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<label class=" required control-label cf_please_provide_your_school_name_1378793-label " for="helpdesk_ticket_cf_please_provide_your_school_name_1378793">Please provide your school name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_please_provide_your_school_name_1378793]" id="helpdesk_ticket_custom_field_cf_please_provide_your_school_name_1378793" /> </div>
<label class=" control-label cf_course_name_1378793-label " for="helpdesk_ticket_cf_course_name_1378793">Course Name</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_course_name_1378793]" id="helpdesk_ticket_custom_field_cf_course_name_1378793" /> </div>
<label class=" control-label cf_grade_level_1378793-label " for="helpdesk_ticket_cf_grade_level_1378793">Grade Level</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_grade_level_1378793]" id="helpdesk_ticket_custom_field_cf_grade_level_1378793" /> </div>
<label class=" required control-label cf_extension_request_is_for_1378793-label " for="helpdesk_ticket_cf_extension_request_is_for_1378793">Extension Request is for:</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_extension_request_is_for_1378793]" id="helpdesk_ticket_custom_field_cf_extension_request_is_for_1378793"><option value="">...</option> <option data-id="60000692036" value="All students from my school">All students from my school</option> <option data-id="60000692039" value="Individual student(s)">Individual student(s)</option> <option data-id="60000692038" value="Specific Course(s)">Specific Course(s)</option> <option data-id="60000692037" value="Specific Grade Level(s)">Specific Grade Level(s)</option></select> </div>
<label class=" required control-label cf_what_is_your_username_1378793-label " for="helpdesk_ticket_cf_what_is_your_username_1378793">What is your username?</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_what_is_your_username_1378793]" id="helpdesk_ticket_custom_field_cf_what_is_your_username_1378793" /> </div>
<label class=" control-label cf_device_type_1378793-label " for="helpdesk_ticket_cf_device_type_1378793">What type of device are you using?</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_device_type_1378793]" id="helpdesk_ticket_custom_field_cf_device_type_1378793"><option value="">...</option> <option data-id="60000692705" value="MAC OSX">MAC OSX</option> <option data-id="60000692706" value="Windows">Windows</option> <option data-id="60000692707" value="Chromebook">Chromebook</option></select> </div>
<label class=" control-label cf_browser_1378793-label " for="helpdesk_ticket_cf_browser_1378793">What browser are you using?</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_browser_1378793]" id="helpdesk_ticket_custom_field_cf_browser_1378793"><option value="">...</option> <option data-id="60000692708" value="Chrome">Chrome</option> <option data-id="60000692709" value="Firefox">Firefox</option> <option data-id="60000692710" value="Edge">Edge</option></select> </div>
<label class=" control-label cf_url_1378793-label " for="helpdesk_ticket_cf_url_1378793">Please provide the URL of where the error occurred:</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_url_1378793]" id="helpdesk_ticket_custom_field_cf_url_1378793" /> </div>
<label class=" required control-label cf_type_of_transcript_1378793-label " for="helpdesk_ticket_cf_type_of_transcript_1378793">Document Type</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_of_transcript_1378793]" id="helpdesk_ticket_custom_field_cf_type_of_transcript_1378793"><option value="">...</option> <option data-id="60000796604" value="Report Card">Report Card</option> <option data-id="60000738850" value="Official Transcript">Official Transcript</option> <option data-id="60000738851" value="Unofficial Transcript">Unofficial Transcript</option> <option data-id="60000773375" value="Inital/First Diploma">Inital/First Diploma</option> <option data-id="60000773376" value="Diploma Copy">Diploma Copy</option> <option data-id="60000773377" value="Apostille Request">Apostille Request</option> <option data-id="60000773378" value="Enrollment Verification">Enrollment Verification</option> <option data-id="60000779908" value="Final Grade Report">Final Grade Report</option></select> </div>
<label class=" required control-label cf_student_id_1378793-label " for="helpdesk_ticket_cf_student_id_1378793">Student ID</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_student_id_1378793]" id="helpdesk_ticket_custom_field_cf_student_id_1378793" /> </div>
<label class=" required control-label cf_first_name69429_1378793-label " for="helpdesk_ticket_cf_first_name69429_1378793">Student First Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_first_name69429_1378793]" id="helpdesk_ticket_custom_field_cf_first_name69429_1378793" /> </div>
<label class=" required control-label cf_last_name331666_1378793-label " for="helpdesk_ticket_cf_last_name331666_1378793">Student Last Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_last_name331666_1378793]" id="helpdesk_ticket_custom_field_cf_last_name331666_1378793" /> </div>
<label class=" required control-label cf_email_1378793-label " for="helpdesk_ticket_cf_email_1378793">Email</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_email_1378793]" id="helpdesk_ticket_custom_field_cf_email_1378793" /> </div>
<label class=" required control-label cf_date_of_birth_1378793-label " for="helpdesk_ticket_cf_date_of_birth_1378793">Date of Birth</label> <div class="controls support-date-field "> <input type="text" name="helpdesk_ticket[custom_field][cf_date_of_birth_1378793]" id="helpdesk_ticket_custom_field_cf_date_of_birth_1378793" class=" required date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="d M, yy" placeholder="" /> </div>
<label class=" required control-label cf_realtionship664234_1378793-label " for="helpdesk_ticket_cf_realtionship664234_1378793">Relationship</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_realtionship664234_1378793]" id="helpdesk_ticket_custom_field_cf_realtionship664234_1378793"><option value="">...</option> <option data-id="60000773969" value="Parent">Parent</option> <option data-id="60000773970" value="Guardian">Guardian</option> <option data-id="60000773971" value="Student">Student</option> <option data-id="60000773972" value="Other">Other</option></select> </div>
<label class=" required control-label cf_school26713_1378793-label " for="helpdesk_ticket_cf_school26713_1378793">School</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_school26713_1378793]" id="helpdesk_ticket_custom_field_cf_school26713_1378793" /> </div>
<label class=" required control-label cf_teachercounselor_1378793-label " for="helpdesk_ticket_cf_teachercounselor_1378793">Teacher/Counselor Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_teachercounselor_1378793]" id="helpdesk_ticket_custom_field_cf_teachercounselor_1378793" /> </div>
<label class=" control-label cf_deadline_1378793-label " for="helpdesk_ticket_cf_deadline_1378793">Needed By Date</label> <div class="controls support-date-field "> <input type="text" name="helpdesk_ticket[custom_field][cf_deadline_1378793]" id="helpdesk_ticket_custom_field_cf_deadline_1378793" class=" date section_field datepicker_popover" readonly="readonly" data-show-image="true" data-date-format="d M, yy" placeholder="" /> </div>
<label class=" control-label cf_email_or_common_app_1378793-label " for="helpdesk_ticket_cf_email_or_common_app_1378793">Email or Common App</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_email_or_common_app_1378793]" id="helpdesk_ticket_custom_field_cf_email_or_common_app_1378793"><option value="">...</option> <option data-id="60000792477" value="Email">Email</option> <option data-id="60000792478" value="Common App">Common App</option></select> </div>
<label class=" control-label cf_brand_1378793-label " for="helpdesk_ticket_cf_brand_1378793">Brand</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_brand_1378793]" id="helpdesk_ticket_custom_field_cf_brand_1378793"><option value="">...</option> <option data-id="60000803756" value="CV">CV</option> <option data-id="60000803757" value="CS">CS</option> <option data-id="60000803758" value="Franklin">Franklin</option> <option data-id="60000803759" value="PCDGC">PCDGC</option></select> </div>
<label class=" control-label cf_school842983_1378793-label " for="helpdesk_ticket_cf_school842983_1378793">School</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_school842983_1378793]" id="helpdesk_ticket_custom_field_cf_school842983_1378793" /> </div>
<label class=" control-label cf_date_1378793-label " for="helpdesk_ticket_cf_date_1378793">Date</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_date_1378793]" id="helpdesk_ticket_custom_field_cf_date_1378793" /> </div>
<label class=" control-label cf_time_1378793-label " for="helpdesk_ticket_cf_time_1378793">Time</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_time_1378793]" id="helpdesk_ticket_custom_field_cf_time_1378793" /> </div>
<label class=" control-label cf_who_will_attend_1378793-label " for="helpdesk_ticket_cf_who_will_attend_1378793">Who Will Attend</label> <div class="controls "> <textarea class=" paragraph section_field span12" rows="6" placeholder="" name="helpdesk_ticket[custom_field][cf_who_will_attend_1378793]" id="helpdesk_ticket_custom_field_cf_who_will_attend_1378793"> </textarea> </div>
<label class=" control-label cf_community_group_video_1378793-label " for="helpdesk_ticket_cf_community_group_video_1378793">Community Group Video</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_community_group_video_1378793]" id="helpdesk_ticket_custom_field_cf_community_group_video_1378793"><option value="">...</option> <option data-id="60000803760" value="Yes">Yes</option> <option data-id="60000803761" value="No">No</option></select> </div>
<label class=" control-label cf_crm_quote_number_1378793-label " for="helpdesk_ticket_cf_crm_quote_number_1378793">CRM Quote Number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_crm_quote_number_1378793]" id="helpdesk_ticket_custom_field_cf_crm_quote_number_1378793" /> </div>
Please enter as much information as you can, describing the issue. For Extension Requests please enter: student name(s), course(s), and/or grade level(s). Include attachment, as needed.
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