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document.write("                    <select id=\"field76173646\" name=\"field76173646\" size=\"1\" class=\"fsField\">"+"\n");
document.write("        <option value=\"\">Day of Birth</option>"+"\n");
document.write("        <option value=\"01\">01</option>"+"\n");
document.write("        <option value=\"02\">02</option>"+"\n");
document.write("        <option value=\"03\">03</option>"+"\n");
document.write("        <option value=\"04\">04</option>"+"\n");
document.write("        <option value=\"05\">05</option>"+"\n");
document.write("        <option value=\"06\">06</option>"+"\n");
document.write("        <option value=\"07\">07</option>"+"\n");
document.write("        <option value=\"08\">08</option>"+"\n");
document.write("        <option value=\"09\">09</option>"+"\n");
document.write("        <option value=\"10\">10</option>"+"\n");
document.write("        <option value=\"11\">11</option>"+"\n");
document.write("        <option value=\"12\">12</option>"+"\n");
document.write("        <option value=\"13\">13</option>"+"\n");
document.write("        <option value=\"14\">14</option>"+"\n");
document.write("        <option value=\"15\">15</option>"+"\n");
document.write("        <option value=\"16\">16</option>"+"\n");
document.write("        <option value=\"17\">17</option>"+"\n");
document.write("        <option value=\"18\">18</option>"+"\n");
document.write("        <option value=\"19\">19</option>"+"\n");
document.write("        <option value=\"20\">20</option>"+"\n");
document.write("        <option value=\"21\">21</option>"+"\n");
document.write("        <option value=\"22\">22</option>"+"\n");
document.write("        <option value=\"23\">23</option>"+"\n");
document.write("        <option value=\"24\">24</option>"+"\n");
document.write("        <option value=\"25\">25</option>"+"\n");
document.write("        <option value=\"26\">26</option>"+"\n");
document.write("        <option value=\"27\">27</option>"+"\n");
document.write("        <option value=\"28\">28</option>"+"\n");
document.write("        <option value=\"29\">29</option>"+"\n");
document.write("        <option value=\"30\">30</option>"+"\n");
document.write("        <option value=\"31\">31</option>"+"\n");
document.write("</select>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
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document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
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document.write("                                        "+"\n");
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document.write("                                        "+"\n");
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document.write("                                        "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsLast fsLabelVertical fsSpan33\" id=\"fsCell76173649\" lang=\"en\" fs-field-type=\"select\" fs-field-validation-name=\"DOB Year\">"+"\n");
document.write("                                                                                                    "+"\n");
document.write("                                        "+"\n");
document.write("                    <select id=\"field76173649\" name=\"field76173649\" size=\"1\" class=\"fsField\">"+"\n");
document.write("        <option value=\"\">Year of Birth</option>"+"\n");
document.write("        <option value=\"1909\">1909</option>"+"\n");
document.write("        <option value=\"1910\">1910</option>"+"\n");
document.write("        <option value=\"1911\">1911</option>"+"\n");
document.write("        <option value=\"1912\">1912</option>"+"\n");
document.write("        <option value=\"1913\">1913</option>"+"\n");
document.write("        <option value=\"1914\">1914</option>"+"\n");
document.write("        <option value=\"1915\">1915</option>"+"\n");
document.write("        <option value=\"1916\">1916</option>"+"\n");
document.write("        <option value=\"1917\">1917</option>"+"\n");
document.write("        <option value=\"1918\">1918</option>"+"\n");
document.write("        <option value=\"1919\">1919</option>"+"\n");
document.write("        <option value=\"1920\">1920</option>"+"\n");
document.write("        <option value=\"1921\">1921</option>"+"\n");
document.write("        <option value=\"1922\">1922</option>"+"\n");
document.write("        <option value=\"1923\">1923</option>"+"\n");
document.write("        <option value=\"1924\">1924</option>"+"\n");
document.write("        <option value=\"1925\">1925</option>"+"\n");
document.write("        <option value=\"1926\">1926</option>"+"\n");
document.write("        <option value=\"1927\">1927</option>"+"\n");
document.write("        <option value=\"1928\">1928</option>"+"\n");
document.write("        <option value=\"1929\">1929</option>"+"\n");
document.write("        <option value=\"1930\">1930</option>"+"\n");
document.write("        <option value=\"1931\">1931</option>"+"\n");
document.write("        <option value=\"1932\">1932</option>"+"\n");
document.write("        <option value=\"1933\">1933</option>"+"\n");
document.write("        <option value=\"1934\">1934</option>"+"\n");
document.write("        <option value=\"1935\">1935</option>"+"\n");
document.write("        <option value=\"1936\">1936</option>"+"\n");
document.write("        <option value=\"1937\">1937</option>"+"\n");
document.write("        <option value=\"1938\">1938</option>"+"\n");
document.write("        <option value=\"1939\">1939</option>"+"\n");
document.write("        <option value=\"1940\">1940</option>"+"\n");
document.write("        <option value=\"1941\">1941</option>"+"\n");
document.write("        <option value=\"1942\">1942</option>"+"\n");
document.write("        <option value=\"1943\">1943</option>"+"\n");
document.write("        <option value=\"1944\">1944</option>"+"\n");
document.write("        <option value=\"1945\">1945</option>"+"\n");
document.write("        <option value=\"1946\">1946</option>"+"\n");
document.write("        <option value=\"1947\">1947</option>"+"\n");
document.write("        <option value=\"1948\">1948</option>"+"\n");
document.write("        <option value=\"1949\">1949</option>"+"\n");
document.write("        <option value=\"1950\">1950</option>"+"\n");
document.write("        <option value=\"1951\">1951</option>"+"\n");
document.write("        <option value=\"1952\">1952</option>"+"\n");
document.write("        <option value=\"1953\">1953</option>"+"\n");
document.write("        <option value=\"1954\">1954</option>"+"\n");
document.write("        <option value=\"1955\">1955</option>"+"\n");
document.write("        <option value=\"1956\">1956</option>"+"\n");
document.write("        <option value=\"1957\">1957</option>"+"\n");
document.write("        <option value=\"1958\">1958</option>"+"\n");
document.write("        <option value=\"1959\">1959</option>"+"\n");
document.write("        <option value=\"1960\">1960</option>"+"\n");
document.write("        <option value=\"1961\">1961</option>"+"\n");
document.write("        <option value=\"1962\">1962</option>"+"\n");
document.write("        <option value=\"1963\">1963</option>"+"\n");
document.write("        <option value=\"1964\">1964</option>"+"\n");
document.write("        <option value=\"1965\">1965</option>"+"\n");
document.write("        <option value=\"1966\">1966</option>"+"\n");
document.write("        <option value=\"1967\">1967</option>"+"\n");
document.write("        <option value=\"1968\">1968</option>"+"\n");
document.write("        <option value=\"1969\">1969</option>"+"\n");
document.write("        <option value=\"1970\">1970</option>"+"\n");
document.write("        <option value=\"1971\">1971</option>"+"\n");
document.write("        <option value=\"1972\">1972</option>"+"\n");
document.write("        <option value=\"1973\">1973</option>"+"\n");
document.write("        <option value=\"1974\">1974</option>"+"\n");
document.write("        <option value=\"1975\">1975</option>"+"\n");
document.write("        <option value=\"1976\">1976</option>"+"\n");
document.write("        <option value=\"1977\">1977</option>"+"\n");
document.write("        <option value=\"1978\">1978</option>"+"\n");
document.write("        <option value=\"1979\">1979</option>"+"\n");
document.write("        <option value=\"1980\">1980</option>"+"\n");
document.write("        <option value=\"1981\">1981</option>"+"\n");
document.write("        <option value=\"1982\">1982</option>"+"\n");
document.write("        <option value=\"1983\">1983</option>"+"\n");
document.write("        <option value=\"1984\">1984</option>"+"\n");
document.write("        <option value=\"1985\">1985</option>"+"\n");
document.write("        <option value=\"1986\">1986</option>"+"\n");
document.write("        <option value=\"1987\">1987</option>"+"\n");
document.write("        <option value=\"1988\">1988</option>"+"\n");
document.write("        <option value=\"1989\">1989</option>"+"\n");
document.write("        <option value=\"1990\">1990</option>"+"\n");
document.write("        <option value=\"1991\">1991</option>"+"\n");
document.write("        <option value=\"1992\">1992</option>"+"\n");
document.write("        <option value=\"1993\">1993</option>"+"\n");
document.write("        <option value=\"1994\">1994</option>"+"\n");
document.write("        <option value=\"1995\">1995</option>"+"\n");
document.write("        <option value=\"1996\">1996</option>"+"\n");
document.write("        <option value=\"1997\">1997</option>"+"\n");
document.write("        <option value=\"1998\">1998</option>"+"\n");
document.write("        <option value=\"1999\">1999</option>"+"\n");
document.write("        <option value=\"2000\">2000</option>"+"\n");
document.write("        <option value=\"2001\">2001</option>"+"\n");
document.write("        <option value=\"2002\">2002</option>"+"\n");
document.write("        <option value=\"2003\">2003</option>"+"\n");
document.write("        <option value=\"2004\">2004</option>"+"\n");
document.write("        <option value=\"2005\">2005</option>"+"\n");
document.write("        <option value=\"2006\">2006</option>"+"\n");
document.write("        <option value=\"2007\">2007</option>"+"\n");
document.write("        <option value=\"2008\">2008</option>"+"\n");
document.write("        <option value=\"2009\">2009</option>"+"\n");
document.write("        <option value=\"2010\">2010</option>"+"\n");
document.write("        <option value=\"2011\">2011</option>"+"\n");
document.write("        <option value=\"2012\">2012</option>"+"\n");
document.write("        <option value=\"2013\">2013</option>"+"\n");
document.write("        <option value=\"2014\">2014</option>"+"\n");
document.write("        <option value=\"2015\">2015</option>"+"\n");
document.write("        <option value=\"2016\">2016</option>"+"\n");
document.write("        <option value=\"2017\">2017</option>"+"\n");
document.write("        <option value=\"2018\">2018</option>"+"\n");
document.write("        <option value=\"2019\">2019</option>"+"\n");
document.write("</select>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                          <div class=\"fs-clear\"></div>"+"\n");
document.write("                        </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("                                "+"\n");
document.write("                </div>"+"\n");
document.write("                                "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            <div class=\"fsSection fs2Col\" id=\"fsSection76173585\">"+"\n");
document.write("                                                    "+"\n");
document.write("                                        "+"\n");
document.write("            <div class=\"fsSectionHeader\">"+"\n");
document.write("        "+"\n");
document.write("    </div>"+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow2283928-8\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell42765578\" lang=\"en\" fs-field-type=\"select\" fs-field-validation-name=\"Level\">"+"\n");
document.write("                                                                                                    "+"\n");
document.write("                                        "+"\n");
document.write("                    <select id=\"field42765578\" name=\"field42765578\" size=\"1\"required class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("        <option value=\"\">I want to learn more about...</option>"+"\n");
document.write("        <option value=\"Undergraduate studies\">Undergraduate studies</option>"+"\n");
document.write("        <option value=\"Graduate studies\">Graduate studies</option>"+"\n");
document.write("</select>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
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document.write("                        "+"\n");
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document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow2283928-9\" class=\"fsRow fsFieldRow fsLastRow fsHidden\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100\" id=\"fsCell40119478\" lang=\"en\" fs-field-type=\"select\" fs-field-validation-name=\"Program of interest\">"+"\n");
document.write("                                                                                                    "+"\n");
document.write("                                        "+"\n");
document.write("                    <select id=\"field40119478\" name=\"field40119478\" size=\"1\"required class=\"fsField fsRequired\" aria-required=\"true\" disabled=\"disabled\">"+"\n");
document.write("        <option value=\"\">Program of interest</option>"+"\n");
document.write("        <option value=\"Undecided\">Undecided</option>"+"\n");
document.write("        <option value=\"Accounting, BS\">Accounting, BS</option>"+"\n");
document.write("        <option value=\"Actuarial Science, BS\">Actuarial Science, BS</option>"+"\n");
document.write("        <option value=\"Biblical Counseling, BS\">Biblical Counseling, BS</option>"+"\n");
document.write("        <option value=\"Biblical Studies, BA\">Biblical Studies, BA</option>"+"\n");
document.write("        <option value=\"Biochemistry and Molecular Biology, BS\">Biochemistry and Molecular Biology, BS</option>"+"\n");
document.write("        <option value=\"Biology, BS\">Biology, BS</option>"+"\n");
document.write("        <option value=\"Business Administration, BS\">Business Administration, BS</option>"+"\n");
document.write("        <option value=\"Business, AS\">Business, AS</option>"+"\n");
document.write("        <option value=\"Chemistry, BS\">Chemistry, BS</option>"+"\n");
document.write("        <option value=\"Child Development, BS\">Child Development, BS</option>"+"\n");
document.write("        <option value=\"Child Growth and Development, AS\">Child Growth and Development, AS</option>"+"\n");
document.write("        <option value=\"Christian Ministries, AS\">Christian Ministries, AS</option>"+"\n");
document.write("        <option value=\"Cinema Production, BS\">Cinema Production, BS</option>"+"\n");
document.write("        <option value=\"Communication, BA\">Communication, BA</option>"+"\n");
document.write("        <option value=\"Communication Disorders, BS\">Communication Disorders, BS</option>"+"\n");
document.write("        <option value=\"Composite Social Studies Education, BS\">Composite Social Studies Education, BS</option>"+"\n");
document.write("        <option value=\"Composition, BMus\">Composition, BMus</option>"+"\n");
document.write("        <option value=\"Computer Science, BS\">Computer Science, BS</option>"+"\n");
document.write("        <option value=\"Criminal Justice, AS\">Criminal Justice, AS</option>"+"\n");
document.write("        <option value=\"Criminal Justice, BS\">Criminal Justice, BS</option>"+"\n");
document.write("        <option value=\"Cross-Cultural Service, BA\">Cross-Cultural Service, BA</option>"+"\n");
document.write("        <option value=\"Culinary Arts, AS\">Culinary Arts, AS</option>"+"\n");
document.write("        <option value=\"Cybersecurity, BS\">Cybersecurity, BS</option>"+"\n");
document.write("        <option value=\"Early Childhood Education, BS\">Early Childhood Education, BS</option>"+"\n");
document.write("        <option value=\"Educational Studies, BS\">Educational Studies, BS</option>"+"\n");
document.write("        <option value=\"Elementary Education, BS\">Elementary Education, BS</option>"+"\n");
document.write("        <option value=\"Engineering, BS\">Engineering, BS</option>"+"\n");
document.write("        <option value=\"English, BA\">English, BA</option>"+"\n");
document.write("        <option value=\"English Education, BS\">English Education, BS</option>"+"\n");
document.write("        <option value=\"Fashion Design, BS\">Fashion Design, BS</option>"+"\n");
document.write("        <option value=\"French, BA\">French, BA</option>"+"\n");
document.write("        <option value=\"Graphic Design, BFA\">Graphic Design, BFA</option>"+"\n");
document.write("        <option value=\"Health Sciences, BS\">Health Sciences, BS</option>"+"\n");
document.write("        <option value=\"History, BA\">History, BA</option>"+"\n");
document.write("        <option value=\"Humanities, BA\">Humanities, BA</option>"+"\n");
document.write("        <option value=\"Information Technology, BS\">Information Technology, BS</option>"+"\n");
document.write("        <option value=\"Interdisciplinary Studies, BA or BS\">Interdisciplinary Studies, BA or BS</option>"+"\n");
document.write("        <option value=\"Interior Architecture and Design, BFA\">Interior Architecture and Design, BFA</option>"+"\n");
document.write("        <option value=\"International Studies, BA\">International Studies, BA</option>"+"\n");
document.write("        <option value=\"Journalism and Mass Communication, BA\">Journalism and Mass Communication, BA</option>"+"\n");
document.write("        <option value=\"Keyboard Performance, BMus\">Keyboard Performance, BMus</option>"+"\n");
document.write("        <option value=\"Kinesiology, BS\">Kinesiology, BS</option>"+"\n");
document.write("        <option value=\"Liberal Arts, AA\">Liberal Arts, AA</option>"+"\n");
document.write("        <option value=\"Mathematics, BS\">Mathematics, BS</option>"+"\n");
document.write("        <option value=\"Mathematics Education, BS\">Mathematics Education, BS</option>"+"\n");
document.write("        <option value=\"Media and Technology, AS\">Media and Technology, AS</option>"+"\n");
document.write("        <option value=\"Middle School Education, BS\">Middle School Education, BS</option>"+"\n");
document.write("        <option value=\"Ministry and Leadership, BS\">Ministry and Leadership, BS</option>"+"\n");
document.write("        <option value=\"Music, BA or BS\">Music, BA or BS</option>"+"\n");
document.write("        <option value=\"Music and Church Ministries, BS\">Music and Church Ministries, BS</option>"+"\n");
document.write("        <option value=\"Music Education, BME\">Music Education, BME</option>"+"\n");
document.write("        <option value=\"Nursing, BSN\">Nursing, BSN</option>"+"\n");
document.write("        <option value=\"Orchestral Instrument Performance, BMus\">Orchestral Instrument Performance, BMus</option>"+"\n");
document.write("        <option value=\"Paralegal Studies, AS\">Paralegal Studies, AS</option>"+"\n");
document.write("        <option value=\"Personal Training, AS\">Personal Training, AS</option>"+"\n");
document.write("        <option value=\"Physics, BS\">Physics, BS</option>"+"\n");
document.write("        <option value=\"Piano Pedagogy, BMus\">Piano Pedagogy, BMus</option>"+"\n");
document.write("        <option value=\"Premed/Predent, BS\">Premed/Predent, BS</option>"+"\n");
document.write("        <option value=\"RN to BSN, BSN\">RN to BSN, BSN</option>"+"\n");
document.write("        <option value=\"Public Health/Global Health, BS\">Public Health/Global Health, BS</option>"+"\n");
document.write("        <option value=\"Science Education, BS\">Science Education, BS</option>"+"\n");
document.write("        <option value=\"Spanish, BA\">Spanish, BA</option>"+"\n");
document.write("        <option value=\"Spanish Education, BS\">Spanish Education, BS</option>"+"\n");
document.write("        <option value=\"Special Education, BS\">Special Education, BS</option>"+"\n");
document.write("        <option value=\"Sport Management, BS\">Sport Management, BS</option>"+"\n");
document.write("        <option value=\"Studio Art, BFA\">Studio Art, BFA</option>"+"\n");
document.write("        <option value=\"Theatre, BA\">Theatre, BA</option>"+"\n");
document.write("        <option value=\"Visual Studies, BS\">Visual Studies, BS</option>"+"\n");
document.write("        <option value=\"Voice Performance, BMus\">Voice Performance, BMus</option>"+"\n");
document.write("</select>"+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                          <div class=\"fs-clear\"></div>"+"\n");
document.write("                        </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
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document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow2283928-10\" class=\"fsRow fsFieldRow fsLastRow fsHidden\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100\" id=\"fsCell42765534\" lang=\"en\" fs-field-type=\"select\" fs-field-validation-name=\"Program of interest - Graduate\">"+"\n");
document.write("                                                                                                    "+"\n");
document.write("                                        "+"\n");
document.write("                    <select id=\"field42765534\" name=\"field42765534\" size=\"1\"required class=\"fsField fsRequired\" aria-required=\"true\" disabled=\"disabled\">"+"\n");
document.write("        <option value=\"\">Program of interest</option>"+"\n");
document.write("        <option value=\"Undecided\">Undecided</option>"+"\n");
document.write("        <option value=\"Biblical Counseling, Graduate Certificate\">Biblical Counseling, Graduate Certificate</option>"+"\n");
document.write("        <option value=\"Biblical Counseling, MA\">Biblical Counseling, MA</option>"+"\n");
document.write("        <option value=\"Biblical Language and Literature, MA\">Biblical Language and Literature, MA</option>"+"\n");
document.write("        <option value=\"Biblical Studies, MA\">Biblical Studies, MA</option>"+"\n");
document.write("        <option value=\"Communication Studies, MA\">Communication Studies, MA</option>"+"\n");
document.write("        <option value=\"Doctor of Ministry\">Doctor of Ministry</option>"+"\n");
document.write("        <option value=\"Educational Leadership, MS\">Educational Leadership, MS</option>"+"\n");
document.write("        <option value=\"Intercultural Studies, MA\">Intercultural Studies, MA</option>"+"\n");
document.write("        <option value=\"Master of Divinity\">Master of Divinity</option>"+"\n");
document.write("        <option value=\"Master of Music Education\">Master of Music Education</option>"+"\n");
document.write("        <option value=\"Ministry Studies, MA\">Ministry Studies, MA</option>"+"\n");
document.write("        <option value=\"Sport Administration and Coaching, MA\">Sport Administration and Coaching, MA</option>"+"\n");
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