"Family Name (Last Name)",
"icon" => "fas fa-users",
"name" => "familyname",
"maxlength" => 100
],
[
"label" => "Father's Name",
"icon" => "fas fa-male",
"name" => "fathername",
"maxlength" => 255
],
[
"label" => "Mother's Name",
"icon" => "fas fa-female",
"name" => "mothername",
"maxlength" => 255
],
[
"label" => "Street Address",
"icon" => "fas fa-home",
"name" => "streetaddress",
"maxlength" => 500
],
[
"label" => "City",
"icon" => "fas fa-city",
"name" => "city",
"maxlength" => 255,
"width" => 3
],
[
"label" => "State",
"icon" => "fas fa-flag",
"name" => "state",
"type" => "select",
"options" => [
'MT' => 'Montana',
'AL' => 'Alabama',
'AK' => 'Alaska',
'AZ' => 'Arizona',
'AR' => 'Arkansas',
'CA' => 'California',
'CO' => 'Colorado',
'CT' => 'Connecticut',
'DE' => 'Delaware',
'DC' => 'District of Columbia',
'FL' => 'Florida',
'GA' => 'Georgia',
'HI' => 'Hawaii',
'ID' => 'Idaho',
'IL' => 'Illinois',
'IN' => 'Indiana',
'IA' => 'Iowa',
'KS' => 'Kansas',
'KY' => 'Kentucky',
'LA' => 'Louisiana',
'ME' => 'Maine',
'MD' => 'Maryland',
'MA' => 'Massachusetts',
'MI' => 'Michigan',
'MN' => 'Minnesota',
'MS' => 'Mississippi',
'MO' => 'Missouri',
'MT' => 'Montana',
'NE' => 'Nebraska',
'NV' => 'Nevada',
'NH' => 'New Hampshire',
'NJ' => 'New Jersey',
'NM' => 'New Mexico',
'NY' => 'New York',
'NC' => 'North Carolina',
'ND' => 'North Dakota',
'OH' => 'Ohio',
'OK' => 'Oklahoma',
'OR' => 'Oregon',
'PA' => 'Pennsylvania',
'RI' => 'Rhode Island',
'SC' => 'South Carolina',
'SD' => 'South Dakota',
'TN' => 'Tennessee',
'TX' => 'Texas',
'UT' => 'Utah',
'VT' => 'Vermont',
'VA' => 'Virginia',
'WA' => 'Washington',
'WV' => 'West Virginia',
'WI' => 'Wisconsin',
'WY' => 'Wyoming'
],
"width" => 2
],
[
"label" => "ZIP/Postal Code",
"icon" => "fas fa-mail-bulk",
"name" => "zip",
"maxlength" => 10,
"width" => 3
],
[
"label" => "Phone Number",
"icon" => "fas fa-phone",
"name" => "phone",
"maxlength" => 20
],
[
"label" => "Email",
"icon" => "fas fa-at",
"name" => "email",
"maxlength" => 255,
"type" => "email",
],
[
"label" => "Newsletter Preference",
"icon" => "fas fa-newspaper",
"name" => "newsletter_method",
"type" => "select",
"options" => [
"1" => "Email ($25)",
"2" => "Paper ($35)",
"3" => "Email and Paper ($35)"
]
]
];
foreach ($textboxes as $item) {
?>
The membership fees (determined by your newsletter
preference) cover costs of the following:
phone; website; postage; distribution of newsletters and
directories; publication of materials; library; and other
HACHE related activities. Dues are reduced as of March 1st.
HACHE will not restrict membership based on inability to
pay. HACHE does not mandate curriculum choices or the
manner in which curriculum is administered. We do encourage
all members to follow and adhere to MT laws governing home
schooling.