{"id":40,"date":"2025-02-24T20:40:22","date_gmt":"2025-02-25T01:40:22","guid":{"rendered":"https:\/\/sites.temple.edu\/butzscholarship\/?page_id=40"},"modified":"2026-05-08T19:41:05","modified_gmt":"2026-05-08T23:41:05","slug":"application","status":"publish","type":"page","link":"https:\/\/sites.temple.edu\/butzscholarship\/application\/","title":{"rendered":"Application"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Dr. Brian &#038; Susan Butz Endowed Scholarship Application &#8211; 2027<\/h2>\n                            <p class='gform_description'>Dr. Brian Butz was a highly respected and valued member of our department for many years prior to his retirement in 2012. As a continued expression of their commitment to ECE students, Dr. Butz and his wife have generously established a scholarship within the Department of Electrical and Computer Engineering to support students who reflect the values Dr. Butz championed throughout his career: technical excellence, mentorship, and dedication to the people around them.\r\n<br><br>\r\nThis scholarship is open to currently enrolled Temple University ECE sophomores and juniors who demonstrate financial need and a strong interest in software development, artificial intelligence systems, health education software, or closely related fields. Recipients will receive a $10,000 award to support studies focused on software development and AI research. Preference will be given to applicants who are actively engaged in an ECE faculty research laboratory and who demonstrate meaningful contributions to the ECE community \u2014 through leadership, mentorship, outreach, or service that strengthens the department and its students.\r\n<br><br>\r\nEligible students are encouraged to apply by submitting the form below no later than <b>April 15, 2027<\/b>.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_8'  action='\/butzscholarship\/wp-json\/wp\/v2\/pages\/40' data-formid='8' novalidate><input type=\"hidden\" name=\"gpuid_existing_value_29\" id=\"gpuid_existing_value_29\" value=\"452c9129cba7e7a6b7a4216b3037dd98\" \/>\n                        <div class='gform-body gform_body'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_8_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your Personal Information<\/h3><\/div><fieldset id=\"field_8_1\" class=\"gfield gfield--type-name gfield--input-type-name field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Name<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_8_1'>\n                            \n                            <span id='input_8_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_8_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_1.3' id='input_8_1_3' value=''   aria-required='false'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_8_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_8_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_1.6' id='input_8_1_6' value=''   aria-required='false'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_8_2\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Email Address<\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_8_2_container'>\n                                <span id='input_8_2_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_8_2' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                    <input class='' type='email' name='input_2' id='input_8_2' value=''     aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                <\/span>\n                                <span id='input_8_2_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_8_2_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                    <input class='' type='email' name='input_2_2' id='input_8_2_2' value=''     aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_8_21\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_8_21' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_8_21_1_container' >\n                                        <label for='input_8_21_1' id='input_8_21_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_21.1' id='input_8_21_1' value=''    aria-required='false'   autocomplete=\"address-line1\" \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_8_21_2_container' >\n                                        <label for='input_8_21_2' id='input_8_21_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_21.2' id='input_8_21_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_8_21_3_container' >\n                                    <label for='input_8_21_3' id='input_8_21_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_21.3' id='input_8_21_3' value=''    aria-required='false'   autocomplete=\"address-level2\" \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_8_21_4_container' >\n                                        <label for='input_8_21_4' id='input_8_21_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_21.4' id='input_8_21_4' value=''      aria-required='false'   autocomplete=\"address-level1\" \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_8_21_5_container' >\n                                    <label for='input_8_21_5' id='input_8_21_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_21.5' id='input_8_21_5' value=''    aria-required='false'   autocomplete=\"postal-code\" \/>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_8_21_6_container' >\n                                        <label for='input_8_21_6' id='input_8_21_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_21.6' id='input_8_21_6'   aria-required='false'   autocomplete=\"country-name\" ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_8_10\" class=\"gfield gfield--type-phone gfield--input-type-phone field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_10'>Your Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_8_10' type='tel' value='' class='medium'    aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_8_7\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Your information<\/h3><\/div><fieldset id=\"field_8_3\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_2col field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Technical area you&#039;re interested in<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_3'>\n\t\t\t<div class='gchoice gchoice_8_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='software development'  id='choice_8_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_0' id='label_8_3_0' class='gform-field-label gform-field-label--type-inline'>software development<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='AI Development Systems'  id='choice_8_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_1' id='label_8_3_1' class='gform-field-label gform-field-label--type-inline'>AI Development Systems<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_3_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Engineering'  id='choice_8_3_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_2' id='label_8_3_2' class='gform-field-label gform-field-label--type-inline'>Engineering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_3_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='IT\/Technical'  id='choice_8_3_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_3' id='label_8_3_3' class='gform-field-label gform-field-label--type-inline'>IT\/Technical<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_3_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='health education software'  id='choice_8_3_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_4' id='label_8_3_4' class='gform-field-label gform-field-label--type-inline'>health education software<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_3_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='gf_other_choice'  id='choice_8_3_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_3_5' id='label_8_3_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_8_3_other' class='gchoice_other_control' name='input_3_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_2col field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >When do you graduate<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_23'>\n\t\t\t<div class='gchoice gchoice_8_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='spring 2028'  id='choice_8_23_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_0' id='label_8_23_0' class='gform-field-label gform-field-label--type-inline'>spring 2028<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='fall 2028'  id='choice_8_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_1' id='label_8_23_1' class='gform-field-label gform-field-label--type-inline'>fall 2028<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='spring 2029'  id='choice_8_23_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_2' id='label_8_23_2' class='gform-field-label gform-field-label--type-inline'>spring 2029<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='fall 2029'  id='choice_8_23_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_3' id='label_8_23_3' class='gform-field-label gform-field-label--type-inline'>fall 2029<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='spring 2030'  id='choice_8_23_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_4' id='label_8_23_4' class='gform-field-label gform-field-label--type-inline'>spring 2030<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='fall 2030'  id='choice_8_23_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_5' id='label_8_23_5' class='gform-field-label gform-field-label--type-inline'>fall 2030<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_23_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='gf_other_choice'  id='choice_8_23_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_8_23_6' id='label_8_23_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_8_23_other' class='gchoice_other_control' name='input_23_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_5\" class=\"gfield gfield--type-list gfield--input-type-list field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Previous Employers<\/legend><div class='gfield_description' id='gfield_description_8_5'>Please list your previous employers, the dates you worked and the position you held<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Employer<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Dates<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Position<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Phone<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_5_cell1 gform-grid-col' data-label='Employer'><input aria-invalid='false'  aria-describedby=\"gfield_description_8_5\" aria-label='Employer, Row 1' data-aria-label-template='Employer, Row {0}' type='text' name='input_5[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_5_cell2 gform-grid-col' data-label='Dates'><input aria-invalid='false'  aria-describedby=\"gfield_description_8_5\" aria-label='Dates, Row 1' data-aria-label-template='Dates, Row {0}' type='text' name='input_5[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_5_cell3 gform-grid-col' data-label='Position'><input aria-invalid='false'  aria-describedby=\"gfield_description_8_5\" aria-label='Position, Row 1' data-aria-label-template='Position, Row {0}' type='text' name='input_5[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_5_cell4 gform-grid-col' data-label='Phone'><input aria-invalid='false'  aria-describedby=\"gfield_description_8_5\" aria-label='Phone, Row 1' data-aria-label-template='Phone, Row {0}' type='text' name='input_5[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 3)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 3)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_8_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">More About You<\/h3><\/div><div id=\"field_8_12\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_12'>Tell Us About Yourself (personal statement)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_8_12'>Please give us short description of yourself why you should be considered for this scholarship. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_8_12' class='textarea medium'  aria-describedby=\"gfield_description_8_12\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_25'>Tell Us About your experience in software and AI<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_8_25'>Please give us short description of yourself why you should be considered for this scholarship. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_8_25' class='textarea medium'  aria-describedby=\"gfield_description_8_25\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_26\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_26'>Tell Us About your long term plans (or after your graduation)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_8_26'>Please give us short description of yourself why you should be considered for this scholarship. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_26' id='input_8_26' class='textarea medium'  aria-describedby=\"gfield_description_8_26\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_13\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_13'>Upload Your Resume<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_8_13'>Upload your resume in .pdf, .doc or .docx format<\/div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_13' id='input_8_13' type='file' class='medium' aria-describedby=\"gfield_upload_rules_8_13 gfield_description_8_13\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_8_13'>Accepted file types: pdf, doc, docx, Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_8_13'><\/div> <\/div><\/div><div id=\"field_8_27\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_27'>Reference Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_8_27'>the email address of your reference so they can upload the recommendation.<\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_27' id='input_8_27' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_8_27\" \/>\n                        <\/div><\/div><div id=\"field_8_29\" class=\"gfield gfield--type-uid gfield--input-type-uid field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\"  ><label class='gfield_label gform-field-label' for='input_8_29'>Unique ID<\/label><div class='ginput_container ginput_container_hidden'><input name='input_29' id='input_8_29' type='hidden' value=''  \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_8' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit Application'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_8' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_8' id='gform_theme_8' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_8' id='gform_style_settings_8' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_8' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='8' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='t0T2XpojDzYU+Rli6a\/U5boGvKS+lY\/WAJ4DBdrwssBXkTBOQnYCOuqMEvqUdAlSWxEnbZQ1UwfWlaLyLFHcZJu6cfyJfSiBtrjO3zrot7OPyfc=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_8' value='WyJbXSIsIjBlNGFmZDI1OTZmMDZlM2ZmYWYxN2RiODAwNjg0M2VkIl0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_8' id='gform_target_page_number_8' value='0' \/>\n            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