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Cost To Convert ASPX Form - Table Layout to DIV Layout + CSS

Cost Of Converting THIS...

ASP.NET Web Form in Table layout (with atrocious CSS text/css)  to efficient DIV layout + CSS ??

   1. I built this but used VStudio verbose Jurassic table layout style and client wants concise DIV layout... so i need to have someone help me convert it...

   2. Here is link to my in progress ASP.Net web form... http://www.enflow.com/CC/P1/P3.aspx   - - minus (VB code and Validation Code)

   3. See source code for this...

<%@ Page Language="VB" AutoEventWireup="false" debug="true" %>
<%@ import Namespace="System" %>
<%@ import Namespace="System.Data" %>
<%@ import Namespace="System.Data.SqlClient" %>
<%@ import Namespace="System.data.OleDb" %>
<%@ import Namespace="System.Web.UI.WebControls" %>

<%@ Register assembly="System.Web, Version=2.0.0.0, Culture=neutral, PublicKeyToken=b03f5f7f11d50a3a" namespace="System.Web.UI.WebControls" tagprefix="asp" %>

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<script runat="server">
    Sub Page_Load(sender As Object, e As EventArgs)
        'a
    End Sub

    Protected Sub RadioButton1_CheckedChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub DropDownList1_SelectedIndexChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub Address0_TextChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub Month_TextChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub Calendar1_SelectionChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub RadioButton1_CheckedChanged1(sender As Object, e As EventArgs)

    End Sub

    Protected Sub Eviction9_CheckedChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub Eviction10_CheckedChanged(sender As Object, e As EventArgs)

    End Sub

    Protected Sub HH_LN1_TextChanged(sender As Object, e As EventArgs)

    End Sub
</script>

<script type="text/javascript">    

    function Count(text, myVar) {
        //asp.net textarea maxlength doesnt work; do it by hand
        //var maxlength = 30; //set your value here (or add a parm and pass it in)
        var maxlength = myVar
        var object = document.getElementById(text.id)  //get your object
        if (object.value.length > maxlength) {
            object.focus(); //set focus to prevent jumping
            object.value = text.value.substring(0, maxlength); //truncate the value
            object.scrollTop = object.scrollHeight; //scroll to the end to prevent jumping
            return false;
        }
        return true;
    }

</script>

<html xmlns="http://www.w3.org/1999/xhtml" lang="en-us">
<head>
    <title>CC Housing Assistance Application: Part One - Page 1</title>
    <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
    <meta http-equiv="Content-Language" content="en" />
    <meta name="robots" content="noindex, nofollow" />
    <link rel="StyleSheet" href="/authority.css" media="all" />
    <style type="text/css">
        .auto-style1 {
            margin-bottom: 10px;
            height: 1179px;
        }
        .auto-style2 {
            height: 55px;
            width: 100%;
        }
        .auto-style11 {
            height: 50px;
            width: 100%;
        }
        .auto-style12 {
            height: 19px;
            width: 100%;
        }
        .auto-style18 {
            height: 20px;
            width: 100%;
        }
        .auto-style24 {
            height: 38px;
            width: 100%;
        }
        .auto-style25 {
            width: 100%;
        }
        .auto-style26 {
            height: 19px;
            width: 100%;
        }
        .auto-style27 {
            height: 32px;
            width: 100%;
        }
        .auto-style28 {
            height: 8px;
            width: 100%;
        }
        .auto-style29 {
            height: 19px;
            width: 100%;
            text-decoration: underline;
        }
        .auto-style30 {
            width: 100%;
            height: 33px;
            text-align: center;
        }
        .auto-style32 {
            width: 100%;
            height: 92px;
            text-align: center;
        }
        .auto-style33 {
            width: 100%;
            height: 79px;
            text-align: center;
        }
        .auto-style34 {
            height: 10px;
            width: 100%;
        }
        .auto-style35 {
            height: 74px;
            width: 100%;
        }
        .auto-style37 {
            width: 100%;
            height: 33px;
            text-align: left;
        }
        .auto-style41 {
            height: 32px;
            font-size: large;
        }
        .auto-style45 {
            text-decoration: underline;
            height: 32px;
        }
        .auto-style46 {
            height: 32px;
            font-size: large;
            width: 93px;
        }
        .auto-style50 {
            height: 10px;
            width: 100%;
            text-align: center;
        }
        .auto-style51 {
            text-decoration: underline;
        }
        .auto-style52 {
            height: 8px;
            width: 100%;
            text-align: center;
            font-size: x-large;
        }
        .auto-style53 {
            height: 32px;
            font-size: large;
            text-decoration: underline;
        }
        .auto-style54 {
            height: 66px;
            font-size: large;
            width: 100px;
        }
        .auto-style55 {
            width: 100%;
            height: 66px;
            text-align: left;
        }
        .auto-style57 {
            height: 32px;
            font-size: large;
            width: 100px;
        }
        .auto-style58 {
            height: 55px;
            font-size: large;
        }
        .auto-style59 {
            height: 32px;
            font-size: large;
            text-align: center;
        }
        .auto-style60 {
            height: 32px;
            font-size: large;
            text-align: left;
        }

        .auto-style61 {
            height: 32px;
            font-size: large;
            text-align: left;
            text-decoration: underline;
        }

        .auto-style62 {
            height: 20px;
            width: 100%;
            text-align: center;
        }
        .auto-style63 {
            height: 54px;
            font-size: large;
            text-align: center;
        }
        .auto-style64 {
            height: 10px;
            width: 100%;
            text-decoration: underline;
        }

        .auto-style65 {
            height: 32px;
            font-size: medium;
            width: 100px;
        }
        .auto-style66 {
            font-size: medium;
        }
        .auto-style69 {
            height: 35px;
            font-size: medium;
            text-align: left;
        }
        .auto-style70 {
            height: 35px;
            width: 100%;
        }

        .auto-style72 {
            font-size: large;
        }
        .auto-style73 {
            height: 10px;
            width: 100%;
            font-size: large;
        }

        .auto-style75 {
            height: 32px;
            font-size: medium;
        }

        .auto-style78 {
            height: 32px;
            font-size: small;
            width: 93px;
        }
        .auto-style80 {
            height: 32px;
            font-size: medium;
            width: 93px;
        }
        .auto-style81 {
            height: 55px;
            width: 100%;
            text-align: center;
        }
        .auto-style82 {
            height: 55px;
            font-size: large;
            text-align: center;
            text-decoration: underline;
        }

        .auto-style84 {
            width: 100%;
            height: 255px;
            text-align: left;
        }
        .auto-style86 {
            width: 100%;
            height: 7px;
            text-align: left;
        }
        .auto-style87 {
            height: 126px;
            width: 100%;
        }
        .auto-style88 {
            height: 15px;
            width: 100%;
        }
        .auto-style89 {
            height: 7px;
            width: 100%;
        }

        .auto-style90 {
            height: 147px;
            width: 100%;
        }

        .auto-style91 {
            height: 32px;
            font-size: large;
            width: 394px;
        }

    </style>
</head>
<body bgcolor="#F2F2F2">
    <form id="frmPartOne" runat="server">
        <div id="main" style="width: 1075px;margin: auto; border:10px solid #003366; background-color: #FFFFFF;">
                <table align="center" class="auto-style1" width="1000px">
                    <tr>
                        <td class="auto-style32" style="font-size: x-large; width: 50%;" colspan="2" >
                            Logo 1</td>
                        <td class="auto-style32" style="font-size: x-large;" colspan="2" >
                            Logo 2</td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;" colspan="4"><strong style="font-size: 25px">SECTION ONE</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style33" style="font-size: large" colspan="4"><strong>XYZ HOUSING APPLICATION CHECKLIST<br />
                            READ IT ALL THEN FILL OUT THIS FORM COMPLETELY</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style27" style="font-size: x-large" colspan="4">We Will Be Accepting Applications from AAA to BBB</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style12" style="font-size: large" colspan="4">If student is&nbsp; <strong>ALMOST</strong>&nbsp; Homeless</td>
                    </tr>
                    <tr>
                        <td class="auto-style12" style="font-size: large" colspan="4">&nbsp;&nbsp;&nbsp;&nbsp; o Completed <strong>XYZ</strong> Application &amp; Signatures on all required lines by adults listed on application</td>
                    </tr>
                    <tr>
                        <td class="auto-style25" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style26" style="font-size: large" colspan="4">If student &nbsp;<strong>IS</strong> &nbsp;Homeless, schedule intake appointment with Marybeth at <strong>XYZ</strong> <strong>ABC</strong> Housing Assistance</td>
                    </tr>
                    <tr>
                        <td class="auto-style18" style="font-size: large" colspan="4">&nbsp;&nbsp;&nbsp;&nbsp; o Completed <strong>XYZ</strong> &amp; <strong>ABC</strong> Application &amp; Signatures on all required lines by adults listed on application</td>
                    </tr>
                    <tr>
                        <td class="auto-style28" colspan="4">
                            </td>
                    </tr>
                    <tr>
                        <td class="auto-style18" style="font-size: large" colspan="4"><span class="auto-style51">Identification Verification</span><br />
&nbsp; Copies of the following documents are needed at time of application submission to <strong>XYZ</strong>:</td>
                    </tr>
                    <tr>
                        <td class="auto-style11" colspan="4">
                            <ul style="font-size: large;">
                                <li>Photo ID for all adults listed on application</li>
                                <li>Social Security cards for all the adults listed on the application</li>
                                <li>Alien Registration / Permanent Resident(copies of BOTH sides of cards)</li>
                            </ul>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style29" style="font-size: large" colspan="4">Financial Verification</td>
                    </tr>
                    <tr>
                        <td class="auto-style18" style="font-size: large" colspan="4">&nbsp;&nbsp; Copies of the following documents are needed at time of application submission to <strong>XYZ</strong>:</td>
                    </tr>
                    <tr>
                        <td class="auto-style11" colspan="4">
                            <ul style="font-size: large;">
                                <li>Financial Aid award letter or Financial Aid award summary print out from CTC Link</li>
                                <li>If no Financial Aid, you will need to describe funding source</li>
                                <li>Print out of tuition &amp; fees due for application quarter from student account</li>
                            </ul>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style29" style="font-size: large" colspan="4">Income Verification</td>
                    </tr>
                    <tr>
                        <td class="auto-style24" style="font-size: large" colspan="4">Please provide the last 3 months proof of income. If information is provided within the application about income, documentation must be provided for processing. (Examples below)</td>
                    </tr>
                    <tr>
                        <td class="auto-style2" colspan="4">
                            <ul style="font-size: large;">
                                <li>Employment pay stubs</li>
                                <li>Unemployment pay stubs</li>
                                <li>Social Security award letter</li>
                                <li>Child Support printout</li>
                                <li>TANF award letter</li>
                                <li>Pension/Retirement award letter</li>
                                <li>VA award letter</li>
                                <li>Self-Employment (last filed income tax)</li>
                                <li>Other</li>
                            </ul>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style24" style="font-size: x-large; color: #FF0000;"; colspan="4"><strong>NOTE</strong>...
                            <br />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style35" style="font-size: large"; colspan="4">Includes <strong>ABC &amp; XYZ</strong> Applications.<br />
                            There are 4 sections to read and fill out.<br />
                            Time is about 20-40 minutes to complete this.<br />                          
                            Fields with a ASTERISK symbol * are REQUIRED.<br />
                            <strong>If you don&#39;t have the info for a required field, put in N/A.</strong><br />
                            You must complete all pages of this form in one go... in one sitting.<br />
                            Your data will <strong>NOT</strong> be saved until you click “<strong>SUBMIT</strong>” at the end of form.<br />
                            <br />                        
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;"; colspan="4"><strong style="font-size: 25px">SECTION TWO</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style28" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="font-size: large" colspan="4"><strong>College Housing Assistance Program Application<br />
                            ABC Form (#) REM-CHP-01Z</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style37" style="font-size: large" colspan="4">You must be an enrolled <strong>XYZ</strong> student registered for or attending classes to participate in this program. Please complete this application and attach other requested materials before submitting to the <strong>XYZ</strong> <strong>ABC</strong> <strong>123</strong>, Counseling and Advising Office (Bldg. 7). Submission of this application does not guarantee an award; please continue your search for housing. Inaccurate or misleading statements may be grounds for disqualifying the application. <br />
                            <br />
                            <strong>If you are invited to participate in the program, you will be required to complete additional forms. These forms must be completed for review, prior to receiving any housing assistance.</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="font-size: large; text-align: left;" colspan="4"><span class="auto-style45">Applicant Information (Head of Household)</span>&nbsp;</td>
                    </tr>
                    <tr>
                        <td class="auto-style46">First Name:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender" runat="server" Text="Gender:*"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last4" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">StudentID:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="6" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="9"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Ethnicity:</td>
                        <td class="auto-style91">
                            <asp:DropDownList ID="Race" runat="server" BackColor="#EAF4FF" Height="28px" OnSelectedIndexChanged="DropDownList1_SelectedIndexChanged" Width="342px" Font-Size="Large" TabIndex="7">
                                <asp:ListItem>Select Race (Optional)</asp:ListItem>
                                <asp:ListItem>One</asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                            </asp:DropDownList>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Address:*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="Address" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="8"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Addr2:</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="Address0" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Address0_TextChanged" TabIndex="9" ToolTip="Add Info Here Only If You Have Additional Address Info"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">City:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">State:</td>
                        <td class="auto-style91">
                            <asp:DropDownList ID="State" runat="server" BackColor="#EAF4FF" Height="27px" OnSelectedIndexChanged="DropDownList1_SelectedIndexChanged" Width="342px" Font-Size="Large" TabIndex="11">
                                <asp:ListItem>Select State (Optional)</asp:ListItem>
                                <asp:ListItem>CA</asp:ListItem>
                                <asp:ListItem>OR</asp:ListItem>
                                <asp:ListItem>NV</asp:ListItem>
                                <asp:ListItem>NM</asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                            </asp:DropDownList>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">ZipCode:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:*</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp;&nbsp; Year:
                            <asp:TextBox ID="Year" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">xxx eMail:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="TEmail" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="16"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Your email*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="PEmail" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="17" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Phone:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="RPhone" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style41" colspan="2">May we leave messages at this number ?*&nbsp;
                            <asp:RadioButton ID="Yes" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Emerg Ph:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="EPhone" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style41" colspan="2">May we leave messages at this number ?&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes0" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgEP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No0" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgEP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Studies*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="StudyProg" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Address0_TextChanged" TabIndex="9"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style50" style="border: thin solid #000000; font-size: x-large; background-color: #E8FFE8;"; colspan="4"><strong style="font-size: 18px">BASIC ELIGIBILITY QUESTIONS</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4">
                            </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do You Currently Owe Money To Any Housing Authority?*&nbsp;
                            <asp:RadioButton ID="Yes1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="OweMoney" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="OweMoney" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">Are you enrolled in credit bearing classes at <strong>XXXXXX</strong> Community College?*&nbsp;
                            <asp:RadioButton ID="Yes2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="Enrolled" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="Enrolled" TabIndex="18" Text="No" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">Do you still need to complete a FAFSA?*&nbsp;
                            <asp:RadioButton ID="Yes3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4"><strong>NOTE **</strong> Assistance filling out the FAFSA is available. Please ask Michelle Allen at <a href="XYZ.org">XYZ.ORG</a> for more information.</td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">Have you had difficulties feeding yourself or your family within the last 2-3 months?*&nbsp; <asp:RadioButton ID="Yes4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style52" colspan="4"><strong>~&nbsp; ~&nbsp; ~</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style35" style="font-size: large" colspan="4"><span class="auto-style51">Definition of homeless: A household that is: </span>
                            <br />
                            <br />
                            1) In an emergency shelter or in a transitional housing facility; or...<br />
                            2) Is a client of a case-management program serving the homeless<br />
                            <br />
                            <span class="auto-style51">Definition of at serious risk of homelessness: A household that is experiencing any of the following:</span><br />
                            <br />
                            1) Unable to meet basic housing expenses such as rent, mortgage, or utilities that will result in the loss of permanent housing; 
                            <br />
                            2) Residing in a motel/hotel due to loss of permanent housing and lacks the resources to remain; 
                            <br />
                            3) Has lost permanent housing and is living temporarily with a friend or family member and cannot be placed on the lease; 
                            <br />
                            4) Eviction notices that will result in loss of permanent housing; 5) Pending unlawful detainer notices that will result in loss; 
                            <br />
                            6) Recent history of serious housing instability; 
                            <br />
                            7) Is a victim of domestic violence; or 
                            <br />
                            8) Is facing discharge from a public institution (e.g. incarceration, hospital etc.) without a housing discharge plan.</td>
                    </tr>
                    <tr>
                        <td class="auto-style53" style="font-size: large" colspan="4">Reason for homelessness or risk of homelessness (Check All That Apply)...</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4">
                            <asp:CheckBox ID="Eviction" runat="server" Text="Eviction" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="DomViolence" runat="server" Text="Domestic Violence" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="NewTCC" runat="server" Text="New To ABC" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="SubAbuse" runat="server" Text="Substance Abuse" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4">
                            <asp:CheckBox ID="FamCrisis" runat="server" Text="Family Crisis" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<asp:CheckBox ID="MedIssues" runat="server" Text="Medical Issues" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="LostIncome" runat="server" Text="Loss Of Income" OnCheckedChanged="Eviction9_CheckedChanged" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<asp:CheckBox ID="NaturalDisaster" runat="server" Text="Natural Disaster" OnCheckedChanged="Eviction10_CheckedChanged" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:CheckBox ID="Natural" runat="server" Text="Other" OnCheckedChanged="Eviction10_CheckedChanged" />
                            ...&nbsp; (If You Check Other Describe that in Textbox below... (Note 200 MAX characters allowed)</td>
                    </tr>
                    <tr>
                        <td class="auto-style54" style="font-size: medium">Describe Other</td>
                        <td class="auto-style55" colspan="3">
                            <asp:TextBox ID="MoreOther" runat="server" Height="60px" Width="854px" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="9" TextMode="MultiLine" onKeyUp="javascript:Count(this,250);" onChange="javascript:Count(this,250);"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style58" style="font-size: large" colspan="4">
                            Please explain in further detail how your circumstances fit into the above <strong>homeless</strong> definitions and what caused you to leave your last permanent residence in the large description textbox below** --- (Note 970 MAX characters allowed)</td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">
                            <asp:TextBox ID="MoreDetail" runat="server" Height="200px" Width="966px" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Address0_TextChanged" TabIndex="9" MaxLength="600" TextMode="MultiLine" onKeyUp="javascript:Count(this,950);" onChange="javascript:Count(this,950);"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style28" style="font-size: large" colspan="4">
                            </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">
                            <strong>If you are identifying that you are homeless</strong>, you will need to provide information about which <strong>Agencies</strong> you are currently working with to resolve your homelessness.
                            Without this information, you will be identified as almost homeless.</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            <asp:Label ID="Label1" runat="server" Text="Agency One Name        " Width="330px"></asp:Label>
                            <asp:Label ID="Label2" runat="server" Text="Agency One Phone" Width="330px"></asp:Label>
                            <asp:Label ID="Label3" runat="server" Text="Agency One Contact  (If Available)     " Width="325px"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="Agency1Name" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Phone" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Contact" runat="server" Height="25px" Width="314px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            <asp:Label ID="Label4" runat="server" Text="Agency Two Name        " Width="330px"></asp:Label>
                            <asp:Label ID="Label5" runat="server" Text="Agency Two Phone" Width="330px"></asp:Label>
                            <asp:Label ID="Label6" runat="server" Text="Agency Two Contact (If Available)       " Width="325px"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="Agency1Name0" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Phone0" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Contact0" runat="server" Height="25px" Width="314px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            <asp:Label ID="Label7" runat="server" Text="Agency Three Name        " Width="330px"></asp:Label>
                            <asp:Label ID="Label8" runat="server" Text="Agency Three Phone" Width="330px"></asp:Label>
                            <asp:Label ID="Label9" runat="server" Text="Agency Three Contact (If Available)      " Width="325px"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="Agency1Name1" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Phone1" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Contact1" runat="server" Height="25px" Width="314px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style53" colspan="4">Head of Household Name* </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;"; colspan="4"><strong style="font-size: 25px">SECTION THREE</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4"></td>
                        </tr>
                    <tr>
                        <td class="auto-style30" colspan="4" style="font-size: large"><strong style="font-size: large">College Housing Assistance Program Participant Obligations<br />
                            ABC Form (#) REM-CHP-05</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style84" colspan="4" style="font-size: large" valign="top">1. I understand that I am required to report online at www.<strong>ABC</strong>.net any changes in income and/or household composition within 10 days of the occurrence. &nbsp;<br />
                            <br />
                            2. I certify that the house or apartment will be my only residence. I will not sublease my assisted residence and will not allow anyone to live in my unit that is not on the lease. &nbsp;<br />
                            <br />
                            3. I must allow <strong>XXXX</strong>XX Housing Authority (ABC ) to perform Housing Quality Standard (HQS) inspections with reasonable notice. Federal regulations state I am responsible for all &nbsp;damages caused by my family and guests. Unit abuse, owing rent and unpaid utilities may result in termination of housing assistance. &nbsp;<br />
                            <br />
                            4. I understand I must receive approval from <strong>ABC</strong> before allowing anyone to move into my unit.I must also receive permission from <strong>ABC</strong> before I move. I must notify <strong>ABC</strong> if I will be away from my unit for more than 30 days. I must make all requests in writing. &nbsp;<br />
                            <br />
                            5. I understand that I must notify <strong>ABC</strong> in writing if a person moves out of my unit within 10 days of the occurrence. I may be required to provide proof of where the person is now living. &nbsp;<br />
                            <br />
                            6. I understand it is my family obligation to cooperate in supplying all information needed to determine my eligibility, level of benefits, or verify my true circumstances. I understand I must provide social security cards, birth certificates or other required documents for household members. Cooperation includes attending pre-scheduled meetings, completing and signing all needed forms. &nbsp;<br />
                            <br />
                            7. I understand I may not make additional payments of any kind to the landlord that are not included in the lease and approved by <strong>ABC</strong> and to do so is considered fraud. &nbsp;<br />
                            <br />
                            8. I understand I must comply with all provisions of my lease and not commit any serious or repeated violations of the lease. I must pay my family share of the rent and utilities. &nbsp;<br />
                            <br />
                            9. I understand that my mailing address is for the sole use of authorized household members and may not be used by any other persons.
                            <br />
                            <br />
                            10. Household members cannot commit fraud, bribery or any other corrupt or criminal act in connection with any federal housing program, including receiving another housing subsidy for my unit or any other unit under any federal, state or local housing assistance program. The household may not own any deed, title or claim to the unit. I understand I may not rent from any person related to any member of my household. &nbsp;<br />
                            <br />
                            11. Household members my not engage in any drug-related criminal activity, alcohol abuse or violent criminal activity, including threatening, abusive or violent behavior toward ABC personnel or other criminal activity that threatens the health, safety, or right to peaceful enjoyment of other residents. &nbsp;<br />
                            <br />
                            12. I understand that knowingly supplying false, incomplete, or inaccurate information is punishable under Federal or State criminal law. I will also be required to repay assistance overpaid on my behalf and may be terminated from the program. I certify that all the information I provide to ABC is true and accurate. &nbsp;<br />
                            <br />
                            13. I acknowledge that I have received, red, and understand the RHIIP EIV Guide that was included in the information that was given to me. Additionally, by signing below, each of my household members over the age of 18 acknowledges that they have read and understand the RHIIP EIV Guide. &nbsp;<br />
                            <br />
                            14. I will be seeking housing within the <strong>ABC</strong> Housing Authority jurisdiction. Details on the boundaries of this jurisdiction are available from <strong>ABC</strong> upon request. &nbsp;<br />
                            <br />
                            15. I will remain enrolled in credit bearing classes at <strong>ABC</strong> Community College. &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style86" colspan="4" style="font-size: large" valign="top"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="top">16. I pledge full cooperation with the <strong>XYZ</strong> Resource Navigator assigned to assist me in fulfillment of program related conditions. This includes but is not limited to: &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large">
                            <blockquote>
                            a. Regular meetings with the Navigator;<br />
                            b. Working with the Navigator to develop an employment plan prior to completion of <strong>XYZ</strong> program. This includes but is not limited to working with the Career Center for resume and job application assistance.
                            <br />
                            c. Setting short and long termgoals;
                            <br />
                            d. Regularly discussing progress and challenges; and
                            <br />
                            e. Following up on recommendations made by the Navigator. 
                            </blockquote>
                            &nbsp;17. I agree that I will participate in a Financial Literacy workshop before the end of my second quarter of enrollment in this program. The College Housing Assistance Program staff member will identify the workshop particulars. &nbsp;<br />
                            <br />
                            18. I agree to allow <strong>ABC</strong> and <strong>XYZ</strong> Community College to share individually identifiable information about myself and my family. This will include the following: &nbsp;a. School data - test scores, attendance, etc. between the college and <strong>ABC</strong> so that <strong>ABC</strong> can determine if the project is helping to improve student achievement. b. Share information on student success in education and economic progress so that ABC and XYZ can determine how to best support my needs as a participant. &nbsp;<br />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style89" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style88" colspan="4" style="font-size: large">19. I understand that if I do not maintain <strong>ABC</strong> and <strong>XYZ</strong> eligibility for this program, I will receive notification of termination and the housing assistance will end 30 days after the notification...</td>
                        </tr>
                    <tr>
                        <td class="auto-style90" colspan="4" style="font-size: large">
                            <ul>
                                <li>a. A hardship may be requested to grant a one (1) month extension to the housing assistance that would otherwise end because of any of the following reasons:<blockquote>
                                    <span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">i. The term limit of three (3) years;<span>&nbsp;</span></span><br style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;" />
                                    <span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">ii. the participant’s graduation from<span>&nbsp;</span></span><strong style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">XYZ</strong><span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">; 
                                    or<span>&nbsp;</span></span><br style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;" />
                                    <span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">iii. the end of the participant’s<span>&nbsp;</span></span><strong style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">XYZ</strong><span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span>&nbsp;</span>enrollment.</span></blockquote>
                                </li>
                            </ul>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style87" colspan="4" style="font-size: large">20. I agree to complete an exit questionnaire to assist the program with improvements. &nbsp;<br />
                            <br />
                            21. I understand that the College Housing Assistance Program is limited to 3 years of enrollment at <strong>XYZ</strong> Community College and requires that I maintain both <strong>XYZ</strong> and <strong>ABC</strong> eligibility throughout. Further, these program benefits are not transferrable to another institution. &nbsp;<br />
                            <br />
                            22. I understand that rental deposits and utility payments, unless utilities are a part of the rent, are not covered under the College Housing Assistance Program. &nbsp;<br />
                            <br />
                            23. I understand that <strong>ABC</strong> and <strong>XYZ</strong>’s ability to provide this assistance depends on the continued availability of government funding and regulatory authority to allow for it. If that funding or authority ends or diminishes, then my assistance may end as well. </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">StudentID:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="SID" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="6" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="9"></asp:TextBox>
                        </td>
                        <td class="auto-style46">&nbsp;</td>
                        <td class="auto-style91">
                            &nbsp;</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large">
                            <strI have read and I understand the above Participant Obligations. I understand that failure to comply with them may result in denial of admission, an obligation to repay assistance overpaid on my behalf, and/or termination from the ABC College Housing Assistance Program.
                            </strong>
                            <strong style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">I have read and I understand the above Participant Obligations. I understand that failure to comply with them may result in denial of admission, an obligation to repay assistance overpaid on my behalf, and/or termination from the ABC College Housing Assistance Program.<span>&nbsp;</span></strong><br />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;"; colspan="4"><strong style="font-size: 25px">SECTION FOUR</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style59" colspan="4" style="font-size: large" valign="bottom"><strong>MTW Income Statementment<br />
                            ABC Form REM-LSNG-101</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style61" colspan="4" style="font-size: large" valign="bottom">Do not leave any blank spaces on this form. If it does not apply, write N/A. </td>
                        </tr>
                    <tr>
                        <td class="auto-style60" colspan="4" style="font-size:"large"; valign="bottom">Head of Household (HoH) Name* </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">StudentID:*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="SID0" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="6" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="9"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Address:*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="Address1" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="8"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Email:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City4" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">ZipCode:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="EPhone3" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">City:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">State:</td>
                        <td class="auto-style91">
                            <asp:DropDownList ID="State0" runat="server" BackColor="#EAF4FF" Height="27px" OnSelectedIndexChanged="DropDownList1_SelectedIndexChanged" Width="344px" Font-Size="Large" TabIndex="11">
                                <asp:ListItem>Select State (Optional)</asp:ListItem>
                                <asp:ListItem>CA</asp:ListItem>
                                <asp:ListItem>OR</asp:ListItem>
                                <asp:ListItem>NV</asp:ListItem>
                                <asp:ListItem>NM</asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                            </asp:DropDownList>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Cell Phone:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City1" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46" style="font-size: large">Home Ph:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="EPhone0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Email:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City2" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Emerg Ph:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="EPhone1" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style60" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style62" colspan="4" style="border: thin solid #000000; font-size: large; background-color: #E8FFE8;" valign="bottom"><strong style="font-size: 18px">ADULT FAMILY MEMBERS</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="middle"></td>
                        </tr>
                    <tr>
                        <td class="auto-style59" colspan="4" style="font-size: large" valign="middle"><strong>All persons 18 and older must be listed INCLUDING YOURSELF<br />
                            List Head of Household first.<br />
                            STUDENTS: For any full time students 18 years or older, please provide proof of full-time status.</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style81" colspan="4" style="font-size: large" valign="middle"><strong>Rel to HoH = The Adult&#39;s Relation to the Head of Household</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName3" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName2" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:*</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:*&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName4" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName3" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:*&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:*&nbsp;&nbsp; Month:
                            <asp:TextBox ID="Month1" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day2" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year2" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style50" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Second Adult&nbsp; (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName5" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName4" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName5" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:&nbsp; &nbsp;Month:
                            <asp:TextBox ID="Month2" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day3" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year3" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Third Adult (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName6" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName8" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName7" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:&nbsp; &nbsp;Month:
                            <asp:TextBox ID="Month3" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day4" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year4" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Fourth Adult (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName9" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName8" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName10" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName9" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:&nbsp; &nbsp;Month:
                            <asp:TextBox ID="Month4" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day5" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year5" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style62" colspan="4" style="border: thin solid #000000; font-size: large; background-color: #E8FFE8;" valign="bottom"><strong style="font-size: 18px">CHILD FAMILY MEMBERS</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style50" colspan="4" style="font-size: large" valign="bottom"><strong>List all children under 18 years of age who currently reside in your household permanently</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style82" colspan="4" style="font-size: large"><strong>Rel to HoH = The Child&#39;s Relation to the Head of Household</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName11" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName10" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender0" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last5" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month5" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day6" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year6" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName12" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName11" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Second Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName13" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName12" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender1" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode1" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month6" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day7" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year7" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName14" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style78"><span class="auto-style66">Absent Parent</span></td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName13" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Third Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName15" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName14" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender2" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode2" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month7" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day8" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year8" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName16" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName15" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Fourth Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName17" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName16" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender3" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last8" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode3" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month8" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day9" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year9" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName18" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName17" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Fifth Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName21" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName20" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender5" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last10" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode5" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month10" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day11" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year11" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName22" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName21" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Sixth Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName23" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName22" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender6" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last11" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month11" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day12" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year12" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName24" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName23" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Seventh Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName25" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName24" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender7" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last12" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month12" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day13" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year13" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style75" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName26" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName25" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style62" colspan="4" style="border: thin solid #000000; font-size: large; background-color: #E8FFE8;" valign="bottom"><strong style="font-size: 18px">INCOME: QUESTIONS / SOURCES / AMOUNTS / SIGNATURES</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">Do you currently owe money to any Housing Authority?</td>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">Do you (or any in household) have a criminal record to declare?</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes9" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No9" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57"></td>
                        <td class="auto-style59" valign="bottom">
                            <strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; HOUSEHOLD INCOME SOURCES</strong></td>
                        <td class="auto-style41"></td>
                        <td class="auto-style91">
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style70" colspan="2">
                            <ul>
                                <li>Employment</li>
                                <li>Self-Employment</li>
                                <li>Unemployment</li>
                                <li>Pensions</li>
                                <li>TANF / GAU / DSHS</li>
                                <li>L &amp; I
                            </li>
                                <li>Annuity<br /></li>
                            </ul>
                        </td>
                        <td class="auto-style69" colspan="2" valign="top">
                            <ul>
                                <li>Alimony</li>
                                <li>Interest</li>
                                <li>SSI / SSA / SSD</li>
                                <li>VA</li>
                                <li>Child Support</li>
                                <li>Gift</li>
                                <li>Financial Aid / Grants<br /></li>
                            </ul>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" valign="top">Please list all income for all members of your household including yourself</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label10" runat="server" Text="Family Member Name*                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label11" runat="server" Text="Income Source*" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label12" runat="server" Text="Monthly Amount*" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label13" runat="server" Text="If Employed, List Employer*" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName27" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName28" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName29" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName30" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label14" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label15" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label16" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label17" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName31" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName32" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName33" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName34" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label18" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label19" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label20" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label21" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName35" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName36" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName37" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName38" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label22" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label23" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label24" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label25" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName39" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName40" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName41" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName42" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label26" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label27" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label28" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label29" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName43" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName44" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName45" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName46" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do you currently pay for childcare?* &nbsp;&nbsp;&nbsp;<asp:RadioButton ID="No11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                            &nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                            (Please provide proof)&nbsp;&nbsp; &nbsp;&nbsp; </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do you have a checking and/or savings account?* &nbsp;&nbsp;&nbsp;&nbsp;<asp:RadioButton ID="No12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do you currently pay child support through a state or local agency?* &nbsp;&nbsp;&nbsp;<asp:RadioButton ID="No13" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="Yes13" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                            (Please provide proof)&nbsp;&nbsp; &nbsp; &nbsp; </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Does anyone outside of your household pay any of your bills or provide/loan you money on a regular basis?*&nbsp;&nbsp;
                            <asp:RadioButton ID="No14" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="Yes14" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" valign="bottom">For persons age 62 and over, or persons with a disability.....</td>
                        </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" valign="top">.....Do you currently pay over $2,500 annually for prescriptions/medical bills/office visits?&nbsp;&nbsp; <asp:RadioButton ID="No15" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="Yes15" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                            (Please provide proof)&nbsp;&nbsp; &nbsp; &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" valign="(Please provide proof)">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" style="border: thin solid #000000; background-color: #E8FFE8"><strong>I certify that to the best of my knowledge all answers to above questions are true and correct.</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="bottom">Head Of Household Signature* - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN6" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True" OnTextChanged="HH_LN1_TextChanged"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN7" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN8" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN8" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN9" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN9" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN10" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN10" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN11" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN11" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">&nbsp;</td>
                        <td class="auto-style41">
                            &nbsp;</td>
                        <td class="auto-style46">&nbsp;</td>
                        <td class="auto-style91">
                            &nbsp;</td>
                    </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" style="background-color: #FFFFCC; border: thin solid #000000"><strong>WARNING: Title 18, Section 1001 of the United States Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of agency of the United States.</strong></td>
                        </tr>
                    </table>
</div>
</form>
</body>       
</html>

Open in new window

Avatar of David S.
David S.
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Is a responsive layout desired, so that it is usable on smartphones and tablets in addition to desktops and laptops?

Questions have been raised about whether it really is a good idea to use such dense layouts on the web, where we're constrained by having to fit things onto as few sides of pieces of paper as possible.

Also, I recommend adding some progressive JS to hide some of those fields until they are needed.
Avatar of Enflow

ASKER

@David S.

Not looking for estimates from EEers... interested in what EEers might think is a fair costing range for this type of work... since my area of work is desktop software for many years and i am not certain of the degree of difficulty on this and of cost... so did not want to go in blind to Guru.com... etc to get blindsided bids...

No responsive design on this... only for PC desktops so I will have media detection code to accept or warn applicants...

only question here is costing... thanks... CJ...
We can't discuss pricing, however, we can give time estimates (if someone here felt so inclined). Pricing varies based on factors including skill-level and cost of living where the developer lives anyway.

Did your client request limited platform support with a warning for those who attempt to use an unsupported platform?
Shouldn't be too bad for some of the guys at https://www.freelancer.com/

 I am certain you will find some takers. As for the page at http://www.enflow.com/CC/P1/P3.aspx. You will find folks that will do it for $35.00-$65.00 per hour. I think that with custom jquery validation for each form field you are looking at 4'ish hours, for the single page found at the link. Without any validation 0.5-1 hours.

Sam
Avatar of Enflow

ASKER

I have used Guru.com and had good results for most work... but I have not yet had the chance to use Freelancer... Do you have an opinion about either or both Sam ?

CJ
Avatar of Enflow

ASKER

@HillTop...

Oh I missed this from you... ""I think that with custom jquery validation for each form field you are looking at 4'ish hours, for the single page found at the link. Without any validation 0.5-1 hours.""

No... I can do the validation no prob... It is the conversion of the TABLE layout to DIV layout that i am looking to understand degree of difficulty leading to cost evaluation...  Convert the table tags (tr, td, spans... everything) to DIV layout and have it look equal to the TABLE layout i posted...

>>>>>>    http://www.enflow.com/CC/P1/P3.aspx

Sorry i missed that.... I will do the Validation and Code behind... TABLE Layout to DIV Layout is the question... thanks... CJ
Avatar of Enflow

ASKER

@David S.

"""Did your client request limited platform support with a warning for those who attempt to use an unsupported platform?
Is this your solution?"""


Yes... My Client is/will not allow(ing) other media besides full screen PC to fill out critical financial and legal gov docs... so media other than PC screen is not in the my contract which was lengthy... CJ
ASKER CERTIFIED SOLUTION
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Julian Hansen
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Hi Enflow,

What are the timelines you have to fix this? I mean is it something that you need like yesterday? or you are comfortable if it takes 5 to 7 days (more or less)

Regards,
Chinmay.
Avatar of Enflow

ASKER

@Julian

It would be only laid out for PC desktop screen only -- no resp mobile beyond that (no smart phones, tablets, etc)

The converted to DIV Layout would need to be planned to be equal -- to look exactly like -- the table layout shown on link.
http://www.enflow.com/CC/P1/P3.aspx

thanks... CJ
There are many ways of approaching this. Your table layout makes use of many classes to set width and height.

 I still would put this at least a half day job rather than an hour or two.
Avatar of Enflow

ASKER

@Julian...

Yes... but my Classes/CSS/Styles are inefficient... they could be better done in CSS then Visual Studio auto produced...

Okay let's be generous... let's call it 2/3's of a day... 6 Hours... what would be the costing range for that... ?
Nah, use https://getbootstrap.com/. To make your tables responsive use the example below. Its a 0.5 hour job. No reason at all to convert to all div.

https://getbootstrap.com/docs/4.0/content/tables/
<div class="table-responsive">
  <table class="table auto-style33" id="tablename">
    
  </table>
  <table class="table auto-style30" id="tablename1">
    
  </table>
</div>

<style>
@media(max-width: 14cm) 
//resize your TD's etc.. here on screens less than 14cm

.auto-style73,
.auto-style74,
.etc
      {
        width: 100%;      
    }

.someof,
.yourtextboxes,
.etc
      {
        width: 50%;      
    }
}

</style>

Open in new window

@hilltop - the point was to eradicate the use of tables for layout inline with current html coding standards.
Bootstrap tables are one of the most used elements on the web today. Here is your page fully responsive. 5 minute job. Everything is built on the bootstrap these days. We all know html browsers will support tables for at least the next 30 years, or more likely forever. In any case don't give up on tables without a fight :).

<html xmlns="http://www.w3.org/1999/xhtml" lang="en-us">
<head>
    <title>CC Housing Assistance Application: Part One - Page 1</title>
    <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
    <meta http-equiv="Content-Language" content="en" />
    <meta name="robots" content="noindex, nofollow" />
    <link rel="StyleSheet" href="/authority.css" media="all" />
<link rel="stylesheet" href="https://stackpath.bootstrapcdn.com/bootstrap/4.3.1/css/bootstrap.min.css" integrity="sha384-ggOyR0iXCbMQv3Xipma34MD+dH/1fQ784/j6cY/iJTQUOhcWr7x9JvoRxT2MZw1T" crossorigin="anonymous">
<script src="https://code.jquery.com/jquery-3.3.1.slim.min.js" integrity="sha384-q8i/X+965DzO0rT7abK41JStQIAqVgRVzpbzo5smXKp4YfRvH+8abtTE1Pi6jizo" crossorigin="anonymous"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/popper.js/1.14.7/umd/popper.min.js" integrity="sha384-UO2eT0CpHqdSJQ6hJty5KVphtPhzWj9WO1clHTMGa3JDZwrnQq4sF86dIHNDz0W1" crossorigin="anonymous"></script>
<script src="https://stackpath.bootstrapcdn.com/bootstrap/4.3.1/js/bootstrap.min.js" integrity="sha384-JjSmVgyd0p3pXB1rRibZUAYoIIy6OrQ6VrjIEaFf/nJGzIxFDsf4x0xIM+B07jRM" crossorigin="anonymous"></script>


    <style type="text/css">
        .auto-style1 {
            margin-bottom: 10px;
            height: 1179px;
        }
        .auto-style2 {
            height: 55px;
            width: 100%;
        }
        .auto-style11 {
            height: 50px;
            width: 100%;
        }
        .auto-style12 {
            height: 19px;
            width: 100%;
        }
        .auto-style18 {
            height: 20px;
            width: 100%;
        }
        .auto-style24 {
            height: 38px;
            width: 100%;
        }
        .auto-style25 {
            width: 100%;
        }
        .auto-style26 {
            height: 19px;
            width: 100%;
        }
        .auto-style27 {
            height: 32px;
            width: 100%;
        }
        .auto-style28 {
            height: 8px;
            width: 100%;
        }
        .auto-style29 {
            height: 19px;
            width: 100%;
            text-decoration: underline;
        }
        .auto-style30 {
            width: 100%;
            height: 33px;
            text-align: center;
        }
        .auto-style32 {
            width: 100%;
            height: 92px;
            text-align: center;
        }
        .auto-style33 {
            width: 100%;
            height: 79px;
            text-align: center;
        }
        .auto-style34 {
            height: 10px;
            width: 100%;
        }
        .auto-style35 {
            height: 74px;
            width: 100%;
        }
        .auto-style37 {
            width: 100%;
            height: 33px;
            text-align: left;
        }
        .auto-style41 {
            height: 32px;
            font-size: large;
        }
        .auto-style45 {
            text-decoration: underline;
            height: 32px;
        }
        .auto-style46 {
            height: 32px;
            font-size: large;
            width: 93px;
        }
        .auto-style50 {
            height: 10px;
            width: 100%;
            text-align: center;
        }
        .auto-style51 {
            text-decoration: underline;
        }
        .auto-style52 {
            height: 8px;
            width: 100%;
            text-align: center;
            font-size: x-large;
        }
        .auto-style53 {
            height: 32px;
            font-size: large;
            text-decoration: underline;
        }
        .auto-style54 {
            height: 66px;
            font-size: large;
            width: 100px;
        }
        .auto-style55 {
            width: 100%;
            height: 66px;
            text-align: left;
        }
        .auto-style57 {
            height: 32px;
            font-size: large;
            width: 100px;
        }
        .auto-style58 {
            height: 55px;
            font-size: large;
        }
        .auto-style59 {
            height: 32px;
            font-size: large;
            text-align: center;
        }
        .auto-style60 {
            height: 32px;
            font-size: large;
            text-align: left;
        }

        .auto-style61 {
            height: 32px;
            font-size: large;
            text-align: left;
            text-decoration: underline;
        }

        .auto-style62 {
            height: 20px;
            width: 100%;
            text-align: center;
        }
        .auto-style63 {
            height: 54px;
            font-size: large;
            text-align: center;
        }
        .auto-style64 {
            height: 10px;
            width: 100%;
            text-decoration: underline;
        }

        .auto-style65 {
            height: 32px;
            font-size: medium;
            width: 100px;
        }
        .auto-style66 {
            font-size: medium;
        }
        .auto-style69 {
            height: 35px;
            font-size: medium;
            text-align: left;
        }
        .auto-style70 {
            height: 35px;
            width: 100%;
        }

        .auto-style72 {
            font-size: large;
        }
        .auto-style73 {
            height: 10px;
            width: 100%;
            font-size: large;
        }

        .auto-style75 {
            height: 32px;
            font-size: medium;
        }

        .auto-style78 {
            height: 32px;
            font-size: small;
            width: 93px;
        }
        .auto-style80 {
            height: 32px;
            font-size: medium;
            width: 93px;
        }
        .auto-style81 {
            height: 55px;
            width: 100%;
            text-align: center;
        }
        .auto-style82 {
            height: 55px;
            font-size: large;
            text-align: center;
            text-decoration: underline;
        }

        .auto-style84 {
            width: 100%;
            height: 255px;
            text-align: left;
        }
        .auto-style86 {
            width: 100%;
            height: 7px;
            text-align: left;
        }
        .auto-style87 {
            height: 126px;
            width: 100%;
        }
        .auto-style88 {
            height: 15px;
            width: 100%;
        }
        .auto-style89 {
            height: 7px;
            width: 100%;
        }

        .auto-style90 {
            height: 147px;
            width: 100%;
        }

        .auto-style91 {
            height: 32px;
            font-size: large;
            width: 394px;
        }

 .auto-style92 {
            width: 1075px;
margin: auto; 
border:10px solid #003366; 
background-color: #FFFFFF;"
        }


@media(max-width: 14cm) {

.main,
.main1,
.auto-style1,
        .auto-style2,
        .auto-style11,
        .auto-style12,
        .auto-style18,
        .auto-style24,
        .auto-style25,
        .auto-style26,
        .auto-style27,
        .auto-style28,
        .auto-style29,
        .auto-style30,
        .auto-style32,
        .auto-style33,
        .auto-style34,
        .auto-style35,
        .auto-style37,
        .auto-style41,
        .auto-style45,
        .auto-style46,
        .auto-style50,
        .auto-style51,
        .auto-style52,
        .auto-style53,
        .auto-style54,
        .auto-style55,
        .auto-style57,
        .auto-style58,
        .auto-style59,
        .auto-style60,
        .auto-style61,
        .auto-style62,
        .auto-style63,
        .auto-style64,
        .auto-style65,
        .auto-style66,
        .auto-style69,
        .auto-style70,
        .auto-style72,
        .auto-style73,
        .auto-style75,
        .auto-style78,
        .auto-style80,
        .auto-style81,
        .auto-style82,
        .auto-style84,
        .auto-style86,
        .auto-style87,
        .auto-style88,
        .auto-style89,
        .auto-style90,
        .auto-style91,
        .auto-style82,
         .auto-style84,
        .auto-style86,
        .auto-style87,
        .auto-style88,
        .auto-style89,
        .auto-style90,
        .auto-style91,
 .auto-style92
      {
        width: 100%;      
    }
}
    </style>
</head>


<body bgcolor="#F2F2F2">
    <form id="frmPartOne" runat="server">
        <div id="main" class=''auto-style92 table-responsive" >
                <table id="main1" align="center" class="auto-style1 table" >
                    <tr>
                        <td class="auto-style32" style="font-size: x-large; width: 50%;" colspan="2" >
                            Logo 1</td>
                        <td class="auto-style32" style="font-size: x-large;" colspan="2" >
                            Logo 2</td>



                   </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;" colspan="4"><strong style="font-size: 25px">SECTION ONE</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style33" style="font-size: large" colspan="4"><strong>XYZ HOUSING APPLICATION CHECKLIST<br />
                            READ IT ALL THEN FILL OUT THIS FORM COMPLETELY</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style27" style="font-size: x-large" colspan="4">We Will Be Accepting Applications from AAA to BBB</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style12" style="font-size: large" colspan="4">If student is&nbsp; <strong>ALMOST</strong>&nbsp; Homeless</td>
                    </tr>
                    <tr>
                        <td class="auto-style12" style="font-size: large" colspan="4">&nbsp;&nbsp;&nbsp;&nbsp; o Completed <strong>XYZ</strong> Application &amp; Signatures on all required lines by adults listed on application</td>
                    </tr>
                    <tr>
                        <td class="auto-style25" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style26" style="font-size: large" colspan="4">If student &nbsp;<strong>IS</strong> &nbsp;Homeless, schedule intake appointment with Marybeth at <strong>XYZ</strong> <strong>ABC</strong> Housing Assistance</td>
                    </tr>
                    <tr>
                        <td class="auto-style18" style="font-size: large" colspan="4">&nbsp;&nbsp;&nbsp;&nbsp; o Completed <strong>XYZ</strong> &amp; <strong>ABC</strong> Application &amp; Signatures on all required lines by adults listed on application</td>
                    </tr>
                    <tr>
                        <td class="auto-style28" colspan="4">
                            </td>
                    </tr>
                    <tr>
                        <td class="auto-style18" style="font-size: large" colspan="4"><span class="auto-style51">Identification Verification</span><br />
&nbsp; Copies of the following documents are needed at time of application submission to <strong>XYZ</strong>:</td>
                    </tr>
                    <tr>
                        <td class="auto-style11" colspan="4">
                            <ul style="font-size: large;">
                                <li>Photo ID for all adults listed on application</li>
                                <li>Social Security cards for all the adults listed on the application</li>
                                <li>Alien Registration / Permanent Resident(copies of BOTH sides of cards)</li>
                            </ul>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style29" style="font-size: large" colspan="4">Financial Verification</td>
                    </tr>
                    <tr>
                        <td class="auto-style18" style="font-size: large" colspan="4">&nbsp;&nbsp; Copies of the following documents are needed at time of application submission to <strong>XYZ</strong>:</td>
                    </tr>
                    <tr>
                        <td class="auto-style11" colspan="4">
                            <ul style="font-size: large;">
                                <li>Financial Aid award letter or Financial Aid award summary print out from CTC Link</li>
                                <li>If no Financial Aid, you will need to describe funding source</li>
                                <li>Print out of tuition &amp; fees due for application quarter from student account</li>
                            </ul>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style29" style="font-size: large" colspan="4">Income Verification</td>
                    </tr>
                    <tr>
                        <td class="auto-style24" style="font-size: large" colspan="4">Please provide the last 3 months proof of income. If information is provided within the application about income, documentation must be provided for processing. (Examples below)</td>
                    </tr>
                    <tr>
                        <td class="auto-style2" colspan="4">
                            <ul style="font-size: large;">
                                <li>Employment pay stubs</li>
                                <li>Unemployment pay stubs</li>
                                <li>Social Security award letter</li>
                                <li>Child Support printout</li>
                                <li>TANF award letter</li>
                                <li>Pension/Retirement award letter</li>
                                <li>VA award letter</li>
                                <li>Self-Employment (last filed income tax)</li>
                                <li>Other</li>
                            </ul>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style24" style="font-size: x-large; color: #FF0000;"; colspan="4"><strong>NOTE</strong>...
                            <br />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style35" style="font-size: large"; colspan="4">Includes <strong>ABC &amp; XYZ</strong> Applications.<br />
                            There are 4 sections to read and fill out.<br />
                            Time is about 20-40 minutes to complete this.<br />                          
                            Fields with a ASTERISK symbol * are REQUIRED.<br />
                            <strong>If you don&#39;t have the info for a required field, put in N/A.</strong><br />
                            You must complete all pages of this form in one go... in one sitting.<br />
                            Your data will <strong>NOT</strong> be saved until you click “<strong>SUBMIT</strong>” at the end of form.<br />
                            <br />                        
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;"; colspan="4"><strong style="font-size: 25px">SECTION TWO</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style28" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="font-size: large" colspan="4"><strong>College Housing Assistance Program Application<br />
                            ABC Form (#) REM-CHP-01Z</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style37" style="font-size: large" colspan="4">You must be an enrolled <strong>XYZ</strong> student registered for or attending classes to participate in this program. Please complete this application and attach other requested materials before submitting to the <strong>XYZ</strong> <strong>ABC</strong> <strong>123</strong>, Counseling and Advising Office (Bldg. 7). Submission of this application does not guarantee an award; please continue your search for housing. Inaccurate or misleading statements may be grounds for disqualifying the application. <br />
                            <br />
                            <strong>If you are invited to participate in the program, you will be required to complete additional forms. These forms must be completed for review, prior to receiving any housing assistance.</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style30" style="font-size: large; text-align: left;" colspan="4"><span class="auto-style45">Applicant Information (Head of Household)</span>&nbsp;</td>
                    </tr>
                    <tr>
                        <td class="auto-style46">First Name:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender" runat="server" Text="Gender:*"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last4" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">StudentID:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="6" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="9"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Ethnicity:</td>
                        <td class="auto-style91">
                            <asp:DropDownList ID="Race" runat="server" BackColor="#EAF4FF" Height="28px" OnSelectedIndexChanged="DropDownList1_SelectedIndexChanged" Width="342px" Font-Size="Large" TabIndex="7">
                                <asp:ListItem>Select Race (Optional)</asp:ListItem>
                                <asp:ListItem>One</asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                            </asp:DropDownList>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Address:*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="Address" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="8"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Addr2:</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="Address0" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Address0_TextChanged" TabIndex="9" ToolTip="Add Info Here Only If You Have Additional Address Info"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">City:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">State:</td>
                        <td class="auto-style91">
                            <asp:DropDownList ID="State" runat="server" BackColor="#EAF4FF" Height="27px" OnSelectedIndexChanged="DropDownList1_SelectedIndexChanged" Width="342px" Font-Size="Large" TabIndex="11">
                                <asp:ListItem>Select State (Optional)</asp:ListItem>
                                <asp:ListItem>CA</asp:ListItem>
                                <asp:ListItem>OR</asp:ListItem>
                                <asp:ListItem>NV</asp:ListItem>
                                <asp:ListItem>NM</asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                            </asp:DropDownList>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">ZipCode:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:*</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp;&nbsp; Year:
                            <asp:TextBox ID="Year" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">xxx eMail:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="TEmail" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="16"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Your email*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="PEmail" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="17" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Phone:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="RPhone" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style41" colspan="2">May we leave messages at this number ?*&nbsp;
                            <asp:RadioButton ID="Yes" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Emerg Ph:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="EPhone" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style41" colspan="2">May we leave messages at this number ?&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes0" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgEP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No0" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgEP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Studies*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="StudyProg" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Address0_TextChanged" TabIndex="9"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4"></td>
                    </tr>
                    <tr>
                        <td class="auto-style50" style="border: thin solid #000000; font-size: x-large; background-color: #E8FFE8;"; colspan="4"><strong style="font-size: 18px">BASIC ELIGIBILITY QUESTIONS</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4">
                            </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do You Currently Owe Money To Any Housing Authority?*&nbsp;
                            <asp:RadioButton ID="Yes1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="OweMoney" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="OweMoney" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">Are you enrolled in credit bearing classes at <strong>XXXXXX</strong> Community College?*&nbsp;
                            <asp:RadioButton ID="Yes2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="Enrolled" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="Enrolled" TabIndex="18" Text="No" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">Do you still need to complete a FAFSA?*&nbsp;
                            <asp:RadioButton ID="Yes3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4"><strong>NOTE **</strong> Assistance filling out the FAFSA is available. Please ask Michelle Allen at <a href="XYZ.org">XYZ.ORG</a> for more information.</td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">Have you had difficulties feeding yourself or your family within the last 2-3 months?*&nbsp; <asp:RadioButton ID="Yes4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="No4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style52" colspan="4"><strong>~&nbsp; ~&nbsp; ~</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style35" style="font-size: large" colspan="4"><span class="auto-style51">Definition of homeless: A household that is: </span>
                            <br />
                            <br />
                            1) In an emergency shelter or in a transitional housing facility; or...<br />
                            2) Is a client of a case-management program serving the homeless<br />
                            <br />
                            <span class="auto-style51">Definition of at serious risk of homelessness: A household that is experiencing any of the following:</span><br />
                            <br />
                            1) Unable to meet basic housing expenses such as rent, mortgage, or utilities that will result in the loss of permanent housing; 
                            <br />
                            2) Residing in a motel/hotel due to loss of permanent housing and lacks the resources to remain; 
                            <br />
                            3) Has lost permanent housing and is living temporarily with a friend or family member and cannot be placed on the lease; 
                            <br />
                            4) Eviction notices that will result in loss of permanent housing; 5) Pending unlawful detainer notices that will result in loss; 
                            <br />
                            6) Recent history of serious housing instability; 
                            <br />
                            7) Is a victim of domestic violence; or 
                            <br />
                            8) Is facing discharge from a public institution (e.g. incarceration, hospital etc.) without a housing discharge plan.</td>
                    </tr>
                    <tr>
                        <td class="auto-style53" style="font-size: large" colspan="4">Reason for homelessness or risk of homelessness (Check All That Apply)...</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4">
                            <asp:CheckBox ID="Eviction" runat="server" Text="Eviction" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="DomViolence" runat="server" Text="Domestic Violence" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="NewTCC" runat="server" Text="New To ABC" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="SubAbuse" runat="server" Text="Substance Abuse" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" style="font-size: large" colspan="4">
                            <asp:CheckBox ID="FamCrisis" runat="server" Text="Family Crisis" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<asp:CheckBox ID="MedIssues" runat="server" Text="Medical Issues" />
                        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:CheckBox ID="LostIncome" runat="server" Text="Loss Of Income" OnCheckedChanged="Eviction9_CheckedChanged" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<asp:CheckBox ID="NaturalDisaster" runat="server" Text="Natural Disaster" OnCheckedChanged="Eviction10_CheckedChanged" />
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:CheckBox ID="Natural" runat="server" Text="Other" OnCheckedChanged="Eviction10_CheckedChanged" />
                            ...&nbsp; (If You Check Other Describe that in Textbox below... (Note 200 MAX characters allowed)</td>
                    </tr>
                    <tr>
                        <td class="auto-style54" style="font-size: medium">Describe Other</td>
                        <td class="auto-style55" colspan="3">
                            <asp:TextBox ID="MoreOther" runat="server" Height="60px" Width="854px" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="9" TextMode="MultiLine" onKeyUp="javascript:Count(this,250);" onChange="javascript:Count(this,250);"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style58" style="font-size: large" colspan="4">
                            Please explain in further detail how your circumstances fit into the above <strong>homeless</strong> definitions and what caused you to leave your last permanent residence in the large description textbox below** --- (Note 970 MAX characters allowed)</td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">
                            <asp:TextBox ID="MoreDetail" runat="server" Height="200px" Width="966px" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Address0_TextChanged" TabIndex="9" MaxLength="600" TextMode="MultiLine" onKeyUp="javascript:Count(this,950);" onChange="javascript:Count(this,950);"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style28" style="font-size: large" colspan="4">
                            </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" style="font-size: large" colspan="4">
                            <strong>If you are identifying that you are homeless</strong>, you will need to provide information about which <strong>Agencies</strong> you are currently working with to resolve your homelessness.
                            Without this information, you will be identified as almost homeless.</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            <asp:Label ID="Label1" runat="server" Text="Agency One Name        " Width="330px"></asp:Label>
                            <asp:Label ID="Label2" runat="server" Text="Agency One Phone" Width="330px"></asp:Label>
                            <asp:Label ID="Label3" runat="server" Text="Agency One Contact  (If Available)     " Width="325px"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="Agency1Name" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Phone" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Contact" runat="server" Height="25px" Width="314px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            <asp:Label ID="Label4" runat="server" Text="Agency Two Name        " Width="330px"></asp:Label>
                            <asp:Label ID="Label5" runat="server" Text="Agency Two Phone" Width="330px"></asp:Label>
                            <asp:Label ID="Label6" runat="server" Text="Agency Two Contact (If Available)       " Width="325px"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="Agency1Name0" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Phone0" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Contact0" runat="server" Height="25px" Width="314px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            <asp:Label ID="Label7" runat="server" Text="Agency Three Name        " Width="330px"></asp:Label>
                            <asp:Label ID="Label8" runat="server" Text="Agency Three Phone" Width="330px"></asp:Label>
                            <asp:Label ID="Label9" runat="server" Text="Agency Three Contact (If Available)      " Width="325px"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="Agency1Name1" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Phone1" runat="server" Height="25px" Width="320px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                            <asp:TextBox ID="Agency1Contact1" runat="server" Height="25px" Width="314px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="50"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style53" colspan="4">Head of Household Name* </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;"; colspan="4"><strong style="font-size: 25px">SECTION THREE</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4"></td>
                        </tr>
                    <tr>
                        <td class="auto-style30" colspan="4" style="font-size: large"><strong style="font-size: large">College Housing Assistance Program Participant Obligations<br />
                            ABC Form (#) REM-CHP-05</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style84" colspan="4" style="font-size: large" valign="top">1. I understand that I am required to report online at www.<strong>ABC</strong>.net any changes in income and/or household composition within 10 days of the occurrence. &nbsp;<br />
                            <br />
                            2. I certify that the house or apartment will be my only residence. I will not sublease my assisted residence and will not allow anyone to live in my unit that is not on the lease. &nbsp;<br />
                            <br />
                            3. I must allow <strong>XXXX</strong>XX Housing Authority (ABC ) to perform Housing Quality Standard (HQS) inspections with reasonable notice. Federal regulations state I am responsible for all &nbsp;damages caused by my family and guests. Unit abuse, owing rent and unpaid utilities may result in termination of housing assistance. &nbsp;<br />
                            <br />
                            4. I understand I must receive approval from <strong>ABC</strong> before allowing anyone to move into my unit.I must also receive permission from <strong>ABC</strong> before I move. I must notify <strong>ABC</strong> if I will be away from my unit for more than 30 days. I must make all requests in writing. &nbsp;<br />
                            <br />
                            5. I understand that I must notify <strong>ABC</strong> in writing if a person moves out of my unit within 10 days of the occurrence. I may be required to provide proof of where the person is now living. &nbsp;<br />
                            <br />
                            6. I understand it is my family obligation to cooperate in supplying all information needed to determine my eligibility, level of benefits, or verify my true circumstances. I understand I must provide social security cards, birth certificates or other required documents for household members. Cooperation includes attending pre-scheduled meetings, completing and signing all needed forms. &nbsp;<br />
                            <br />
                            7. I understand I may not make additional payments of any kind to the landlord that are not included in the lease and approved by <strong>ABC</strong> and to do so is considered fraud. &nbsp;<br />
                            <br />
                            8. I understand I must comply with all provisions of my lease and not commit any serious or repeated violations of the lease. I must pay my family share of the rent and utilities. &nbsp;<br />
                            <br />
                            9. I understand that my mailing address is for the sole use of authorized household members and may not be used by any other persons.
                            <br />
                            <br />
                            10. Household members cannot commit fraud, bribery or any other corrupt or criminal act in connection with any federal housing program, including receiving another housing subsidy for my unit or any other unit under any federal, state or local housing assistance program. The household may not own any deed, title or claim to the unit. I understand I may not rent from any person related to any member of my household. &nbsp;<br />
                            <br />
                            11. Household members my not engage in any drug-related criminal activity, alcohol abuse or violent criminal activity, including threatening, abusive or violent behavior toward ABC personnel or other criminal activity that threatens the health, safety, or right to peaceful enjoyment of other residents. &nbsp;<br />
                            <br />
                            12. I understand that knowingly supplying false, incomplete, or inaccurate information is punishable under Federal or State criminal law. I will also be required to repay assistance overpaid on my behalf and may be terminated from the program. I certify that all the information I provide to ABC is true and accurate. &nbsp;<br />
                            <br />
                            13. I acknowledge that I have received, red, and understand the RHIIP EIV Guide that was included in the information that was given to me. Additionally, by signing below, each of my household members over the age of 18 acknowledges that they have read and understand the RHIIP EIV Guide. &nbsp;<br />
                            <br />
                            14. I will be seeking housing within the <strong>ABC</strong> Housing Authority jurisdiction. Details on the boundaries of this jurisdiction are available from <strong>ABC</strong> upon request. &nbsp;<br />
                            <br />
                            15. I will remain enrolled in credit bearing classes at <strong>ABC</strong> Community College. &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style86" colspan="4" style="font-size: large" valign="top"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="top">16. I pledge full cooperation with the <strong>XYZ</strong> Resource Navigator assigned to assist me in fulfillment of program related conditions. This includes but is not limited to: &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large">
                            <blockquote>
                            a. Regular meetings with the Navigator;<br />
                            b. Working with the Navigator to develop an employment plan prior to completion of <strong>XYZ</strong> program. This includes but is not limited to working with the Career Center for resume and job application assistance.
                            <br />
                            c. Setting short and long termgoals;
                            <br />
                            d. Regularly discussing progress and challenges; and
                            <br />
                            e. Following up on recommendations made by the Navigator. 
                            </blockquote>
                            &nbsp;17. I agree that I will participate in a Financial Literacy workshop before the end of my second quarter of enrollment in this program. The College Housing Assistance Program staff member will identify the workshop particulars. &nbsp;<br />
                            <br />
                            18. I agree to allow <strong>ABC</strong> and <strong>XYZ</strong> Community College to share individually identifiable information about myself and my family. This will include the following: &nbsp;a. School data - test scores, attendance, etc. between the college and <strong>ABC</strong> so that <strong>ABC</strong> can determine if the project is helping to improve student achievement. b. Share information on student success in education and economic progress so that ABC and XYZ can determine how to best support my needs as a participant. &nbsp;<br />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style89" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style88" colspan="4" style="font-size: large">19. I understand that if I do not maintain <strong>ABC</strong> and <strong>XYZ</strong> eligibility for this program, I will receive notification of termination and the housing assistance will end 30 days after the notification...</td>
                        </tr>
                    <tr>
                        <td class="auto-style90" colspan="4" style="font-size: large">
                            <ul>
                                <li>a. A hardship may be requested to grant a one (1) month extension to the housing assistance that would otherwise end because of any of the following reasons:<blockquote>
                                    <span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">i. The term limit of three (3) years;<span>&nbsp;</span></span><br style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;" />
                                    <span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">ii. the participant’s graduation from<span>&nbsp;</span></span><strong style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">XYZ</strong><span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">; 
                                    or<span>&nbsp;</span></span><br style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;" />
                                    <span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">iii. the end of the participant’s<span>&nbsp;</span></span><strong style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">XYZ</strong><span style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span>&nbsp;</span>enrollment.</span></blockquote>
                                </li>
                            </ul>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style87" colspan="4" style="font-size: large">20. I agree to complete an exit questionnaire to assist the program with improvements. &nbsp;<br />
                            <br />
                            21. I understand that the College Housing Assistance Program is limited to 3 years of enrollment at <strong>XYZ</strong> Community College and requires that I maintain both <strong>XYZ</strong> and <strong>ABC</strong> eligibility throughout. Further, these program benefits are not transferrable to another institution. &nbsp;<br />
                            <br />
                            22. I understand that rental deposits and utility payments, unless utilities are a part of the rent, are not covered under the College Housing Assistance Program. &nbsp;<br />
                            <br />
                            23. I understand that <strong>ABC</strong> and <strong>XYZ</strong>’s ability to provide this assistance depends on the continued availability of government funding and regulatory authority to allow for it. If that funding or authority ends or diminishes, then my assistance may end as well. </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">StudentID:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="SID" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="6" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="9"></asp:TextBox>
                        </td>
                        <td class="auto-style46">&nbsp;</td>
                        <td class="auto-style91">
                            &nbsp;</td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large">
                            <strI have read and I understand the above Participant Obligations. I understand that failure to comply with them may result in denial of admission, an obligation to repay assistance overpaid on my behalf, and/or termination from the ABC College Housing Assistance Program.
                            </strong>
                            <strong style="color: rgb(0, 0, 0); font-family: &quot;Times New Roman&quot;; font-size: large; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-style: initial; text-decoration-color: initial;">I have read and I understand the above Participant Obligations. I understand that failure to comply with them may result in denial of admission, an obligation to repay assistance overpaid on my behalf, and/or termination from the ABC College Housing Assistance Program.<span>&nbsp;</span></strong><br />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style30" style="border: thin solid #000000; font-size: x-large; background-color: #FFFFCC;"; colspan="4"><strong style="font-size: 25px">SECTION FOUR</strong></td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style59" colspan="4" style="font-size: large" valign="bottom"><strong>MTW Income Statementment<br />
                            ABC Form REM-LSNG-101</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style61" colspan="4" style="font-size: large" valign="bottom">Do not leave any blank spaces on this form. If it does not apply, write N/A. </td>
                        </tr>
                    <tr>
                        <td class="auto-style60" colspan="4" style="font-size:"large"; valign="bottom">Head of Household (HoH) Name* </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">StudentID:*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="SID0" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="6" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" MaxLength="9"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Address:*</td>
                        <td class="auto-style41" colspan="3">
                            <asp:TextBox ID="Address1" runat="server" Height="25px" Width="835px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" TabIndex="8"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style46">Email:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City4" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">ZipCode:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="EPhone3" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">City:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">State:</td>
                        <td class="auto-style91">
                            <asp:DropDownList ID="State0" runat="server" BackColor="#EAF4FF" Height="27px" OnSelectedIndexChanged="DropDownList1_SelectedIndexChanged" Width="344px" Font-Size="Large" TabIndex="11">
                                <asp:ListItem>Select State (Optional)</asp:ListItem>
                                <asp:ListItem>CA</asp:ListItem>
                                <asp:ListItem>OR</asp:ListItem>
                                <asp:ListItem>NV</asp:ListItem>
                                <asp:ListItem>NM</asp:ListItem>
                                <asp:ListItem></asp:ListItem>
                            </asp:DropDownList>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Cell Phone:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City1" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46" style="font-size: large">Home Ph:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="EPhone0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style46">Email:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="City2" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="10" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Emerg Ph:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="EPhone1" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style60" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style62" colspan="4" style="border: thin solid #000000; font-size: large; background-color: #E8FFE8;" valign="bottom"><strong style="font-size: 18px">ADULT FAMILY MEMBERS</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="middle"></td>
                        </tr>
                    <tr>
                        <td class="auto-style59" colspan="4" style="font-size: large" valign="middle"><strong>All persons 18 and older must be listed INCLUDING YOURSELF<br />
                            List Head of Household first.<br />
                            STUDENTS: For any full time students 18 years or older, please provide proof of full-time status.</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style81" colspan="4" style="font-size: large" valign="middle"><strong>Rel to HoH = The Adult&#39;s Relation to the Head of Household</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName3" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName2" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:*</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:*&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName4" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:*</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName3" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:*&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate1" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:*&nbsp;&nbsp; Month:
                            <asp:TextBox ID="Month1" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day2" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year2" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style50" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Second Adult&nbsp; (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName5" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName4" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName5" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate2" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:&nbsp; &nbsp;Month:
                            <asp:TextBox ID="Month2" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day3" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year3" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Third Adult (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName6" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName8" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName7" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate3" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:&nbsp; &nbsp;Month:
                            <asp:TextBox ID="Month3" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day4" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year4" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Fourth Adult (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName9" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName8" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">Gender:</td>
                        <td class="auto-style41">
                            <asp:RadioButton ID="Male4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                        </td>
                        <td class="auto-style41" colspan="2">Full Time Student:&nbsp; &nbsp;
                            <asp:RadioButton ID="Yes8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName10" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last 4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName9" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="middle">Marital Status:&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Single4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Single" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="Married4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Married / Domestic Partnership" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;
                            <asp:RadioButton ID="Widow4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Widowed" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Divorce4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Divorced" />
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Separate4" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Seperated" />
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style63" colspan="4" style="border-width: thin; border-bottom-style: solid; border-color: #000000">Birthdate:&nbsp; &nbsp;Month:
                            <asp:TextBox ID="Month4" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day5" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year5" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style62" colspan="4" style="border: thin solid #000000; font-size: large; background-color: #E8FFE8;" valign="bottom"><strong style="font-size: 18px">CHILD FAMILY MEMBERS</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style50" colspan="4" style="font-size: large" valign="bottom"><strong>List all children under 18 years of age who currently reside in your household permanently</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style82" colspan="4" style="font-size: large"><strong>Rel to HoH = The Child&#39;s Relation to the Head of Household</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName11" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName10" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender0" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other5" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last5" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode0" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month5" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day6" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year6" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName12" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName11" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Second Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName13" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName12" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender1" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other6" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode1" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month6" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day7" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year7" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName14" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style78"><span class="auto-style66">Absent Parent</span></td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName13" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Third Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName15" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName14" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender2" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other7" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode2" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month7" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day8" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year8" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName16" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName15" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Fourth Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName17" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName16" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender3" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other8" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last8" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode3" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month8" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day9" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year9" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName18" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName17" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Fifth Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName21" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName20" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender5" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last10" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode5" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month10" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day11" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year11" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName22" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName21" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Sixth Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName23" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName22" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender6" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last11" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month11" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day12" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year12" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName24" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName23" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style64" colspan="4" style="font-size: large" valign="bottom"><em>Add Seventh Child (Optional)</em></td>
                        </tr>
                    <tr>
                        <td class="auto-style57">First Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName25" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Last Name:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName24" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style41" colspan="2">
                            <asp:Label ID="Gender7" runat="server" Text="Gender:"></asp:Label>
                            &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Male12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="2" Text="Male" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Female12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="3" Text="Female" />
                            &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Other12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged" GroupName="Gender" TabIndex="4" Text="Other" />
                            </td>
                        <td class="auto-style46">Last4 SS:</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="Last12" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" TabIndex="5" Font-Size="Large" MaxLength="4" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style65">School Name:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="ZipCode7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" TabIndex="12" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Birthdate:</td>
                        <td class="auto-style91">
                            &nbsp;Month:
                            <asp:TextBox ID="Month12" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" style="text-align: center" Height="25px" MaxLength="2" TabIndex="13" Font-Size="Large"></asp:TextBox>
                        &nbsp;&nbsp; Day:
                            <asp:TextBox ID="Day13" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="25px" Height="25px" MaxLength="2" style="text-align: center" TabIndex="14" Font-Size="Large" ToolTip="Two Numbers Max"></asp:TextBox>
                        &nbsp; Year:
                            <asp:TextBox ID="Year13" runat="server" BackColor="#EAF4FF" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" OnTextChanged="Month_TextChanged" Width="55px" Height="25px" style="text-align: center" MaxLength="4" TabIndex="15" Font-Size="Large" ToolTip="4 Numbers Minimum - 4 Numbers Maximum"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style75" valign="middle">Rel to HoH:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="FirstName26" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px" ToolTip="What is this child's relationship to Head of Household"></asp:TextBox>
                        </td>
                        <td class="auto-style80">Absent Parent</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="LastName25" runat="server" Height="25px" Width="342px" Wrap="False" BackColor="#EAF4FF" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large; border-bottom-style: solid; border-bottom-width: thin; border-bottom-color: #000000;" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style62" colspan="4" style="border: thin solid #000000; font-size: large; background-color: #E8FFE8;" valign="bottom"><strong style="font-size: 18px">INCOME: QUESTIONS / SOURCES / AMOUNTS / SIGNATURES</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">Do you currently owe money to any Housing Authority?</td>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">Do you (or any in household) have a criminal record to declare?</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes9" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No9" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        <td class="auto-style34" colspan="2" style="font-size: large" valign="bottom">&nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            <asp:RadioButton ID="No10" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style57"></td>
                        <td class="auto-style59" valign="bottom">
                            <strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; HOUSEHOLD INCOME SOURCES</strong></td>
                        <td class="auto-style41"></td>
                        <td class="auto-style91">
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style70" colspan="2">
                            <ul>
                                <li>Employment</li>
                                <li>Self-Employment</li>
                                <li>Unemployment</li>
                                <li>Pensions</li>
                                <li>TANF / GAU / DSHS</li>
                                <li>L &amp; I
                            </li>
                                <li>Annuity<br /></li>
                            </ul>
                        </td>
                        <td class="auto-style69" colspan="2" valign="top">
                            <ul>
                                <li>Alimony</li>
                                <li>Interest</li>
                                <li>SSI / SSA / SSD</li>
                                <li>VA</li>
                                <li>Child Support</li>
                                <li>Gift</li>
                                <li>Financial Aid / Grants<br /></li>
                            </ul>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" valign="top">Please list all income for all members of your household including yourself</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label10" runat="server" Text="Family Member Name*                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label11" runat="server" Text="Income Source*" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label12" runat="server" Text="Monthly Amount*" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label13" runat="server" Text="If Employed, List Employer*" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName27" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName28" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName29" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName30" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label14" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label15" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label16" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label17" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName31" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName32" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName33" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName34" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label18" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label19" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label20" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label21" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName35" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName36" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName37" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName38" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label22" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label23" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label24" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label25" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName39" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName40" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName41" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName42" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            <asp:Label ID="Label26" runat="server" Text="Family Member Name                                            " CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label27" runat="server" Text="Income Source" CssClass="auto-style72" Width="245px"></asp:Label>
&nbsp;<asp:Label ID="Label28" runat="server" Text="Monthly Amount" CssClass="auto-style72" Width="235px"></asp:Label>
&nbsp;
                            <asp:Label ID="Label29" runat="server" Text="If Employed, List Employer" CssClass="auto-style72"></asp:Label>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">
                            <asp:TextBox ID="FirstName43" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName44" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName45" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        <asp:TextBox ID="FirstName46" runat="server" Height="25px" Width="240px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" valign="bottom">
                            &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do you currently pay for childcare?* &nbsp;&nbsp;&nbsp;<asp:RadioButton ID="No11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                            &nbsp;&nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes11" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                            (Please provide proof)&nbsp;&nbsp; &nbsp;&nbsp; </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do you have a checking and/or savings account?* &nbsp;&nbsp;&nbsp;&nbsp;<asp:RadioButton ID="No12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;&nbsp;
                            <asp:RadioButton ID="Yes12" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Do you currently pay child support through a state or local agency?* &nbsp;&nbsp;&nbsp;<asp:RadioButton ID="No13" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="Yes13" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                            (Please provide proof)&nbsp;&nbsp; &nbsp; &nbsp; </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4">Does anyone outside of your household pay any of your bills or provide/loan you money on a regular basis?*&nbsp;&nbsp;
                            <asp:RadioButton ID="No14" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="Yes14" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                        &nbsp;&nbsp;&nbsp; &nbsp;
                            </td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" valign="bottom">For persons age 62 and over, or persons with a disability.....</td>
                        </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" valign="top">.....Do you currently pay over $2,500 annually for prescriptions/medical bills/office visits?&nbsp;&nbsp; <asp:RadioButton ID="No15" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" TabIndex="18" Text="No" />
                        &nbsp;&nbsp;
                            <asp:RadioButton ID="Yes15" runat="server" OnCheckedChanged="RadioButton1_CheckedChanged1" GroupName="LeaveMsgRP" Text="Yes  " />
                            (Please provide proof)&nbsp;&nbsp; &nbsp; &nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" valign="(Please provide proof)">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" style="border: thin solid #000000; background-color: #E8FFE8"><strong>I certify that to the best of my knowledge all answers to above questions are true and correct.</strong></td>
                        </tr>
                    <tr>
                        <td class="auto-style41" colspan="4" style="font-size: large" valign="bottom">Head Of Household Signature* - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:*</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN6" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN6" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True" OnTextChanged="HH_LN1_TextChanged"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN7" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN7" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN8" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN8" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN9" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN9" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom"></td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member Signature - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN10" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN10" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style34" colspan="4">&nbsp;</td>
                        </tr>
                    <tr>
                        <td class="auto-style34" colspan="4" style="font-size: large" valign="bottom">Adult Family Member - Type In Your Signature</td>
                        </tr>
                    <tr>
                        <td class="auto-style57">Type Sign:</td>
                        <td class="auto-style41">
                            <asp:TextBox ID="HH_FN11" runat="server" Height="25px" Width="340px" Wrap="False" BackColor="#EAF4FF" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1px"></asp:TextBox>
                        </td>
                        <td class="auto-style46">Auto Date</td>
                        <td class="auto-style91">
                            <asp:TextBox ID="HH_LN11" runat="server" Height="25px" Width="335px" Wrap="False" BackColor="#F2F2F2" TabIndex="1" Font-Size="Large" BorderColor="Black" BorderStyle="Solid" BorderWidth="1pt" ReadOnly="True"></asp:TextBox>
                        </td>
                    </tr>
                    <tr>
                        <td class="auto-style57">&nbsp;</td>
                        <td class="auto-style41">
                            &nbsp;</td>
                        <td class="auto-style46">&nbsp;</td>
                        <td class="auto-style91">
                            &nbsp;</td>
                    </tr>
                    <tr>
                        <td class="auto-style73" colspan="4" style="background-color: #FFFFCC; border: thin solid #000000"><strong>WARNING: Title 18, Section 1001 of the United States Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of agency of the United States.</strong></td>
                        </tr>
                    </table>
</div>
</form>
</body>       
</html>

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Avatar of Enflow

ASKER

@Hilltop...

Thanks for the effort at showing how to stay with table layouts + responsive website -- by using bootstrap... always interesting to learn something new...

The issue is... I am integrating this with my client's site and their WHOLE site is DIV format... that is why i am pursuing the DIV conversion route... but bravo for showing how legacy table layout can be converted to acceptable responsive design in a very short period of time... that i will file away... fascinating...

I integrated your BootStrap code with my HTML body and uploaded it to this page... http://www.enflow.com/CC/P1/BS.aspx

needs a bit of tweaking of course like any code.

I am going to go at the DIV conversion myself and ask for help as i go... on EE or SOverflow or where ever

CAN I VOTE EVERYONE HERE HELPFUL ? -- Everyone has been helpful... DOES THAT HELP WITH POINTS ---  or suggestions on how to distribute points ?
There are only a couple of reasons why we see so many web developers these days, Bootstrap and charts.js. You can not find a template on template monster or the like that is not built almost entirely on bootstrap and chart.js. Its the latest and the greatest I suppose. Pretty sure Twiiter made Bootstrap.

Best of luck with your project.
Bootstrap tables are one of the most used elements on the web today.
Not for layout.
I too heard the tale of tables going away, but they are used literally everywhere.
Again, not for layout.

Bootstrap was designed as a responsive mobile first framework. The idea was to provide a means to scale a site to any device. No matter what aspects you use of Bootstrap you cannot make tables fully responsive - not where you allow for stacking of elements or variable columns - that just does not happen. So your statement that tables are literally everywhere for layout is simply not true.

99.9% of bootstrap implementations are going to be based on a div col-XX layout or a flex layout - never on a table layout. The only time tables are used is when the page is displaying tabular data.

I would strongly recommend that bootstrap tables NOT be used for this project - it is not within the scope of what was asked for and goes against every HTML standard for building solid responsive pages.
Of course you are right Julian. Its just one of those days.
Avatar of Enflow

ASKER

@Julian...

Thanks for your comments... and...

"""I would strongly recommend that bootstrap tables NOT be used for this project - it is not within the scope of what was asked for and goes against every HTML standard for building solid responsive pages."""

Yes... NOT going to use Bootstrap... I thought it was just an interesting read thought... I am going DIV conversion route...

Thanks... CJ
If you are doing this yourself a utility like https://divtable.com/converter/ may come in handy. That sample is missing the meta viewport stuff, and you would resize or hide your TD's and inputs when the screen was X size, but at the end of the day that existing layout can be made perfectly responsive pretty quickly. I know its out of scope though. Once again best of luck with your project, and thanks for the points.