University of Alabama Birmingham

<style><!-- [et_pb_line_break_holder] -->label{<!-- [et_pb_line_break_holder] -->text-align:left;<!-- [et_pb_line_break_holder] -->font-size:14px;<!-- [et_pb_line_break_holder] -->margin-top:10px;<!-- [et_pb_line_break_holder] -->font-family:Arial;width:200px;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] -->input[type=text]{<!-- [et_pb_line_break_holder] -->font-size:16px;<!-- [et_pb_line_break_holder] -->padding:10px;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --></style><!-- [et_pb_line_break_holder] --> <META HTTP-EQUIV ='content-type' CONTENT='text/html;charset=UTF-8'><!-- [et_pb_line_break_holder] --> <form action='https://crm.zoho.com/crm/WebToLeadForm' name=WebToLeads3447630000001226035 method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatory()' accept-charset='UTF-8'><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. --><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='xnQsjsdp' value='ddfead0388e805ce78305e1e33c05c028fe5e64b40aba6e6b05088102d135983'/><!-- [et_pb_line_break_holder] --> <input type='hidden' name='zc_gad' id='zc_gad' value=''/><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='xmIwtLD' value='ddbbe5fc53a08fbf3e176b74da8c06c6f710304c1ff4a2875eed5ad51f71c2c6'/><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='actionType' value='TGVhZHM='/><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='returnURL' value='https://www.juniorgolfhub.com/college-prep-series-new/' /> <!-- [et_pb_line_break_holder] --><select style='display:none;' name='LEADCF21'><!-- [et_pb_line_break_holder] --> <option selected value='Junior Golf Hub'>Junior Golf Hub</option><!-- [et_pb_line_break_holder] --> </select> <!-- [et_pb_line_break_holder] --><select style='display:none; ' name='Lead Source'><!-- [et_pb_line_break_holder] --> <option selected value='JGH Web Form'>JGH Web Form</option><!-- [et_pb_line_break_holder] --> </select><!-- [et_pb_line_break_holder] --><input type='hidden' maxlength='255' name='LEADCF37' value='College Prep Series'></input><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. -->

<div><!-- [et_pb_line_break_holder] --><label>Parents First Name</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='255' name='LEADCF39' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Parents Last Name<label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='255' name='LEADCF41' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Parents Email</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='100' name='LEADCF40' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Phone</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='30' name='Phone' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Zip Code</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='30' name='Zip Code' /><!-- [et_pb_line_break_holder] --></div>

<div align="center"><!-- [et_pb_line_break_holder] --> <input class="et_pb_button et_pb_button_0 et_pb_module et_pb_bg_layout_light" style='padding:20px;width:150px;font-size:16px;color:black' type='submit' value='Submit' /><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <script><!-- [et_pb_line_break_holder] --> var mndFileds=new Array('First Name','Last Name','Email');<!-- [et_pb_line_break_holder] --> var fldLangVal=new Array('First Name','Last Name','Email');<!-- [et_pb_line_break_holder] --> var name='';<!-- [et_pb_line_break_holder] --> var email='';<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> function checkMandatory() {<!-- [et_pb_line_break_holder] --> for(i=0;i<mndFileds.length;i++) {<!-- [et_pb_line_break_holder] --> var fieldObj=document.forms['WebToLeads3447630000001226035'][mndFileds[i]];<!-- [et_pb_line_break_holder] --> if(fieldObj) {<!-- [et_pb_line_break_holder] --> if (((fieldObj.value).replace(/^s+|s+$/g, '')).length==0) {<!-- [et_pb_line_break_holder] --> if(fieldObj.type =='file')<!-- [et_pb_line_break_holder] --> { <!-- [et_pb_line_break_holder] --> alert('Please select a file to upload.'); <!-- [et_pb_line_break_holder] --> fieldObj.focus(); <!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } <!-- [et_pb_line_break_holder] --> alert(fldLangVal[i] +' cannot be empty.'); <!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } else if(fieldObj.nodeName=='SELECT') {<!-- [et_pb_line_break_holder] --> if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {<!-- [et_pb_line_break_holder] --> alert(fldLangVal[i] +' cannot be none.'); <!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else if(fieldObj.type =='checkbox'){<!-- [et_pb_line_break_holder] --> if(fieldObj.checked == false){<!-- [et_pb_line_break_holder] --> alert('Please accept '+fldLangVal[i]);<!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } <!-- [et_pb_line_break_holder] --> } <!-- [et_pb_line_break_holder] --> try {<!-- [et_pb_line_break_holder] --> if(fieldObj.name == 'Last Name') {<!-- [et_pb_line_break_holder] --> name = fieldObj.value;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } catch (e) {}<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --></script><!-- [et_pb_line_break_holder] --> </form><!-- [et_pb_line_break_holder] --></div>

<style><!-- [et_pb_line_break_holder] -->label{<!-- [et_pb_line_break_holder] -->text-align:left;<!-- [et_pb_line_break_holder] -->font-size:14px;<!-- [et_pb_line_break_holder] -->margin-top:10px;<!-- [et_pb_line_break_holder] -->font-family:Arial;width:200px;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] -->input[type=text]{<!-- [et_pb_line_break_holder] -->font-size:16px;<!-- [et_pb_line_break_holder] -->padding:10px;<!-- [et_pb_line_break_holder] -->}<!-- [et_pb_line_break_holder] --></style><!-- [et_pb_line_break_holder] --> <META HTTP-EQUIV ='content-type' CONTENT='text/html;charset=UTF-8'><!-- [et_pb_line_break_holder] --> <form action='https://crm.zoho.com/crm/WebToLeadForm' name=WebToLeads3447630000001226035 method='POST' onSubmit='javascript:document.charset="UTF-8"; return checkMandatory()' accept-charset='UTF-8'><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. --><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='xnQsjsdp' value='ddfead0388e805ce78305e1e33c05c028fe5e64b40aba6e6b05088102d135983'/><!-- [et_pb_line_break_holder] --> <input type='hidden' name='zc_gad' id='zc_gad' value=''/><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='xmIwtLD' value='ddbbe5fc53a08fbf3e176b74da8c06c6f710304c1ff4a2875eed5ad51f71c2c6'/><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='actionType' value='TGVhZHM='/><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <input type='text' style='display:none;' name='returnURL' value='https://www.juniorgolfhub.com/college-prep-series-new/' /> <!-- [et_pb_line_break_holder] --><select style='display:none;' name='LEADCF21'><!-- [et_pb_line_break_holder] --> <option selected value='Junior Golf Hub'>Junior Golf Hub</option><!-- [et_pb_line_break_holder] --> </select> <!-- [et_pb_line_break_holder] --><select style='display:none; ' name='Lead Source'><!-- [et_pb_line_break_holder] --> <option selected value='JGH Web Form'>JGH Web Form</option><!-- [et_pb_line_break_holder] --> </select><!-- [et_pb_line_break_holder] --><input type='hidden' maxlength='255' name='LEADCF37' value='College Prep Series'></input><!-- [et_pb_line_break_holder] --> <!-- Do not remove this code. -->

<div><!-- [et_pb_line_break_holder] --><label>Parents First Name</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='255' name='LEADCF39' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Parents Last Name<label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='255' name='LEADCF41' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Parents Email</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='100' name='LEADCF40' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Phone</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='30' name='Phone' /><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --><div><!-- [et_pb_line_break_holder] --><label>Zip Code</label><!-- [et_pb_line_break_holder] --><input type='text' style='width:100%;' maxlength='30' name='Zip Code' /><!-- [et_pb_line_break_holder] --></div>

<div align="center"><!-- [et_pb_line_break_holder] --> <input class="et_pb_button et_pb_button_0 et_pb_module et_pb_bg_layout_light" style='padding:20px;width:150px;font-size:16px;color:black' type='submit' value='Submit' /><!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> <script><!-- [et_pb_line_break_holder] --> var mndFileds=new Array('First Name','Last Name','Email');<!-- [et_pb_line_break_holder] --> var fldLangVal=new Array('First Name','Last Name','Email');<!-- [et_pb_line_break_holder] --> var name='';<!-- [et_pb_line_break_holder] --> var email='';<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> function checkMandatory() {<!-- [et_pb_line_break_holder] --> for(i=0;i<mndFileds.length;i++) {<!-- [et_pb_line_break_holder] --> var fieldObj=document.forms['WebToLeads3447630000001226035'][mndFileds[i]];<!-- [et_pb_line_break_holder] --> if(fieldObj) {<!-- [et_pb_line_break_holder] --> if (((fieldObj.value).replace(/^\s+|\s+$/g, '')).length==0) {<!-- [et_pb_line_break_holder] --> if(fieldObj.type =='file')<!-- [et_pb_line_break_holder] --> { <!-- [et_pb_line_break_holder] --> alert('Please select a file to upload.'); <!-- [et_pb_line_break_holder] --> fieldObj.focus(); <!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } <!-- [et_pb_line_break_holder] --> alert(fldLangVal[i] +' cannot be empty.'); <!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } else if(fieldObj.nodeName=='SELECT') {<!-- [et_pb_line_break_holder] --> if(fieldObj.options[fieldObj.selectedIndex].value=='-None-') {<!-- [et_pb_line_break_holder] --> alert(fldLangVal[i] +' cannot be none.'); <!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } else if(fieldObj.type =='checkbox'){<!-- [et_pb_line_break_holder] --> if(fieldObj.checked == false){<!-- [et_pb_line_break_holder] --> alert('Please accept '+fldLangVal[i]);<!-- [et_pb_line_break_holder] --> fieldObj.focus();<!-- [et_pb_line_break_holder] --> return false;<!-- [et_pb_line_break_holder] --> } <!-- [et_pb_line_break_holder] --> } <!-- [et_pb_line_break_holder] --> try {<!-- [et_pb_line_break_holder] --> if(fieldObj.name == 'Last Name') {<!-- [et_pb_line_break_holder] --> name = fieldObj.value;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } catch (e) {}<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> <!-- [et_pb_line_break_holder] --></script><!-- [et_pb_line_break_holder] --> </form><!-- [et_pb_line_break_holder] --></div>