option value='225' >Edmund A. Burns Elementary<\/option><option value='226' >Fort Johnson Middle<\/option><option value='227' >Garrett Academy of Technology<\/option><option value='228' >Greg Mathis Charter High School<\/option><option value='229' >Harbor View Elementary<\/option><option value='230' >Haut Gap Middle<\/option><option value='231' >Hunley Park Elementary<\/option><option value='232' >James B. Edwards Elementary<\/option><option value='233' >James Island Charter High School<\/option><option value='234' >James Island Elementary<\/option><option value='236' >James Simons Montessori School<\/option><option value='237' >Jane Edwards Elementary<\/option><option value='238' >Jennie Moore Elementary<\/option><option value='239' >Jerry Zucker Middle School of Science<\/option><option value='240' >Ladson Elementary<\/option><option value='241' >Laing Middle School of Science and Technology<\/option><option value='242' >Lambs Elementary School<\/option><option value='243' >Laurel Hill Primary<\/option><option value='1267' >Liberty Hill Academy<\/option><option value='244' >Lincoln High School<\/option><option value='245' >Malcolm C. Hursey Elementary<\/option><option value='246' >Mamie Whitesides Elementary<\/option><option value='247' >Mary Ford Early Learning &amp; Family Center<\/option><option value='248' >Matilda Dunston Elementary<\/option><option value='1270' >Meeting Street Academy<\/option><option value='249' >Meeting Street Elementary at Brentwood<\/option><option value='250' >Memminger School of Global Studies<\/option><option value='251' >Midland Park Primary<\/option><option value='252' >Military Magnet Academy<\/option><option value='253' >Minnie Hughes Elementary<\/option><option value='254' >Mitchell Elementary<\/option><option value='255' >Montessori Community School<\/option><option value='256' >Morningside Middle<\/option><option value='257' >Morningside Middle ANNEX<\/option><option value='258' >Moultrie Middle<\/option><option value='259' >Mt. Pleasant Academy<\/option><option value='260' >Mt. Zion Elementary<\/option><option value='261' >Murray LaSaine Elementary<\/option><option value='262' >North Charleston Creative Arts Elementary<\/option><option value='263' >North Charleston Elementary<\/option><option value='264' >North Charleston High School<\/option><option value='265' >Northwoods Middle<\/option><option value='1037' >Oakland Elementary-Charleston<\/option><option value='267' >Orange Grove Elementary Charter<\/option><option value='268' >Pattison&#039;s Academy for Comprehensive Education<\/option><option value='269' >Pepperhill Elementary<\/option><option value='270' >Pinehurst Elementary<\/option><option value='271' >R. B. Stall High School<\/option><option value='272' >Sanders-Clyde Elementary<\/option><option value='1261' >Septima Clarke Alternative<\/option><option value='273' >Simmons Pinckney Middle<\/option><option value='274' >Springfield Elementary<\/option><option value='275' >St. Andrew&#039;s School of Math and Science<\/option><option value='276' >St. James Santee Elementary<\/option><option value='277' >St. John&#039;s High School<\/option><option value='278' >Stiles Point Elementary<\/option><option value='279' >Stono Park Elementary<\/option><option value='280' >Sullivan&#039;s Island Elementary<\/option><option value='281' >Thomas C. Cario Middle<\/option><option value='282' >W. B. Goodwin Elementary<\/option><option value='283' >Wando High School<\/option><option value='284' >West Ashley High School<\/option><option value='285' >West Ashley Middle<\/option><option value='1271' >West Ashley Advanced Study Magnet<\/option><\/select><\/div><\/div><div id=\"field_9_151\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_151' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_151'>Charter Institute at Erskine<\/div><div class='ginput_container ginput_container_select'><select name='input_151' id='input_9_151' class='large gfield_select'  aria-describedby=\"gfield_description_9_151\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1299' >Belton Preparatory Academy<\/option><option value='1300' >Berkeley Preparatory Academy<\/option><option value='1301' >Brashier Middle College Charter School<\/option><option value='1302' >Calhoun Falls Charter School<\/option><option value='1303' >Cherokee Charter Academy<\/option><option value='1304' >Clear Dot Charter School<\/option><option value='1305' >Coastal Leadership Academy<\/option><option value='1306' >Cyber Academy of SC<\/option><option value='1307' >Gates School<\/option><option value='1308' >Gray Collegiate Academy<\/option><option value='1309' >Horse Creek Academy<\/option><option value='1310' >Legion Collegiate Academy<\/option><option value='1311' >Lowcountry Leadership Charter School<\/option><option value='1312' >Lowcountry Connections Academy<\/option><option value='1313' >Mevers School of Excellence<\/option><option value='1218' >Midlands STEM Institute<\/option><option value='1316' >Oceanside Collegiate Academy<\/option><option value='1317' >Odyssey Online Learning<\/option><option value='1318' >Royal Live Oaks Academy<\/option><option value='1319' >South Carolina Connections Academy<\/option><option value='1320' >SC Preparatory Academy<\/option><option value='1321' >South Carolina Virtual Charter School<\/option><option value='1322' >Summit Classical School<\/option><option value='1315' >The Montessori School of Camden<\/option><option value='1323' >Thornwell Charter School<\/option><option value='1324' >Virtus Academy of South Carolina<\/option><\/select><\/div><\/div><div id=\"field_9_98\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_98' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_98'>Cherokee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_98' id='input_9_98' class='large gfield_select'  aria-describedby=\"gfield_description_9_98\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='286' >Alma Elementary<\/option><option value='287' >B. D. Lee Elementary<\/option><option value='288' >Blacksburg Elementary<\/option><option value='289' >Blacksburg High School<\/option><option value='290' >Blacksburg Middle<\/option><option value='291' >Blacksburg Primary<\/option><option value='292' >Cherokee Technology Center<\/option><option value='293' >Corinth Elementary<\/option><option value='294' >Draytonville Elementary<\/option><option value='295' >Gaffney High School<\/option><option value='296' >Gaffney Middle<\/option><option value='297' >Goucher Elementary<\/option><option value='298' >Granard Middle<\/option><option value='299' >Grassy Pond Elementary<\/option><option value='300' >John E. Ewing Middle<\/option><option value='301' >Limestone-Central Elementary<\/option><option value='302' >Luther L. Vaughan  Elementary<\/option><option value='303' >Mary Bramlett Elementary<\/option><option value='304' >Northwest Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_99\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_99' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_99'>Chester County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_99' id='input_9_99' class='large gfield_select'  aria-describedby=\"gfield_description_9_99\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='305' >Academy for Teaching and Learning  K-8<\/option><option value='306' >Chester County Career Center<\/option><option value='307' >Chester Middle<\/option><option value='308' >Chester Park Elementary of Inquiry<\/option><option value='309' >Chester Park Elementary School for the Arts<\/option><option value='310' >Chester Park Elementary School of Literacy and Technology<\/option><option value='311' >Chester Senior High School<\/option><option value='312' >Great Falls Elementary<\/option><option value='313' >Great Falls High School<\/option><option value='314' >Lewisville Elementary<\/option><option value='315' >Lewisville High School<\/option><option value='316' >Lewisville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_100\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_100' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_100'>Chesterfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_100' id='input_9_100' class='large gfield_select'  aria-describedby=\"gfield_description_9_100\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='317' >Central High School<\/option><option value='1274' >Cheraw Headstart<\/option><option value='318' >Cheraw High School<\/option><option value='319' >Cheraw Intermediate<\/option><option value='320' >Cheraw Primary<\/option><option value='321' >Chesterfield High School<\/option><option value='322' >Chesterfield-Ruby Middle<\/option><option value='323' >Edwards Elementary<\/option><option value='26' >Jefferson Elementary-Chesterfield<\/option><option value='325' >Long Middle<\/option><option value='326' >McBee Elementary<\/option><option value='1262' >McBee HeadStart<\/option><option value='327' >McBee High School<\/option><option value='328' >New Heights Middle<\/option><option value='329' >Pageland Elementary<\/option><option value='330' >Petersburg Primary<\/option><option value='331' >Plainview Elementary<\/option><option value='332' >Ruby Elementary<\/option><option value='1263' >Ruby HeadStart<\/option><option value='1296' >Pageland Headstart<\/option><\/select><\/div><\/div><div id=\"field_9_101\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_101' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_101'>Clarendon County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_101' id='input_9_101' class='large gfield_select'  aria-describedby=\"gfield_description_9_101\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='333' >Scott&#039;s Branch High School<\/option><option value='334' >Scott&#039;s Branch Middle<\/option><option value='335' >St. Paul Elementary<\/option><option value='336' >Summerton Early Childhood Center<\/option><\/select><\/div><\/div><div id=\"field_9_102\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_102' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_102'>Clarendon County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_102' id='input_9_102' class='large gfield_select'  aria-describedby=\"gfield_description_9_102\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='337' >Manning Early Childhood Center<\/option><option value='338' >Manning Elementary<\/option><option value='339' >Manning High School<\/option><option value='340' >Manning Junior High<\/option><option value='341' >Manning Primary<\/option><option value='342' >Phoenix Charter High School<\/option><\/select><\/div><\/div><div id=\"field_9_103\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_103' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_103'>Clarendon County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_103' id='input_9_103' class='large gfield_select'  aria-describedby=\"gfield_description_9_103\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='343' >East Clarendon Middle-High School<\/option><option value='344' >Walker-Gamble Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_105\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_105' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_105'>Colleton County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_105' id='input_9_105' class='large gfield_select'  aria-describedby=\"gfield_description_9_105\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='346' >Bells Elementary<\/option><option value='347' >Black Street Early Childhood Center<\/option><option value='348' >Colleton County High School<\/option><option value='349' >Colleton County Middle<\/option><option value='350' >Cottageville Elementary<\/option><option value='351' >Forest Hills Elementary<\/option><option value='352' >Hendersonville Elementary<\/option><option value='353' >Northside Elementary-Colleton<\/option><option value='354' >Thunderbolt Career and Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_152\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_152' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_152'>Cope Area Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_152' id='input_9_152' class='large gfield_select'  aria-describedby=\"gfield_description_9_152\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='902' >Cope Area Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_153\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_153' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_153'>Daniel Morgan Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_153' id='input_9_153' class='large gfield_select'  aria-describedby=\"gfield_description_9_153\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1088' >Daniel Morgan Technolgy Center<\/option><\/select><\/div><\/div><div id=\"field_9_106\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_106' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_106'>Darlington County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_106' id='input_9_106' class='large gfield_select'  aria-describedby=\"gfield_description_9_106\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='355' >Brockington Elementary<\/option><option value='356' >Brunson-Dargan Elementary<\/option><option value='357' >Cain Elementary<\/option><option value='358' >Carolina Elementary<\/option><option value='359' >Darlington County Institute Of<\/option><option value='360' >Darlington High School<\/option><option value='361' >Darlington Middle<\/option><option value='362' >Hartsville High School<\/option><option value='363' >Hartsville Middle<\/option><option value='364' >Lamar Elementary<\/option><option value='365' >Lamar High School<\/option><option value='366' >Mayo High School for Math, Science, and Technology<\/option><option value='367' >North Hartsville Elementary<\/option><option value='368' >Pate Elementary<\/option><option value='369' >Rosenwald Elementary-Middle<\/option><option value='370' >Southside Early Childhood Education Center<\/option><option value='371' >Spaulding Elementary<\/option><option value='372' >Spaulding Middle<\/option><option value='373' >St. Johns Elementary<\/option><option value='374' >Thornwell School for the Arts<\/option><option value='375' >Washington St. Elementary<\/option><option value='376' >West Hartsville Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_109\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_109' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_109'>Dillon County Applied Tech Center<\/div><div class='ginput_container ginput_container_select'><select name='input_109' id='input_9_109' class='large gfield_select'  aria-describedby=\"gfield_description_9_109\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='388' >Dillon County Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_107\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_107' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_107'>Dillon School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_107' id='input_9_107' class='large gfield_select'  aria-describedby=\"gfield_description_9_107\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='377' >Latta Elementary<\/option><option value='378' >Latta High School<\/option><option value='379' >Latta Middle<\/option><\/select><\/div><\/div><div id=\"field_9_108\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_108' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_108'>Dillon School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_108' id='input_9_108' class='large gfield_select'  aria-describedby=\"gfield_description_9_108\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='380' >Dillon High School<\/option><option value='381' >Dillon Middle<\/option><option value='382' >East Elementary<\/option><option value='383' >Gordon Elementary<\/option><option value='384' >Lake View Elementary<\/option><option value='385' >Lake View High School<\/option><option value='386' >South Elementary<\/option><option value='387' >Stewart Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_154\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_154' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_154'>Spartanburg County District One<\/div><div class='ginput_container ginput_container_select'><select name='input_154' id='input_9_154' class='large gfield_select'  aria-describedby=\"gfield_description_9_154\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1015' >Campobello-Gramling School<\/option><option value='1016' >Chapman High School<\/option><option value='1017' >Holly Springs-Motlow Elementary<\/option><option value='1018' >Inman Elementary<\/option><option value='1019' >Inman Intermediate<\/option><option value='1020' >Landrum High School<\/option><option value='1021' >Landrum Middle<\/option><option value='1022' >New Prospect Elementary<\/option><option value='1023' >O. P. Earle Elementary<\/option><option value='1024' >T. E. Mabry Middle<\/option><\/select><\/div><\/div><div id=\"field_9_112\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_112' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_112'>Dorchester County Career School<\/div><div class='ginput_container ginput_container_select'><select name='input_112' id='input_9_112' class='large gfield_select'  aria-describedby=\"gfield_description_9_112\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='416' >Dorchester County Career &amp; Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_110\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_110' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_110'>Dorchester County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_110' id='input_9_110' class='large gfield_select'  aria-describedby=\"gfield_description_9_110\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='389' >Alston Middle<\/option><option value='390' >Ashley Ridge High School<\/option><option value='391' >Beech Hill Elementary<\/option><option value='392' >Charles B. DuBose Middle<\/option><option value='393' >Eagle Nest Elementary<\/option><option value='394' >Flowertown Elementary<\/option><option value='395' >Fort Dorchester Elementary<\/option><option value='396' >Fort Dorchester High School<\/option><option value='397' >Gregg Middle<\/option><option value='398' >James H. Spann Elementary<\/option><option value='399' >Joseph R. Pye Elementary<\/option><option value='400' >Knightsville Elementary<\/option><option value='401' >Newington Elementary<\/option><option value='402' >Oakbrook Elementary<\/option><option value='403' >Oakbrook Middle<\/option><option value='404' >River Oaks Middle<\/option><option value='405' >Rollings Middle School of the Arts<\/option><option value='406' >Summerville Elementary<\/option><option value='407' >Summerville High School<\/option><option value='408' >William M. Reeves Elementary<\/option><option value='409' >Windsor Hill Arts Infused Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_111\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_111' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_111'>Dorchester County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_111' id='input_9_111' class='large gfield_select'  aria-describedby=\"gfield_description_9_111\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='410' >Clay Hill Elementary<\/option><option value='411' >Harleyville Elementary<\/option><option value='414' >Williams Memorial Elementary<\/option><option value='415' >Woodland High School<\/option><option value='1449' >Woodland Middle<\/option><\/select><\/div><\/div><div id=\"field_9_113\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_113' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_113'>Edgefield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_113' id='input_9_113' class='large gfield_select'  aria-describedby=\"gfield_description_9_113\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='417' >Douglas Elementary<\/option><option value='418' >Johnston Elementary<\/option><option value='419' >Johnston-Edgefield-Trenton Middle<\/option><option value='420' >Merriwether Elementary<\/option><option value='421' >Merriwether Middle<\/option><option value='422' >Strom Thurmond Career Center<\/option><option value='423' >Strom Thurmond High School<\/option><option value='424' >W. E. Parker Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_104\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_104' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_104'>F E Dubose Vocational Center<\/div><div class='ginput_container ginput_container_select'><select name='input_104' id='input_9_104' class='large gfield_select'  aria-describedby=\"gfield_description_9_104\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='345' >F E Dubose Career Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_114\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_114' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_114'>Fairfield County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_114' id='input_9_114' class='large gfield_select'  aria-describedby=\"gfield_description_9_114\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='425' >Fairfield Career and Technology Center<\/option><option value='426' >Fairfield Central High School<\/option><option value='427' >Fairfield Elementary<\/option><option value='428' >Fairfield Magnet for Math and Science<\/option><option value='429' >Fairfield Middle<\/option><option value='430' >Geiger Elementary<\/option><option value='431' >Kelly Miller Elementary<\/option><option value='432' >McCrorey-Liston School of Technology<\/option><\/select><\/div><\/div><div id=\"field_9_156\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_156' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_156'>Felton Laboratory School<\/div><div class='ginput_container ginput_container_select'><select name='input_156' id='input_9_156' class='large gfield_select'  aria-describedby=\"gfield_description_9_156\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1235' >Felton Laboratory Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_115\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_115' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_115'>Florence School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_115' id='input_9_115' class='large gfield_select'  aria-describedby=\"gfield_description_9_115\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='433' >Alfred Rush Academy<\/option><option value='434' >Beck Learning Center<\/option><option value='435' >Briggs Elementary<\/option><option value='436' >Carver Elementary<\/option><option value='437' >Child Development Center at Woods Road<\/option><option value='438' >Delmae Elementary<\/option><option value='439' >Dewey-Carter Elementary<\/option><option value='440' >Florence Career Center<\/option><option value='441' >Greenwood Elementary<\/option><option value='442' >Henry L. Sneed Middle<\/option><option value='443' >Henry Timrod Elementary<\/option><option value='444' >John W. Moore Middle<\/option><option value='445' >Lucy T. Davis Elementary<\/option><option value='446' >McLaurin Elementary<\/option><option value='447' >North Vista Elementary<\/option><option value='448' >Palmetto Youth Academy Charter<\/option><option value='449' >Poynor Center<\/option><option value='450' >Royall Elementary<\/option><option value='451' >Savannah Grove Elementary<\/option><option value='452' >South Florence High School<\/option><option value='453' >Southside Middle<\/option><option value='454' >Theodore Lester Elementary<\/option><option value='455' >Wallace Gregg Elementary<\/option><option value='456' >West Florence High School<\/option><option value='457' >Williams Middle<\/option><option value='458' >Wilson High School<\/option><\/select><\/div><\/div><div id=\"field_9_116\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_116' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_116'>Florence School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_116' id='input_9_116' class='large gfield_select'  aria-describedby=\"gfield_description_9_116\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='459' >Early Childhood Success Center ANNEX<\/option><option value='460' >Hannah Pamplico High School<\/option><option value='461' >Hannah-Pamplico Elementary and Middle<\/option><\/select><\/div><\/div><div id=\"field_9_117\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_117' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_117'>Florence School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_117' id='input_9_117' class='large gfield_select'  aria-describedby=\"gfield_description_9_117\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='462' >J. C. Lynch Elementary<\/option><option value='463' >J. Paul Truluck Intermediate<\/option><option value='464' >Lake City Early Childhood Center<\/option><option value='465' >Lake City High School<\/option><option value='466' >Main Street Elementary<\/option><option value='467' >Olanta Elementary<\/option><option value='468' >Ronald E. McNair Junior High<\/option><option value='469' >Scranton Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_118\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_118' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_118'>Florence School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_118' id='input_9_118' class='large gfield_select'  aria-describedby=\"gfield_description_9_118\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='470' >Brockington Elementary<\/option><option value='471' >Johnson Middle<\/option><option value='472' >Timmonsville High School<\/option><option value='1275' >Woods Road HeadStart<\/option><\/select><\/div><\/div><div id=\"field_9_119\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_119' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_119'>Florence School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_119' id='input_9_119' class='large gfield_select'  aria-describedby=\"gfield_description_9_119\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='473' >Johnsonville Elementary<\/option><option value='474' >Johnsonville High School<\/option><option value='475' >Johnsonville Middle<\/option><\/select><\/div><\/div><div id=\"field_9_162\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_162' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_162'>Fort Mill School District<\/div><div class='ginput_container ginput_container_select'><select name='input_162' id='input_9_162' class='large gfield_select'  aria-describedby=\"gfield_description_9_162\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1187' >Banks Trail Middle<\/option><option value='1188' >Doby&#039;s Bridge Elementary<\/option><option value='1189' >Fort Mill Elementary<\/option><option value='1190' >Fort Mill High School<\/option><option value='1191' >Fort Mill Middle<\/option><option value='1192' >Gold Hill Elementary<\/option><option value='1193' >Gold Hill Middle<\/option><option value='1194' >Nation Ford High School<\/option><option value='1195' >Orchard Park Elementary-Fort Mill<\/option><option value='1196' >Pleasant Knoll Elementary<\/option><option value='1283' >Pleasant Knoll Middle<\/option><option value='1197' >Riverview Elementary<\/option><option value='1198' >Springfield Elementary<\/option><option value='1199' >Springfield Middle<\/option><option value='1200' >Sugar Creek Elementary<\/option><option value='1201' >Tega Cay Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_120\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_120' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_120'>Georgetown County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_120' id='input_9_120' class='large gfield_select'  aria-describedby=\"gfield_description_9_120\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='476' >Andrews Elementary<\/option><option value='477' >Andrews High School<\/option><option value='478' >Brown&#039;s Ferry Elementary<\/option><option value='479' >Carvers Bay High School<\/option><option value='480' >Carvers Bay Middle<\/option><option value='481' >Coastal Montessori Charter School<\/option><option value='482' >Georgetown High School<\/option><option value='483' >Georgetown Middle<\/option><option value='484' >Kensington Elementary<\/option><option value='485' >Maryville Elementary<\/option><option value='486' >McDonald Elementary<\/option><option value='487' >Plantersville Elementary<\/option><option value='488' >Pleasant Hill Elementary<\/option><option value='489' >Rosemary Middle<\/option><option value='490' >Sampit Elementary<\/option><option value='491' >Waccamaw Elementary<\/option><option value='492' >Waccamaw High  School<\/option><option value='493' >Waccamaw Intermediate<\/option><option value='494' >Waccamaw Middle<\/option><\/select><\/div><\/div><div id=\"field_9_163\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_163' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_163'>GLEAMNS Human Resources Commission, Inc.<\/div><div class='ginput_container ginput_container_select'><select name='input_163' id='input_9_163' class='large gfield_select'  aria-describedby=\"gfield_description_9_163\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1419' >Abbeville Early Head Start &amp; Head Start Center<\/option><option value='1420' >Batesburg Head Start Center<\/option><option value='1421' >Blythewood Head Start Center<\/option><option value='1422' >Edgefield Early Head Start &amp;  Head Start Center<\/option><option value='1423' >Greenwood Early Head Start &amp;  Head Start Center<\/option><option value='1424' >Lexington Head Start Center<\/option><option value='1425' >McCormick Head Start Center<\/option><option value='1426' >North Hodges Head Start Center<\/option><option value='1427' >Pineview  Head Start Center<\/option><option value='1428' >Platt Springs Head Start Center<\/option><option value='1429' >Rikard Head Start Center<\/option><option value='1430' >Saluda Early Head Start &amp; Head Start Center<\/option><option value='1431' >Sanders Head Start Center<\/option><option value='1432' >St. Andrews Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_164\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_164' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_164'>Governor's School for the Arts and Humanities<\/div><div class='ginput_container ginput_container_select'><select name='input_164' id='input_9_164' class='large gfield_select'  aria-describedby=\"gfield_description_9_164\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1254' >SC Governor&#039;s School for the Arts and Humanities<\/option><\/select><\/div><\/div><div id=\"field_9_165\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_165' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_165'>Governor's School for Math and Science<\/div><div class='ginput_container ginput_container_select'><select name='input_165' id='input_9_165' class='large gfield_select'  aria-describedby=\"gfield_description_9_165\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1255' >Governor&#039;s School for Math and Science<\/option><\/select><\/div><\/div><div id=\"field_9_121\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_121' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_121'>Greenville County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_121' id='input_9_121' class='large gfield_select'  aria-describedby=\"gfield_description_9_121\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='495' >A.J. Whittenburg Elementary<\/option><option value='496' >Alexander Elementary<\/option><option value='497' >Armstrong Elementary<\/option><option value='498' >Augusta Circle Elementary<\/option><option value='499' >Beck Academy<\/option><option value='500' >Bell&#039;s Crossing Elementary<\/option><option value='501' >Berea Elementary<\/option><option value='502' >Berea High School<\/option><option value='503' >Berea Middle<\/option><option value='504' >Bethel Elementary<\/option><option value='505' >Blue Ridge High School<\/option><option value='506' >Blue Ridge Middle<\/option><option value='507' >Blythe Academy<\/option><option value='508' >Brashier Middle College Charter School<\/option><option value='509' >Brook Glenn Elementary<\/option><option value='510' >Brushy Creek Elementary<\/option><option value='511' >Bryson Elementary<\/option><option value='512' >Bryson Middle<\/option><option value='513' >Buena Vista Elementary<\/option><option value='514' >Carolina Academy<\/option><option value='515' >Chandler Creek Elementary<\/option><option value='516' >Cherrydale Elementary<\/option><option value='517' >Crestview Elementary<\/option><option value='518' >Donaldson Career Center<\/option><option value='519' >Dr. Phinnize J. Fisher Middle<\/option><option value='520' >Duncan Chapel Elementary<\/option><option value='521' >East North Street Academy<\/option><option value='522' >Eastside High School<\/option><option value='523' >Ellen Woodside Elementary<\/option><option value='524' >Enoree Career Center<\/option><option value='525' >Fork Shoals School<\/option><option value='526' >Fountain Inn Elementary<\/option><option value='527' >Gateway Elementary<\/option><option value='528' >Golden Strip Career and Technology Center<\/option><option value='529' >Greenbrier Elementary<\/option><option value='530' >Greenville Middle Academy<\/option><option value='531' >Greenville Senior High Academy<\/option><option value='532' >Greenville Technical Charter High School<\/option><option value='533' >Greer High School<\/option><option value='534' >Greer Middle<\/option><option value='535' >Greer Middle College Charter School<\/option><option value='536' >Grove Elementary<\/option><option value='537' >Heritage Elementary<\/option><option value='538' >Hillcrest High School<\/option><option value='539' >Hillcrest Middle<\/option><option value='540' >Hollis Academy<\/option><option value='541' >Hughes Academy of Science and Technology<\/option><option value='542' >J. Harley Bonds Career Center<\/option><option value='543' >J. L. Mann High Academy<\/option><option value='544' >Lake Forest Elementary<\/option><option value='545' >Lakeview Middle<\/option><option value='546' >Langston Charter Middle<\/option><option value='547' >League Academy<\/option><option value='548' >Legacy Charter School<\/option><option value='549' >Mauldin Elementary<\/option><option value='550' >Mauldin High School<\/option><option value='551' >Mauldin Middle<\/option><option value='552' >Meyer Center for Special Children Charter<\/option><option value='553' >Mitchell Road Elementary<\/option><option value='554' >Monarch Elementary-Greenville<\/option><option value='555' >Monaview Elementary<\/option><option value='556' >Mountain View Elementary<\/option><option value='557' >Northwest Middle<\/option><option value='558' >Northwood Middle<\/option><option value='559' >Oakview Elementary<\/option><option value='560' >Overbrook Child Development Center<\/option><option value='561' >Paris Elementary<\/option><option value='562' >Pelham Road Elementary<\/option><option value='563' >Plain Elementary<\/option><option value='564' >Ralph Chandler Middle<\/option><option value='565' >Riverside High School<\/option><option value='566' >Riverside Middle-Greenville<\/option><option value='567' >Robert E. Cashion Elementary<\/option><option value='568' >Rudolph Gordon Elementary<\/option><option value='569' >Sara Collins Elementary<\/option><option value='570' >Sevier Middle<\/option><option value='571' >Simpsonville Elementary<\/option><option value='572' >Skyland Elementary<\/option><option value='573' >Slater Marietta Elementary<\/option><option value='574' >Southside High School<\/option><option value='575' >Sterling School<\/option><option value='576' >Stone Academy<\/option><option value='577' >Sue Cleveland Elementary<\/option><option value='578' >Summit Drive Elementary<\/option><option value='579' >Tanglewood Middle<\/option><option value='580' >Taylors Elementary<\/option><option value='581' >Thomas E. Kerns Elementary<\/option><option value='582' >Tigerville Elementary<\/option><option value='583' >Travelers Rest High School<\/option><option value='584' >Wade Hampton High School<\/option><option value='585' >Washington Center<\/option><option value='586' >Welcome Elementary<\/option><option value='587' >Westcliffe Elementary<\/option><option value='588' >Woodland Elementary<\/option><option value='589' >Woodmont High School<\/option><option value='590' >Woodmont Middle<\/option><\/select><\/div><\/div><div id=\"field_9_125\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_125' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_125'>Greenwood County Career Center<\/div><div class='ginput_container ginput_container_select'><select name='input_125' id='input_9_125' class='large gfield_select'  aria-describedby=\"gfield_description_9_125\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='612' >G Frank Russell Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_122\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_122' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_122'>Greenwood County School District 50<\/div><div class='ginput_container ginput_container_select'><select name='input_122' id='input_9_122' class='large gfield_select'  aria-describedby=\"gfield_description_9_122\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='591' >Brewer Middle<\/option><option value='592' >Eleanor S. Rice Elementary<\/option><option value='593' >Emerald High School<\/option><option value='594' >Greenwood Early Childhood Center<\/option><option value='595' >Greenwood High School<\/option><option value='596' >Hodges Elementary<\/option><option value='597' >Lakeview Elementary<\/option><option value='598' >Mathews Elementary<\/option><option value='599' >Merrywood Elementary<\/option><option value='600' >Northside Middle-Greenwood<\/option><option value='601' >Pinecrest Elementary<\/option><option value='602' >Springfield Elementary<\/option><option value='603' >Westview Middle<\/option><option value='604' >Woodfields Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_123\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_123' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_123'>Greenwood County School District 51<\/div><div class='ginput_container ginput_container_select'><select name='input_123' id='input_9_123' class='large gfield_select'  aria-describedby=\"gfield_description_9_123\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='605' >Ware Shoals Elementary Middle<\/option><option value='606' >Ware Shoals High School<\/option><option value='607' >Ware Shoals Primary<\/option><\/select><\/div><\/div><div id=\"field_9_124\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_124' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_124'>Greenwood County School District 52<\/div><div class='ginput_container ginput_container_select'><select name='input_124' id='input_9_124' class='large gfield_select'  aria-describedby=\"gfield_description_9_124\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='608' >Edgewood Middle<\/option><option value='609' >Ninety Six Elementary<\/option><option value='610' >Ninety Six High School<\/option><option value='611' >Ninety Six Primary<\/option><\/select><\/div><\/div><div id=\"field_9_166\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_166' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_166'>H B Swofford AVC<\/div><div class='ginput_container ginput_container_select'><select name='input_166' id='input_9_166' class='large gfield_select'  aria-describedby=\"gfield_description_9_166\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1090' >H B Swofford Career Center<\/option><\/select><\/div><\/div><div id=\"field_9_126\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_126' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_126'>Hampton County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_126' id='input_9_126' class='large gfield_select'  aria-describedby=\"gfield_description_9_126\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='613' >Ben Hazel Primary<\/option><option value='614' >Brunson Elementary<\/option><option value='615' >Fennell Elementary<\/option><option value='616' >Hampton Elementary<\/option><option value='617' >North District Middle<\/option><option value='618' >Varnville Elementary<\/option><option value='619' >Wade Hampton High School<\/option><\/select><\/div><\/div><div id=\"field_9_127\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_127' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_127'>Hampton County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_127' id='input_9_127' class='large gfield_select'  aria-describedby=\"gfield_description_9_127\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='620' >Estill Elementary<\/option><option value='621' >Estill High School<\/option><option value='622' >Estill Middle<\/option><\/select><\/div><\/div><div id=\"field_9_128\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_128' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_128'>Horry County Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_128' id='input_9_128' class='large gfield_select'  aria-describedby=\"gfield_description_9_128\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='623' >Academy For Arts Science Techn<\/option><option value='624' >Academy For Technolgy and Acad<\/option><option value='625' >Academy of Hope Charter<\/option><option value='626' >Aynor Elementary<\/option><option value='627' >Aynor High School<\/option><option value='628' >Aynor Middle<\/option><option value='629' >Black Water Middle<\/option><option value='630' >Bridgewater Academy Charter<\/option><option value='631' >Burgess Elementary<\/option><option value='632' >Carolina Forest Elementary<\/option><option value='633' >Carolina Forest High School<\/option><option value='634' >Conway Elementary<\/option><option value='635' >Conway High School<\/option><option value='636' >Conway Middle<\/option><option value='637' >Daisy Elementary<\/option><option value='638' >Forestbrook Elementary<\/option><option value='639' >Forestbrook Middle<\/option><option value='640' >Green Sea Floyds Elementary<\/option><option value='641' >Green Sea Floyds High School<\/option><option value='642' >HCS Early College High School<\/option><option value='643' >Homewood Elementary<\/option><option value='644' >Kingston Elementary<\/option><option value='645' >Lakewood Elementary<\/option><option value='646' >Loris Elementary<\/option><option value='647' >Loris High School<\/option><option value='648' >Loris Middle<\/option><option value='649' >Midland Elementary<\/option><option value='650' >Myrtle Beach Elementary<\/option><option value='651' >Myrtle Beach High School<\/option><option value='652' >Myrtle Beach Intermediate<\/option><option value='653' >Myrtle Beach Middle<\/option><option value='654' >Myrtle Beach Primary<\/option><option value='655' >North Myrtle Beach High School<\/option><option value='656' >North Myrtle Beach Middle<\/option><option value='657' >Ocean Bay Elementary<\/option><option value='658' >Ocean Bay Middle<\/option><option value='659' >Ocean Drive Elementary<\/option><option value='660' >Palmetto Academy for Learning Motorsports<\/option><option value='661' >Palmetto Academy of Learning and Success Charter<\/option><option value='662' >Palmetto Bays Elementary<\/option><option value='663' >Pee Dee Elementary<\/option><option value='664' >River Oaks Elementary<\/option><option value='665' >Riverside Elementary<\/option><option value='666' >Seaside Elementary<\/option><option value='667' >Socastee Elementary<\/option><option value='668' >Socastee High School<\/option><option value='669' >South Conway Elementary<\/option><option value='670' >St. James Elementary<\/option><option value='671' >St. James High School<\/option><option value='672' >St. James Middle<\/option><option value='673' >Waccamaw Elementary<\/option><option value='674' >Waterway Elementary<\/option><option value='675' >Whittemore Park Middle<\/option><\/select><\/div><\/div><div id=\"field_9_129\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_129' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_129'>Jasper County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_129' id='input_9_129' class='large gfield_select'  aria-describedby=\"gfield_description_9_129\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='676' >Hardeeville Elementary<\/option><option value='677' >Hardeeville-Ridgeland Middle<\/option><option value='678' >Ridgeland Elementary<\/option><option value='679' >Ridgeland-Hardeeville High School<\/option><\/select><\/div><\/div><div id=\"field_9_167\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_167' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_167'>John De La Howe<\/div><div class='ginput_container ginput_container_select'><select name='input_167' id='input_9_167' class='large gfield_select'  aria-describedby=\"gfield_description_9_167\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1236' >John De La Howe School<\/option><\/select><\/div><\/div><div id=\"field_9_168\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_168' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_168'>Juvenile Justice Schools<\/div><div class='ginput_container ginput_container_select'><select name='input_168' id='input_9_168' class='large gfield_select'  aria-describedby=\"gfield_description_9_168\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1242' >Birchwood School<\/option><option value='1243' >Evaluation and Detention Center<\/option><option value='1244' >Willow Lane School<\/option><\/select><\/div><\/div><div id=\"field_9_130\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_130' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_130'>Kershaw County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_130' id='input_9_130' class='large gfield_select'  aria-describedby=\"gfield_description_9_130\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='680' >Applied Technology Education Campus<\/option><option value='681' >Baron Dekalb Elementary<\/option><option value='682' >Bethune Elementary<\/option><option value='683' >Blaney Elementary<\/option><option value='684' >Camden Elementary of the Creative Arts<\/option><option value='685' >Camden High School<\/option><option value='686' >Camden Middle<\/option><option value='687' >Doby&#039;s Mill Elementary<\/option><option value='688' >Jackson School<\/option><option value='689' >Leslie M. Stover Middle<\/option><option value='690' >Lugoff Elementary<\/option><option value='691' >Lugoff-Elgin High School<\/option><option value='692' >Lugoff-Elgin Middle<\/option><option value='693' >Midway Elementary<\/option><option value='694' >Mt. Pisgah Elementary<\/option><option value='695' >North Central High School<\/option><option value='696' >North Central Middle<\/option><option value='697' >Pine Tree Hill Elementary<\/option><option value='698' >Wateree Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_131\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_131' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_131'>Lancaster County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_131' id='input_9_131' class='large gfield_select'  aria-describedby=\"gfield_description_9_131\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='699' >A. R. Rucker Middle<\/option><option value='700' >Andrew Jackson High School<\/option><option value='701' >Andrew Jackson Middle<\/option><option value='702' >Brooklyn Springs Elementary<\/option><option value='703' >Buford Elementary<\/option><option value='704' >Buford High School<\/option><option value='705' >Buford Middle<\/option><option value='728' >Clinton Elementary-Lancaster<\/option><option value='707' >Discovery Charter of Lancaster<\/option><option value='708' >Erwin Elementary<\/option><option value='709' >Harrisburg Elementary<\/option><option value='710' >Heath Springs Elementary<\/option><option value='711' >Indian Land Elementary<\/option><option value='712' >Indian Land High School<\/option><option value='713' >Indian Land Middle<\/option><option value='714' >Kershaw Elementary<\/option><option value='715' >Lancaster High School<\/option><option value='716' >McDonald Green Elementary<\/option><option value='717' >North Elementary<\/option><option value='718' >South Middle<\/option><\/select><\/div><\/div><div id=\"field_9_132\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_132' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_132'>Laurens County School District No. 55\n<\/div><div class='ginput_container ginput_container_select'><select name='input_132' id='input_9_132' class='large gfield_select'  aria-describedby=\"gfield_description_9_132\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='719' >E. B. Morse Elementary<\/option><option value='720' >Ford Elementary<\/option><option value='721' >Gray Court-Owings Elementary-Middle<\/option><option value='722' >Hickory Tavern Elementary-Middle<\/option><option value='723' >Laurens District 55 High School<\/option><option value='724' >Laurens Elementary<\/option><option value='725' >Laurens Middle<\/option><option value='726' >Sanders Middle<\/option><option value='727' >Waterloo Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_133\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_133' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_133'>Laurens County School District 56<\/div><div class='ginput_container ginput_container_select'><select name='input_133' id='input_9_133' class='large gfield_select'  aria-describedby=\"gfield_description_9_133\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='706' >Clinton Elementary-Laurens<\/option><option value='729' >Clinton High School<\/option><option value='730' >Clinton Middle<\/option><option value='731' >Eastside Elementary<\/option><option value='732' >Joanna-Woodson Elementary<\/option><option value='733' >M. S. Bailey Child Development Center<\/option><option value='1295' >Summit Classical Charter School<\/option><option value='1294' >Thornwell Charter School<\/option><\/select><\/div><\/div><div id=\"field_9_134\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_134' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_134'>Lee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_134' id='input_9_134' class='large gfield_select'  aria-describedby=\"gfield_description_9_134\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='734' >Dennis Elementary<\/option><option value='735' >Lee Central High School<\/option><option value='736' >Lee Central Middle<\/option><option value='737' >Lee County Career and Technology Center<\/option><option value='738' >Lower Lee Elementary<\/option><option value='739' >West Lee Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_135\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_135' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_135'>Lexington County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_135' id='input_9_135' class='large gfield_select'  aria-describedby=\"gfield_description_9_135\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1293' >Beechwood Middle<\/option><option value='740' >Carolina Springs Elementary<\/option><option value='741' >Carolina Springs Middle<\/option><option value='1297' >Centerville Elementary-Lexington 1<\/option><option value='742' >Deerfield Elementary<\/option><option value='1265' >East Pointe Academy Charter School<\/option><option value='743' >Forts Pond Elementary<\/option><option value='744' >Gilbert Elementary<\/option><option value='745' >Gilbert High School<\/option><option value='746' >Gilbert Middle<\/option><option value='747' >Gilbert Primary<\/option><option value='748' >Lake Murray Elementary<\/option><option value='1444' >Lakeside Middle School<\/option><option value='749' >Lexington Elementary<\/option><option value='750' >Lexington High School<\/option><option value='751' >Lexington Middle<\/option><option value='752' >Lexington Technology Center<\/option><option value='753' >Meadow Glen Elementary<\/option><option value='754' >Meadow Glen Middle<\/option><option value='755' >Midway Elementary<\/option><option value='756' >New Providence Elementary<\/option><option value='757' >Oak Grove Elementary<\/option><option value='758' >Pelion Elementary<\/option><option value='759' >Pelion High School<\/option><option value='760' >Pelion Middle<\/option><option value='761' >Pleasant Hill Elementary<\/option><option value='762' >Pleasant Hill Middle<\/option><option value='763' >Red Bank Elementary<\/option><option value='764' >River Bluff High School<\/option><option value='765' >Rocky Creek Elementary<\/option><option value='766' >Saxe Gotha Elementary<\/option><option value='1446' >South Lake Elementary<\/option><option value='767' >White Knoll Elementary<\/option><option value='768' >White Knoll High School<\/option><option value='769' >White Knoll Middle<\/option><\/select><\/div><\/div><div id=\"field_9_136\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_136' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_136'>Lexington County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_136' id='input_9_136' class='large gfield_select'  aria-describedby=\"gfield_description_9_136\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='770' >Airport High School<\/option><option value='771' >Brookland Cayce Grammar School No. 1<\/option><option value='772' >Brookland-Cayce Senior High School<\/option><option value='1277' >Cayce Elementary<\/option><option value='774' >Congaree Elementary<\/option><option value='775' >Congaree-Wood Early Childhood Center<\/option><option value='776' >Cyril B. Busbee Creative Arts Academy<\/option><option value='777' >Herbert A. Wood Elementary<\/option><option value='1256' >New Bridge Academy<\/option><option value='778' >Northside Middle-Lexington 2<\/option><option value='779' >Pine Ridge Middle<\/option><option value='780' >Pineview Elementary<\/option><option value='781' >R. Earle Davis-CLOSED<\/option><option value='782' >R. H. Fulmer Middle<\/option><option value='1288' >Riverbank Elementary School<\/option><option value='783' >Saluda River Academy for the Arts<\/option><option value='784' >Springdale Elementary<\/option><option value='' ><\/option><\/select><\/div><\/div><div id=\"field_9_137\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_137' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_137'>Lexington County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_137' id='input_9_137' class='large gfield_select'  aria-describedby=\"gfield_description_9_137\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='785' >Batesburg-Leesville Elementary<\/option><option value='786' >Batesburg-Leesville High School<\/option><option value='787' >Batesburg-Leesville Middle<\/option><option value='788' >Batesburg-Leesville Primary<\/option><\/select><\/div><\/div><div id=\"field_9_138\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_138' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_138'>Lexington County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_138' id='input_9_138' class='large gfield_select'  aria-describedby=\"gfield_description_9_138\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='789' >Frances F. Mack Intermediate<\/option><option value='790' >Lexington Four Early Childhood Center<\/option><option value='791' >Sandhills Elementary<\/option><option value='792' >Sandhills Middle<\/option><option value='793' >Sandhills Primary<\/option><option value='794' >Swansea High Freshman Academy<\/option><option value='795' >Swansea High School<\/option><\/select><\/div><\/div><div id=\"field_9_139\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_139' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_139'>Lexington and Richland School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_139' id='input_9_139' class='large gfield_select'  aria-describedby=\"gfield_description_9_139\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='796' >Ballentine Elementary<\/option><option value='797' >Center for Advanced Technical Studies<\/option><option value='798' >Chapin Elementary<\/option><option value='799' >Chapin High School<\/option><option value='800' >Chapin Intermediate<\/option><option value='801' >Chapin Middle<\/option><option value='802' >CrossRoads Intermediate<\/option><option value='803' >Dutch Fork Elementary<\/option><option value='804' >Dutch Fork High School<\/option><option value='805' >Dutch Fork Middle<\/option><option value='806' >H. E. Corley Elementary<\/option><option value='807' >Harbison West Elementary<\/option><option value='808' >Irmo Elementary<\/option><option value='809' >Irmo High School<\/option><option value='810' >Irmo Middle<\/option><option value='811' >Lake Murray Elementary<\/option><option value='812' >Leaphart Elementary<\/option><option value='813' >Nursery Road Elementary<\/option><option value='814' >Oak Pointe Elementary<\/option><option value='1433' >Piney Woods Elementary<\/option><option value='815' >River Springs Elementary<\/option><option value='816' >Seven Oaks Elementary<\/option><option value='817' >Spring Hill High School<\/option><\/select><\/div><\/div><div id=\"field_9_169\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_169' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_169'>Marion County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_169' id='input_9_169' class='large gfield_select'  aria-describedby=\"gfield_description_9_169\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='821' >Academy of Careers and Technology<\/option><option value='822' >Britton&#039;s Neck Elementary<\/option><option value='823' >Creek Bridge High School<\/option><option value='824' >Easterling Primary<\/option><option value='825' >Johnakin Middle<\/option><option value='828' >McCormick Elementary-Marion<\/option><option value='826' >Manning High School<\/option><option value='1287' >Marion High School<\/option><option value='827' >Marion Intermediate<\/option><option value='829' >Mullins Early Childhood Center ANNEX<\/option><option value='830' >Mullins High School<\/option><option value='831' >North Mullins Primary<\/option><option value='832' >Palmetto Middle<\/option><\/select><\/div><\/div><div id=\"field_9_141\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_141' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_141'>Marlboro County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_141' id='input_9_141' class='large gfield_select'  aria-describedby=\"gfield_description_9_141\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='833' >Bennettsville Intermediate<\/option><option value='834' >Bennettsville Primary<\/option><option value='1264' >Blenheim HeadStart<\/option><option value='835' >Blenheim Middle School of Discovery<\/option><option value='836' >Clio Elementary<\/option><option value='837' >Marlboro County High School<\/option><option value='838' >Marlboro School of Discovery<\/option><option value='839' >McColl Elementary-Middle<\/option><option value='840' >Wallace Elementary-Middle<\/option><\/select><\/div><\/div><div id=\"field_9_140\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_140' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_140'>McCormick County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_140' id='input_9_140' class='large gfield_select'  aria-describedby=\"gfield_description_9_140\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='818' >McCormick Elementary-McCormick<\/option><option value='819' >McCormick High School<\/option><option value='820' >McCormick Middle<\/option><\/select><\/div><\/div><div id=\"field_9_190\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_190' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_190'>Movement School<\/div><div class='ginput_container ginput_container_select'><select name='input_190' id='input_9_190' class='large gfield_select'  aria-describedby=\"gfield_description_9_190\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='1451' >Bridge View Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_142\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_142' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_142'>Newberry County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_142' id='input_9_142' class='large gfield_select'  aria-describedby=\"gfield_description_9_142\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='841' >Boundary Street Elementary<\/option><option value='842' >Gallman Elementary<\/option><option value='843' >Little Mountain Elementary<\/option><option value='844' >Mid-Carolina High School<\/option><option value='845' >Mid-Carolina Middle<\/option><option value='846' >Newberry County Career Center<\/option><option value='847' >Newberry Elementary<\/option><option value='848' >Newberry High School<\/option><option value='849' >Newberry Middle<\/option><option value='850' >Pomaria-Garmany Elementary<\/option><option value='851' >Prosperity-Rikard Elementary<\/option><option value='852' >Reuben Elementary<\/option><option value='853' >Whitmire Community High School<\/option><option value='854' >Whitmire Community School (Elementary)<\/option><\/select><\/div><\/div><div id=\"field_9_143\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_143' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_143'>Oconee County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_143' id='input_9_143' class='large gfield_select'  aria-describedby=\"gfield_description_9_143\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='855' >Blue Ridge Elementary<\/option><option value='856' >Fair-Oak Elementary<\/option><option value='857' >Fred P. Hamilton Career Center<\/option><option value='858' >James M. Brown Elementary<\/option><option value='859' >Keowee Elementary<\/option><option value='860' >Northside Elementary-Oconee<\/option><option value='861' >Orchard Park Elementary<\/option><option value='862' >Ravenel Elementary<\/option><option value='863' >Seneca High School<\/option><option value='864' >Seneca Middle<\/option><option value='865' >Tamassee-Salem Elementary<\/option><option value='866' >Tamassee-Salem Middle-High School<\/option><option value='867' >Walhalla Elementary<\/option><option value='868' >Walhalla High School<\/option><option value='869' >Walhalla Middle<\/option><option value='870' >West Oak Middle<\/option><option value='871' >West-Oak High School<\/option><option value='872' >Westminster Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_146\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_146' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_146'>Orangeburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_146' id='input_9_146' class='large gfield_select'  aria-describedby=\"gfield_description_9_146\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='887' >Bethune-Bowman Elementary<\/option><option value='888' >Bethune-Bowman Middle-High School<\/option><option value='879' >Branchville High School<\/option><option value='889' >Brookdale Elementary<\/option><option value='880' >Carver Edisto Middle<\/option><option value='890' >Dover Elementary<\/option><option value='1454' >East Lake Elementary School<\/option><option value='881' >Edisto Elementary<\/option><option value='882' >Edisto High<\/option><option value='883' >Edisto Primary<\/option><option value='873' >Elloree Elementary<\/option><option value='884' >Hunter-Kinard-Tyler Elementary<\/option><option value='885' >Hunter-Kinard-Tyler High<\/option><option value='1455' >Lake Marion Middle School<\/option><option value='876' >Lake Marion High<\/option><option value='886' >Lockett Elementary<\/option><option value='891' >Marshall Elementary<\/option><option value='892' >Mellichamp Elementary<\/option><option value='893' >North Middle-High School<\/option><option value='894' >OCSD5 High School for Health Professions<\/option><option value='895' >Orangeburg Consolitated School District Five Technology Center<\/option><option value='896' >Orangeburg Wilkinson High School<\/option><option value='899' >Sheridan Elementary<\/option><option value='900' >Whittaker Elementary<\/option><option value='901' >William J. Clark Middle<\/option><\/select><\/div><\/div><div id=\"field_9_171\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_171' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_171'>Palmetto Unified<\/div><div class='ginput_container ginput_container_select'><select name='input_171' id='input_9_171' class='large gfield_select'  aria-describedby=\"gfield_description_9_171\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1245' >Lee  High School<\/option><option value='1246' >MacDougall High School<\/option><option value='1247' >Manning High School<\/option><option value='1248' >Ridgeland High School<\/option><option value='1249' >Sara Babb High School<\/option><option value='1250' >Trenton High School<\/option><option value='1251' >Turbeville High School<\/option><option value='1252' >Tyger River High School<\/option><option value='1253' >Wateree River High School<\/option><\/select><\/div><\/div><div id=\"field_9_170\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_170' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_170'>Pee Dee Head Starts<\/div><div class='ginput_container ginput_container_select'><select name='input_170' id='input_9_170' class='large gfield_select'  aria-describedby=\"gfield_description_9_170\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1292' >Lake City HS Center<\/option><\/select><\/div><\/div><div id=\"field_9_172\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_172' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_172'>Pickens County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_172' id='input_9_172' class='large gfield_select'  aria-describedby=\"gfield_description_9_172\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='903' >A. R. Lewis Elementary<\/option><option value='904' >Ambler Elementary<\/option><option value='905' >Central Elementary<\/option><option value='906' >Liberty Primary<\/option><option value='907' >Clemson Elementary<\/option><option value='908' >Crosswell Elementary-Pickens<\/option><option value='909' >D. W. Daniel High School<\/option><option value='910' >Dacusville Elementary<\/option><option value='911' >Dacusville Middle<\/option><option value='912' >Easley High School<\/option><option value='913' >East End Elementary<\/option><option value='914' >Forest Acres Elementary<\/option><option value='915' >Hagood Elementary<\/option><option value='916' >Holly Springs Elementary<\/option><option value='917' >Liberty Elementary<\/option><option value='918' >Liberty High School<\/option><option value='919' >Liberty Middle<\/option><option value='920' >McKissick Elementary<\/option><option value='921' >Pickens County Career and Technolgy Center<\/option><option value='922' >Pickens Elementary<\/option><option value='923' >Pickens High School<\/option><option value='924' >Pickens Middle<\/option><option value='925' >R. C. Edwards Middle<\/option><option value='926' >Richard H. Gettys Middle<\/option><option value='927' >Six Mile Elementary<\/option><option value='928' >West End Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_173\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_173' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_173'>R D Anderson Applied Technology Center<\/div><div class='ginput_container ginput_container_select'><select name='input_173' id='input_9_173' class='large gfield_select'  aria-describedby=\"gfield_description_9_173\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1089' >R. D. Anderson Applied Technology Center<\/option><\/select><\/div><\/div><div id=\"field_9_174\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_174' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_174'>Richland County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_174' id='input_9_174' class='large gfield_select'  aria-describedby=\"gfield_description_9_174\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='929' >A. C. Flora High School<\/option><option value='930' >A. C. Moore Elementary<\/option><option value='931' >A. J. Lewis Greenview Elementary<\/option><option value='932' >Alcorn Middle<\/option><option value='933' >Annie Burnside Elementary<\/option><option value='934' >Arden Elementary<\/option><option value='935' >Bradley Elementary<\/option><option value='936' >Brennen Elementary<\/option><option value='937' >Brockman Elementary<\/option><option value='938' >Burton Pack Elementary<\/option><option value='939' >C. A. Johnson High School<\/option><option value='940' >Carolina School for Inquiry<\/option><option value='941' >Carver-Lyon Elementary<\/option><option value='942' >Caughman Road Elementary<\/option><option value='943' >Columbia High School<\/option><option value='944' >Crayton Middle<\/option><option value='945' >Dreher High School<\/option><option value='946' >Eau Claire High School<\/option><option value='947' >Edward E. Taylor Elementary<\/option><option value='948' >Forest Heights Elementary<\/option><option value='949' >Gadsden Elementary<\/option><option value='950' >H. B. Rhame Elementary<\/option><option value='951' >Hall Institute<\/option><option value='952' >Hand Middle<\/option><option value='953' >Heyward Gibbes Middle<\/option><option value='954' >Hopkins Elementary<\/option><option value='955' >Hopkins Middle<\/option><option value='956' >Horrell Hill Elementary<\/option><option value='957' >Hyatt Park Elementary<\/option><option value='958' >J. P. Thomas Elementary<\/option><option value='959' >Logan Elementary<\/option><option value='960' >Lower Richland High School<\/option><option value='961' >Meadowfield Elementary<\/option><option value='962' >Mill Creek Elementary<\/option><option value='963' >Pendergrass Fairwold School<\/option><option value='964' >Pine Grove Elementary<\/option><option value='965' >Richland One Charter Middle College<\/option><option value='966' >Rosewood Elementary<\/option><option value='967' >Samuel A. Heyward Career and Tech Center<\/option><option value='968' >Sandel Elementary<\/option><option value='969' >Satchel Ford Elementary<\/option><option value='970' >South Kilbourne Elementary<\/option><option value='971' >Southeast Middle<\/option><option value='972' >St. Andrews Middle<\/option><option value='973' >W. A. Perry Middle<\/option><option value='974' >W. G. Sanders Middle<\/option><option value='975' >W.J. Keenan High School<\/option><option value='976' >Watkins-Nance Elementary<\/option><option value='977' >Webber School<\/option><\/select><\/div><\/div><div id=\"field_9_175\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_175' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_175'>Richland County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_175' id='input_9_175' class='large gfield_select'  aria-describedby=\"gfield_description_9_175\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='978' >Bethel-Hanberry Elementary<\/option><option value='979' >Blythewood High School<\/option><option value='980' >Blythewood Middle School<\/option><option value='981' >Bookman Road Elementary<\/option><option value='982' >Bridge Creek Elementary<\/option><option value='983' >Catawba Trail Elementary<\/option><option value='984' >Dent Middle<\/option><option value='985' >E. L. Wright Middle<\/option><option value='986' >Forest Lake Elementary<\/option><option value='1280' >Jackson Creek Elementary<\/option><option value='987' >Joseph Keels Elementary<\/option><option value='988' >Kelly Mill Middle<\/option><option value='989' >Killian Elementary<\/option><option value='990' >L. B. Nelson Elementary<\/option><option value='991' >L. W. Conder Elementary<\/option><option value='992' >Lake Carolina Elementary<\/option><option value='993' >Lake Carolina Elementary Upper Campus<\/option><option value='994' >Langford Elementary<\/option><option value='995' >Longleaf Middle<\/option><option value='996' >Muller Road Middle<\/option><option value='997' >North Springs Elementary<\/option><option value='998' >Polo Road Elementary<\/option><option value='999' >Pontiac Elementary<\/option><option value='1000' >Rice Creek Elementary<\/option><option value='1001' >Richland Northeast High School<\/option><option value='1002' >Richland Two Charter High School<\/option><option value='1003' >Ridge View High School<\/option><option value='1004' >Round Top Elementary<\/option><option value='1005' >Sandlapper Elementary<\/option><option value='1006' >Spring Valley High School<\/option><option value='1007' >Summit Parkway Middle<\/option><option value='1008' >Westwood High School<\/option><option value='1009' >Windsor Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_176\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_176' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_176'>Rock Hill School District Three of York County<\/div><div class='ginput_container ginput_container_select'><select name='input_176' id='input_9_176' class='large gfield_select'  aria-describedby=\"gfield_description_9_176\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1159' >Applied Technology Center<\/option><option value='1160' >Belleview Elementary<\/option><option value='1161' >Castle Heights Middle<\/option><option value='1162' >Central Child Development Center<\/option><option value='1163' >Dutchman Creek Middle<\/option><option value='1164' >Ebenezer Avenue Elementary<\/option><option value='1165' >Ebinport Elementary<\/option><option value='1166' >Finley Road Elementary<\/option><option value='1167' >Independence Elementary<\/option><option value='1168' >India Hook Elementary<\/option><option value='1169' >Lesslie Elementary<\/option><option value='1170' >Mount Gallant Elementary<\/option><option value='1171' >Mount Holly Elementary<\/option><option value='1172' >Northside Elementary-York 3<\/option><option value='1173' >Northwestern High School<\/option><option value='1174' >Oakdale Elementary<\/option><option value='1175' >Old Pointe Elementary<\/option><option value='1176' >Rawlinson Road Middle<\/option><option value='1177' >Richmond Drive Elementary<\/option><option value='1178' >Rock Hill High School<\/option><option value='1179' >Rosewood Elementary<\/option><option value='1180' >Saluda Trail Middle<\/option><option value='1181' >South Pointe High School<\/option><option value='1182' >Sunset Park Center for Accelerated Studies<\/option><option value='1183' >The Children&#039;s School at Sylvia Circle<\/option><option value='1184' >The Palmetto School at the Children&#039;s Attention Home<\/option><option value='1185' >W. C. Sullivan Middle<\/option><option value='1186' >York Road Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_177\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_177' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_177'>Saluda County School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_177' id='input_9_177' class='large gfield_select'  aria-describedby=\"gfield_description_9_177\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1010' >Hollywood Elementary<\/option><option value='1011' >Saluda Elementary<\/option><option value='1012' >Saluda High School<\/option><option value='1013' >Saluda Middle<\/option><option value='1014' >Saluda Primary<\/option><\/select><\/div><\/div><div id=\"field_9_178\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_178' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_178'>SC Public School Charter District<\/div><div class='ginput_container ginput_container_select'><select name='input_178' id='input_9_178' class='large gfield_select'  aria-describedby=\"gfield_description_9_178\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1202' >Bridges Preparatory School<\/option><option value='1203' >Calhoun Falls Charter School<\/option><option value='1204' >Cape Romain Environmental Education Charter<\/option><option value='1205' >Coastal Leadership Academy<\/option><option value='1206' >Cyber Academy of South Carolina<\/option><option value='1207' >East Point Academy<\/option><option value='1208' >Fox Creek High School<\/option><option value='1209' >Garden City Preparatory Academy for Boys<\/option><option value='1210' >Gray Collegiate Academy<\/option><option value='1211' >GREEN Charter School<\/option><option value='1212' >High Point Academy<\/option><option value='1213' >Imagine Columbia Leadership Academy Charter<\/option><option value='1214' >Lead Academy<\/option><option value='1215' >Lowcountry Leadership Charter School<\/option><option value='1216' >Lowcountry Montessori School<\/option><option value='1217' >Midlands Middle College<\/option><option value='1219' >NEXT High School<\/option><option value='1279' >Oceanside Collegiate Academy<\/option><option value='1220' >Palmetto Scholars Academy<\/option><option value='1221' >Pee Dee Math, Science, and Technology Academy<\/option><option value='1222' >Provost Academy South Carolina<\/option><option value='1223' >Quest Leadership Academy<\/option><option value='1224' >Riverwalk Academy<\/option><option value='1225' >Royal Live Oaks Academy of the Arts and Sciences Charter<\/option><option value='1226' >SC Connections Academy<\/option><option value='1227' >SC Science Academy<\/option><option value='1228' >SC Virtual Charter School<\/option><option value='1229' >SC Whitmore School<\/option><option value='1230' >South Carolina Calvert Academy<\/option><option value='1231' >Spartanburg Preparatory School<\/option><option value='1232' >York Preparatory Academy<\/option><option value='1233' >Youth Leadership Academy Charter<\/option><\/select><\/div><\/div><div id=\"field_9_179\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_179' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_179'>SC School for the Deaf and Blind<\/div><div class='ginput_container ginput_container_select'><select name='input_179' id='input_9_179' class='large gfield_select'  aria-describedby=\"gfield_description_9_179\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1237' >Cedar Springs Academy<\/option><option value='1238' >SC School For Blind Elementary-Middle<\/option><option value='1239' >SC School For Deaf Elementary-Middle<\/option><option value='1240' >SC School for the Blind High School<\/option><option value='1241' >SC School for the Deaf High School<\/option><\/select><\/div><\/div><div id=\"field_9_180\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_180' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_180'>Share Community Action Partnership<\/div><div class='ginput_container ginput_container_select'><select name='input_180' id='input_9_180' class='large gfield_select'  aria-describedby=\"gfield_description_9_180\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1399' >BHW Head Start\/Early Head Start Center<\/option><option value='1404' >Children&#039;s Center &quot;B&quot; Head Start Center<\/option><option value='1415' >Clemson  Head Start Center<\/option><option value='1405' >Easley Bridge Road Head Start Center<\/option><option value='1407' >Golden Strip Head Start\/Early Head Start Center<\/option><option value='1412' >Margaret A. Sherred Head Start Center<\/option><option value='1406' >North Franklin Road Head Start Center<\/option><option value='1409' >North Greenville  Head Start Center<\/option><option value='1408' >Parker Head Start\/Early Head Start Center<\/option><option value='1400' >Pendleton Head Start Center<\/option><option value='1416' >Pickens  Head Start Center<\/option><option value='1417' >Reece Mill Road Head Start\/Early Head Start Center<\/option><option value='1411' >Rubye H. Jones Head Start\/Early Head Start Center<\/option><option value='1414' >Seneca  Head Start\/Early Head Start Center<\/option><option value='1418' >Simpson Head  Head Start Center<\/option><option value='1401' >Starr Head Start Center<\/option><option value='1410' >Tommie C. Brooks Early Head Start Center<\/option><option value='1413' >Watkins Road  Head Start\/Early Head Start Center<\/option><option value='1402' >Westside Head Start Center<\/option><option value='1403' >Willis H. Crosby Head Start\/Early Head Start Center<\/option><\/select><\/div><\/div><div id=\"field_9_159\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_159' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_159'>Spartanburg County School District Two<\/div><div class='ginput_container ginput_container_select'><select name='input_159' id='input_9_159' class='large gfield_select'  aria-describedby=\"gfield_description_9_159\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='266' >Oakland Elementary-Spartanburg<\/option><option value='1025' >Boiling Springs Elementary<\/option><option value='1026' >Boiling Springs High Ninth Grade Campus<\/option><option value='1027' >Boiling Springs High School<\/option><option value='1028' >Sugar Ridge Elementary<\/option><option value='1029' >Boiling Springs Middle<\/option><option value='1030' >Carlisle-Foster&#039;s Grove Elementary<\/option><option value='1031' >Chesnee Elementary<\/option><option value='1032' >Chesnee High School<\/option><option value='1033' >Chesnee Middle<\/option><option value='1034' >Cooley Springs-Fingerville Elementary<\/option><option value='1035' >James H. Hendrix  Elementary<\/option><option value='1036' >Mayo Elementary<\/option><option value='1038' >Rainbow Lake Middle<\/option><option value='1260' >Shoally Creek Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_160\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_160' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_160'>Spartanburg County School District Three<\/div><div class='ginput_container ginput_container_select'><select name='input_160' id='input_9_160' class='large gfield_select'  aria-describedby=\"gfield_description_9_160\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1039' >Broome High School<\/option><option value='1040' >Cannons Elementary<\/option><option value='1041' >Cliffdale Middle<\/option><option value='1042' >Cowpens Elementary<\/option><option value='1045' >Pacolet Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_161\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_161' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_161'>Spartanburg County School District Four<\/div><div class='ginput_container ginput_container_select'><select name='input_161' id='input_9_161' class='large gfield_select'  aria-describedby=\"gfield_description_9_161\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1046' >Woodruff Elementary<\/option><option value='1047' >Woodruff High School<\/option><option value='1048' >Woodruff Middle<\/option><option value='1049' >Woodruff Primary<\/option><\/select><\/div><\/div><div id=\"field_9_155\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_155' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_155'>Spartanburg County School District Five<\/div><div class='ginput_container ginput_container_select'><select name='input_155' id='input_9_155' class='large gfield_select'  aria-describedby=\"gfield_description_9_155\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1050' >Abner Creek Academy<\/option><option value='1051' >Beech Springs Intermediate<\/option><option value='1052' >Berry Shoals Intermediate<\/option><option value='1053' >D. R. Hill Middle<\/option><option value='1054' >Duncan Elementary<\/option><option value='1055' >Florence Chapel Middle<\/option><option value='1056' >James Byrnes Freshman Academy<\/option><option value='1057' >James F. Byrnes High School<\/option><option value='1058' >Lyman Elementary<\/option><option value='1059' >Reidville Elementary<\/option><option value='1060' >River Ridge Elementary<\/option><option value='1061' >Wellford Academy of Science and Techology<\/option><\/select><\/div><\/div><div id=\"field_9_158\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_158' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_158'>Spartanburg County School District Six<\/div><div class='ginput_container ginput_container_select'><select name='input_158' id='input_9_158' class='large gfield_select'  aria-describedby=\"gfield_description_9_158\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1062' >Anderson Mill Elementary<\/option><option value='1063' >Arcadia Elementary<\/option><option value='1064' >Dorman High Freshman Campus<\/option><option value='1065' >Dorman High School<\/option><option value='1066' >Fairforest Elementary<\/option><option value='1067' >Fairforest Middle<\/option><option value='1068' >Jesse S. Bobo Elementary<\/option><option value='1069' >L. E. Gable Middle<\/option><option value='1070' >Lone Oak Elementary<\/option><option value='1071' >Pauline Glenn Springs Elementary<\/option><option value='1072' >R. P. Dawkins Middle<\/option><option value='1073' >Roebuck Elementary<\/option><option value='1074' >West View Elementary<\/option><option value='1075' >Woodland Heights Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_157\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_157' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_157'>Spartanburg County School District Seven<\/div><div class='ginput_container ginput_container_select'><select name='input_157' id='input_9_157' class='large gfield_select'  aria-describedby=\"gfield_description_9_157\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1076' >Carver Middle<\/option><option value='1077' >Cleveland Academy of Leadership<\/option><option value='1078' >E. P. Todd School<\/option><option value='1079' >Houston Elementary<\/option><option value='1080' >Jesse Boyd Elementary<\/option><option value='1081' >Mary H. Wright Elementary<\/option><option value='1082' >McCracken Middle<\/option><option value='1083' >Pine Street Elementary<\/option><option value='1084' >Spartanburg Freshman Academy<\/option><option value='1085' >Spartanburg High School<\/option><option value='1086' >Spartanburg School District 7 Early Childhood Center<\/option><option value='1087' >W. Herbert Chapman Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_181\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_181' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_181'>Sumter School District<\/div><div class='ginput_container ginput_container_select'><select name='input_181' id='input_9_181' class='large gfield_select'  aria-describedby=\"gfield_description_9_181\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1092' >Alice Drive Elementary<\/option><option value='1091' >Alice Drive Middle<\/option><option value='1093' >Bates Middle<\/option><option value='1273' >Brewington Alternative<\/option><option value='1094' >Cherryvale Elementary<\/option><option value='1095' >Chestnut Oaks Middle<\/option><option value='1096' >Crestwood High School<\/option><option value='1097' >Crosswell Elementary-Sumter<\/option><option value='1098' >Ebenezer Middle<\/option><option value='1099' >F. J. Delaine Elementary<\/option><option value='1100' >Furman Middle<\/option><option value='1101' >High Hills Elementary<\/option><option value='1102' >Hillcrest Middle<\/option><option value='1103' >Kingsbury  Elementary<\/option><option value='1104' >Lakewood High  School<\/option><option value='1105' >Lemira Elementary<\/option><option value='1106' >Manchester Elementary<\/option><option value='1107' >Mayewood Middle<\/option><option value='1108' >Millwood Elementary<\/option><option value='1109' >Oakland Primary-Sumter<\/option><option value='1110' >Pocalla Springs Elementary<\/option><option value='1111' >R. E. Davis College Preperatory Academy<\/option><option value='1112' >Rafting Creek Elementary<\/option><option value='1113' >Shaw Heights Elementary<\/option><option value='1114' >Sumter Career and Technology Center<\/option><option value='1115' >Sumter High  School<\/option><option value='1116' >Wilder Elementary<\/option><option value='1117' >Willow Drive Elementary<\/option><\/select><\/div><\/div><div id=\"field_9_182\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_182' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_182'>Union County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_182' id='input_9_182' class='large gfield_select'  aria-describedby=\"gfield_description_9_182\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1118' >Buffalo Elementary<\/option><option value='1119' >Foster Park Elementary<\/option><option value='1120' >Jonesville Elementary<\/option><option value='1121' >Jonesville Middle<\/option><option value='1122' >Lockhart School<\/option><option value='1123' >Lockhart School ANNEX<\/option><option value='1124' >Monarch Elementary-Union<\/option><option value='1125' >Sims Middle<\/option><option value='1126' >Union County Career and Technology Center<\/option><option value='1127' >Union County High School<\/option><\/select><\/div><\/div><div id=\"field_9_183\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_183' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_183'>Williamsburg County School District<\/div><div class='ginput_container ginput_container_select'><select name='input_183' id='input_9_183' class='large gfield_select'  aria-describedby=\"gfield_description_9_183\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1445' >C. E. Murray Elementary School<\/option><option value='1129' >C.E. Murray Middle<\/option><option value='1130' >D.P. Cooper Charter<\/option><option value='1331' >Greeleyville Primary<\/option><option value='1132' >Hemingway Career and Technology Center<\/option><option value='1133' >Hemingway Elementary<\/option><option value='1134' >Hemingway High School<\/option><option value='1135' >Hemingway MB Lee Middle<\/option><option value='1136' >Kenneth Gardner Leadership Academy<\/option><option value='1137' >Kingstree High School<\/option><option value='1138' >Kingstree Middle Magnet<\/option><option value='1139' >W.M. Anderson Primary<\/option><option value='1140' >Williamsburg Co. Magnet School<\/option><\/select><\/div><\/div><div id=\"field_9_184\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_184' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_184'>Williamsburg Tech<\/div><div class='ginput_container ginput_container_select'><select name='input_184' id='input_9_184' class='large gfield_select'  aria-describedby=\"gfield_description_9_184\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1234' >Wmsbg Tec Voc Adult Ed Ctr<\/option><\/select><\/div><\/div><div id=\"field_9_90\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_90' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_90'>Williston School District (Barnwell County 29)<\/div><div class='ginput_container ginput_container_select'><select name='input_90' id='input_9_90' class='large gfield_select'  aria-describedby=\"gfield_description_9_90\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='118' >Kelly Edwards Elementary<\/option><option value='119' >Williston-Elko High School<\/option><option value='120' >Williston-Elko Middle<\/option><\/select><\/div><\/div><div id=\"field_9_186\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_186' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_186'>York School District One<\/div><div class='ginput_container ginput_container_select'><select name='input_186' id='input_9_186' class='large gfield_select'  aria-describedby=\"gfield_description_9_186\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1141' >Cotton Belt Elementary<\/option><option value='1142' >Floyd D. Johnson Technology Ctr<\/option><option value='1143' >Harold C. Johnson Elementary<\/option><option value='1144' >Hickory Grove-Sharon Elementary<\/option><option value='1145' >Hunter Street Elementary<\/option><option value='1146' >Jefferson Elementary-York 1<\/option><option value='1147' >York Comprehensive High School<\/option><option value='1148' >York Intermediate<\/option><option value='1149' >York Middle<\/option><\/select><\/div><\/div><div id=\"field_9_185\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_185' >Nombre de la Escuela<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_9_185'>York County School District Two\n<\/div><div class='ginput_container ginput_container_select'><select name='input_185' id='input_9_185' class='large gfield_select'  aria-describedby=\"gfield_description_9_185\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='1150' >Bethany Elementary<\/option><option value='1151' >Bethel Elementary<\/option><option value='1284' >Blue Eagle Academy<\/option><option value='1152' >Clover High School<\/option><option value='1153' >Clover Middle<\/option><option value='1282' >Clover Ninth Grade Campus<\/option><option value='1154' >Crowders Creek Elem<\/option><option value='1155' >Griggs Road Elementary<\/option><option value='1156' >Kinard Elementary<\/option><option value='1157' >Larne Elementary<\/option><option value='1289' >Oakridge Elementary<\/option><option value='1158' >Oakridge Middle<\/option><\/select><\/div><\/div><div id=\"field_9_50\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informaci\u00f3n del Estudiante<\/h3><\/div><fieldset id=\"field_9_2\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name' id='input_9_2'>\n                            \n                            <span id='input_9_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_9_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_3' >Primeiro<\/label>\n                                                <\/span>\n                            <span id='input_9_2_4_container' class='name_middle' >\n                                                    <input type='text' name='input_2.4' id='input_9_2_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_2_4' >Meio<\/label>\n                                                <\/span>\n                            <span id='input_9_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_9_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_2_6' >Sobrenome<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_9_3\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Sexo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_3'>\n\t\t\t<div class='gchoice gchoice_9_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Male'  id='choice_9_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_0' id='label_9_3_0'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Female'  id='choice_9_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_3_1' id='label_9_3_1'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_10\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de Nacimiento del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_10' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_10_1_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_10_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_10_2_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_10_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_10_3_container'>\n                                            <input type='number'  name='input_10[]' id='input_9_10_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_10_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_9_188\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_188' >Grado<\/label><div class='ginput_container ginput_container_text'><input name='input_188' id='input_9_188' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_189\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_189' >Maestra Tutora<\/label><div class='ginput_container ginput_container_text'><input name='input_189' id='input_9_189' type='text' value='' class='large'  aria-describedby=\"gfield_description_9_189\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_189'>Maestra tutora \/ \"Homeroom Teacher\"<\/div><\/div><div id=\"field_9_48\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_48' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_48' id='input_9_48' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_11\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_11' >Telefono de Casa<\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_9_11' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_9_75\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de correo electronico pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_9_75'>La Direccion de correo electronico debe ser valida ya que recibir\u00e1 una copia de la informaci\u00f3n enviada en el mismo<\/div><div class='ginput_complex ginput_container ginput_container_email' id='input_9_75_container'>\n                                <span id='input_9_75_1_container' class='ginput_left'>\n                                    <input class='' type='email' name='input_75' id='input_9_75' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75' >ingrese correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <span id='input_9_75_2_container' class='ginput_right'>\n                                    <input class='' type='email' name='input_75_2' id='input_9_75_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_75\" \/>\n                                    <label for='input_9_75_2' >Confirmar correo electr\u00f3nico<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_9_5\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direcci\u00f3n del Estudiante<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address' id='input_9_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_9_5_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_5_1' id='input_9_5_1_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_9_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_9_5_2' value=''   placeholder='Street 2'  aria-required='false'   \/>\n                                        <label for='input_9_5_2' id='input_9_5_2_label' class='hidden_sub_label screen-reader-text'>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_9_5_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_5_3' id='input_9_5_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_5_4_container' >\n                                        <select name='input_5.4' id='input_9_5_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_5_4' id='input_9_5_4_label' class='hidden_sub_label screen-reader-text'>Provincia<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_9_5_5' value=''   placeholder='ZIP Code' aria-required='true'    \/>\n                                    <label for='input_9_5_5' id='input_9_5_5_label' class='hidden_sub_label screen-reader-text'>C\u00f3digo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_9_5_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_9_54' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_8\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Preguntas M\u00e9dicas<\/h3><\/div><div id=\"field_9_15\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_15' >Doctor del ni\u00f1o<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_9_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_13\" class=\"gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_13' >Dentista de ni\u00f1os<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_9_13' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_14\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de ultima limpieza dental<\/legend><div id='input_9_14' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_14_1_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_14_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_14_2_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_14_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_14_3_container'>\n                                            <input type='number'  name='input_14[]' id='input_9_14_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_14_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><fieldset id=\"field_9_16\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfSu hijo tiene alergias?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_16'>\n\t\t\t<div class='gchoice gchoice_9_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Yes'  id='choice_9_16_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_16\"   \/>\n\t\t\t\t\t<label for='choice_9_16_0' id='label_9_16_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='No'  id='choice_9_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_16_1' id='label_9_16_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_9_16'>(incluyendo alimentos, medicamentos y\/o l\u00e1tex?)<\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_17\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_17' >En caso afirmativo, enumere<\/label><div class='gfield_description' id='gfield_description_9_17'>Por favor enum\u00e9relos aqu\u00ed. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_9_17' class='textarea medium'  aria-describedby=\"gfield_description_9_17\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_9_18\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez su hijo tuvo un reemplazo artificial de articulaci\u00f3n?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_18'>\n\t\t\t<div class='gchoice gchoice_9_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Yes'  id='choice_9_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_0' id='label_9_18_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='No'  id='choice_9_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_18_1' id='label_9_18_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_20\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfAlguna vez le han diagnosticado a su hijo fiebre reum\u00e1tica?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_20'>\n\t\t\t<div class='gchoice gchoice_9_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_9_20_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_0' id='label_9_20_0'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_9_20_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_20_1' id='label_9_20_1'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_9_21\" class=\"gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >\u00bfTiene su hijo anemia de c\u00e9lulas falciformes o rasgo drepanoc\u00edtico?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_21'>\n\t\t\t<div class='gchoice gchoice_9_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_9_21_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_0' id='label_9_21_0'>Ninguno<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Trait'  id='choice_9_21_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_1' id='label_9_21_1'>rasgo falciforme<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_21_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Sickle Cell Anemia'  id='choice_9_21_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_21_2' id='label_9_21_2'>anemia falciforme<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_25\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_25' >Problemas de Salud<\/label><div class='gfield_description' id='gfield_description_9_25'>Por favor utilice el siguiente espacio para enumerar cualquier otro problema grave de salud que su hijo haya tenido o tenga ahora.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_9_25' class='textarea medium'  aria-describedby=\"gfield_description_9_25\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_24\" class=\"gfield gfield--width-full field_sublabel_below field_description_above gfield_visibility_visible\" ><label class='gfield_label' for='input_9_24' >Lista de Medicamentos<\/label><div class='gfield_description' id='gfield_description_9_24'>Haga una lista de todos los medicamentos, medicamentos de venta libre o suplementos herbales que su hijo est\u00e9 tomando en este momento.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_9_24' class='textarea medium'  aria-describedby=\"gfield_description_9_24\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_55' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_55' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_26\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Informacion de pago<\/h3><div class='gsection_description' id='gfield_description_9_26'>DEBE verificar y completar y firmar en la parte inferior<\/div><\/div><fieldset id=\"field_9_72\" class=\"gfield gfield--width-third field_sublabel_below field_description_above gfield_visibility_visible\" ><legend class='gfield_label'  >Informacion de pago<\/legend><div class='gfield_description' id='gfield_description_9_72'>Elige uno.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_9_72'>\n\t\t\t<div class='gchoice gchoice_9_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid'  id='choice_9_72_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_9_72\"   \/>\n\t\t\t\t\t<label for='choice_9_72_0' id='label_9_72_0'>Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Medicaid and Insurance'  id='choice_9_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_1' id='label_9_72_1'>Seguro Privado y Medicaid<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Private Insurance'  id='choice_9_72_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_2' id='label_9_72_2'>Seguro Privado<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_9_72_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Self-pay\/no insurance'  id='choice_9_72_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_9_72_3' id='label_9_72_3'>No tengo seguro\/Soy responsable del pago<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 8;\"><\/div><div id=\"field_9_71\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_71' >Numero de MEDICAID<\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_9_71' type='text' value='' class='medium'  aria-describedby=\"gfield_description_9_71\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_9_71'>N\u00famero individual de 10 d\u00edgitos del NI\u00d1O(A) - NO EL # DE PLAN.<\/div><\/div><div id=\"field_9_61\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado y Medicaid<\/h3><\/div><fieldset id=\"field_9_58\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian que tiene seguro<\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_58'>\n                            \n                            <span id='input_9_58_3_container' class='name_first' >\n                                                    <input type='text' name='input_58.3' id='input_9_58_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_58_6_container' class='name_last' >\n                                                    <input type='text' name='input_58.6' id='input_9_58_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_9_58_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_63\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_63' >Nombre de la seguro compania<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_9_63' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_65\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_65' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_65' id='input_9_65' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_66\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_hidden\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><h3 class=\"gsection_title\">Seguro Privado<\/h3><\/div><div id=\"field_9_148\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_148' >Nombre de la compania para la cual trabaja el pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_9_148' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_67\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Direccion de Padre o Guardian asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_67' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_67_1_container' >\n                                        <input type='text' name='input_67.1' id='input_9_67_1' value=''   placeholder='Street 1' aria-required='true'    \/>\n                                        <label for='input_9_67_1' id='input_9_67_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_67_3_container' >\n                                    <input type='text' name='input_67.3' id='input_9_67_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_67_3' id='input_9_67_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_67_4_container' >\n                                        <select name='input_67.4' id='input_9_67_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_67_4' id='input_9_67_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_67_5_container' >\n                                    <input type='text' name='input_67.5' id='input_9_67_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_67_5' id='input_9_67_5_label' class='hidden_sub_label screen-reader-text'>Codigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_67.6' id='input_9_67_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_78\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_78' >N\u00famero de seguridad social<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_9_78' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_35\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_hidden_label field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre de la empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_9_35' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_9_35_1_container' >\n                                        <input type='text' name='input_35.1' id='input_9_35_1' value=''   placeholder='Street' aria-required='true'    \/>\n                                        <label for='input_9_35_1' id='input_9_35_1_label' class='hidden_sub_label screen-reader-text'>Direccion<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_9_35_3_container' >\n                                    <input type='text' name='input_35.3' id='input_9_35_3' value=''   placeholder='City' aria-required='true'    \/>\n                                    <label for='input_9_35_3' id='input_9_35_3_label' class='hidden_sub_label screen-reader-text'>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_9_35_4_container' >\n                                        <select name='input_35.4' id='input_9_35_4'     aria-required='true'    ><option value='' selected='selected'>State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_9_35_4' id='input_9_35_4_label' class='hidden_sub_label screen-reader-text'>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_9_35_5_container' >\n                                    <input type='text' name='input_35.5' id='input_9_35_5' value=''   placeholder='ZIP' aria-required='true'    \/>\n                                    <label for='input_9_35_5' id='input_9_35_5_label' class='hidden_sub_label screen-reader-text'>Condigo Postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_35.6' id='input_9_35_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_9_147\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_147' >Numero de Seguro<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_9_147' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_79\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_79' >Identificaci\u00f3n # del grupo<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_9_79' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_9_69\" class=\"gfield gfield--width-half gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Fecha de nacimiento de padre o guardian que esta asegurado<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_9_69' class='ginput_container ginput_complex'><div class='gfield_date_month ginput_container ginput_container_date' id='input_9_69_1_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_9_69_1' class='screen-reader-text'>Mes<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_9_69_2_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_9_69_2' class='screen-reader-text'>D\u00eda<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_9_69_3_container'>\n                                            <input type='number'  name='input_69[]' id='input_9_69_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                            <label for='input_9_69_3' class='screen-reader-text'>A\u00f1o<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div class=\"spacer gfield\" style=\"grid-column: span 6;\"><\/div><div id=\"field_9_37\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_37' >Numero de telefono de empresa de seguro dental<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_37' id='input_9_37' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_80\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_80' >Telefono Celular<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_80' id='input_9_80' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_9_80\"  \/><\/div><div class='gfield_description' id='gfield_description_9_80'>Vuelva a confirmar su n\u00famero de tel\u00e9fono celular; nos pondremos en contacto con usted antes del servicio.<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_9_74' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_9_74' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_9_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_9_70\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent Section<\/h3><\/div><div id=\"field_9_44\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Parent Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_44'>I agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022\u00a0Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_150\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Financial Responsibility<\/h3><div class='gsection_description' id='gfield_description_9_150'>I understand if my child is not eligible for Medicaid or private insurance coverage, I am financially responsible and agree to pay for services.\n <br> <p style=\"margin-left:5%; margin-right:5%;\">  \u2022  Teeth Cleaning - Age 11 & Under - $40.00,  Age 12 & older - $54.00 \n <br>   \u2022 Fluoride Varnish - $26.00 \n <br>   \u2022 Sealants (only permanent back teeth) - $32 per tooth \n <br>   \u2022 SDF (silver diamine flouride) - $15 per tooth \n <br>   \u2022 Therapeutic fillings - $50 per tooth <\/p><\/div><\/div><div id=\"field_9_38\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Sign &amp; Consent<\/h3><div class='gsection_description' id='gfield_description_9_38'><b>Printed name is considered legal signature.<\/b>\n\n\nSolicito y autorizo a HPS, a sus odont\u00f3logos contratantes y al personal, debidamente autorizado como Doctores en Odontolog\u00eda o higienistas dentales con licencia, a realizar cualquier procedimiento de diagn\u00f3stico, procedimientos preventivos o procedimientos de tratamiento para mi hijo. <br>Entiendo que los servicios preventivos no reemplazan un examen realizado por un dentista con licencia. Entiendo que las fotos pueden tomarse con fines educativos. <br>Adem\u00e1s, entiendo que si mi hijo no est\u00e1 inscrito en Medicaid, soy financieramente responsable ante HPS por los servicios prestados. <br>Autorizo el pago de Medicaid o beneficios de seguro directamente a HPS y sus dentistas asociados. Solicito y autorizo la divulgaci\u00f3n de cualquier informaci\u00f3n en este formulario o adquirida en el transcurso del tratamiento para fines de pago, referencia, y para todo el personal escolar apropiado y SC ORS y SC DHEC, seg\u00fan lo considere necesario por HPS. La firma da permiso para que el informe se env\u00ede por correo electr\u00f3nico o mensaje de texto. <br><b>El nombre impreso del padre o guardian se considera firma.<\/b><\/div><\/div><fieldset id=\"field_9_39\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Nombre del pariente o guardian<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_9_39'>\n                            \n                            <span id='input_9_39_3_container' class='name_first' >\n                                                    <input type='text' name='input_39.3' id='input_9_39_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_3' >Primer nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_9_39_6_container' class='name_last' >\n                                                    <input type='text' name='input_39.6' id='input_9_39_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_9_39_6' >Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_9_41\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_41' >Firma impresa<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_9_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_9_42\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_9_42' >Relacion hacia el ni\u00f1o(a)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_9_42' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_9' class='gform_previous_button button' value='Previous'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_9\"]){return false;}  if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_9\"]){return false;} if( !jQuery(\"#gform_9\")[0].checkValidity || jQuery(\"#gform_9\")[0].checkValidity()){window[\"gf_submitting_9\"]=true;}  jQuery(\"#gform_9\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='9' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_9' value='WyJ7XCI3MlwiOltcIjdlMDY1ZTAyYjU1YjBmOTcxNDUxN2MyYzZhNGEyNzMzXCIsXCJmMTEyNDUwMjlmOTk5ZDZhOTVmYThlMDA1ZWVkMWZkM1wiLFwiMWRkOWM3MDczY2VhODVlYTM0NDU5YWFiYjVkZjQ0ZTdcIixcIjhiZDBiMzgzZWZjZGY1Njg3NTUwMzE0ZGJkMTE2MjM4XCJdfSIsIjI2YjE2ZmRiOThhZTJlODM2ZWFmNmJjMDNiNWI0YzU3Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n","protected":false},"excerpt":{"rendered":"Consentimiento para Servicios Este formulario nos da permiso para tratar a su hijo. Los datos se mantienen confidenciales y se usan solo para el tratamiento y la facturaci\u00f3n, de acuerdo con las leyes estatales y federales. Si la informaci\u00f3n cambia antes del tratamiento, comun\u00edquese con nosotros. &quot;*&quot; se\u00f1ala los campos obligatorios 1Secci\u00f3n de informaci\u00f3n del","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"footnotes":""},"class_list":["post-1224","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/pages\/1224","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/comments?post=1224"}],"version-history":[{"count":19,"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/pages\/1224\/revisions"}],"predecessor-version":[{"id":1766,"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/pages\/1224\/revisions\/1766"}],"wp:attachment":[{"href":"https:\/\/www.hps-sc.com\/es\/wp-json\/wp\/v2\/media?parent=1224"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}