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Password *
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First Name *
Last Name *
Cell Phone *
Username *
Email address *
Are you a Student or Agency?* —Select—
Student
Agency
Date of Birth *
jQuery(document).on('change', '#afreg_select_user_role', function() {
var val = this.value; var field_roles = new Array(); var is_dependable = 'on';
field_roles.push('um_student');
var match_val = field_roles.includes(val);
if (match_val == true && is_dependable == 'on') {
jQuery('#afreg_additionalshowhide_3710').show();
} else if (match_val == false && is_dependable == 'on') {
jQuery('#afreg_additionalshowhide_3710').hide(); } else {
}
}); jQuery(document).on('ready' , function() {
var val = jQuery('#afreg_select_user_role').val(); var field_roles = new Array(); var is_dependable = 'on';
});
field_roles.push('um_agency');
jQuery('#afreg_additionalshowhide_3554').show();
jQuery('#afreg_additionalshowhide_3554').hide(); } else {
Agency Name *
jQuery('#afreg_additionalshowhide_3541').show();
jQuery('#afreg_additionalshowhide_3541').hide(); } else {
Agency Email *
jQuery('#afreg_additionalshowhide_3553').show();
jQuery('#afreg_additionalshowhide_3553').hide(); } else {
Agency Phone *
jQuery('#afreg_additionalshowhide_3552').show();
jQuery('#afreg_additionalshowhide_3552').hide(); } else {
Agency Point of Contact *
jQuery('#afreg_additionalshowhide_3551').show();
jQuery('#afreg_additionalshowhide_3551').hide(); } else {
City *
jQuery('#afreg_additionalshowhide_3706').show();
jQuery('#afreg_additionalshowhide_3706').hide(); } else {
State *
jQuery('#afreg_additionalshowhide_3707').show();
jQuery('#afreg_additionalshowhide_3707').hide(); } else {
Zipcode *
jQuery('#afreg_additionalshowhide_3708').show();
jQuery('#afreg_additionalshowhide_3708').hide(); } else {
Mailing Address Street *
jQuery('#afreg_additionalshowhide_3705').show();
jQuery('#afreg_additionalshowhide_3705').hide(); } else {
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