Electronic Application

The following form is an in-depth application. Taking the time to fill it out fully and correctly can take several hours. Please read the following carefully before continuing:

Autosave: This form includes an autosave script to allow users to return to the form at anytime to finish it. This autosave function will only work on modern browsers (IE9+, FF3.5+, Safari, Chrome, Opera 11+). If your browser is not up-to-date, we suggest that you update it (links provided above) before beginning the form. The form will function properly on older browsers, but your information will not be saved and you may lose it.

Your autosave information will be cleared upon submission of the form.

Uploading Documents: If you leave the application page for any reason (navigate away from it, close the current window or the browser quits or crashes), you will have to redo the file upload information. Autosave will not retain the information telling the form where to find the documents on your computer. We apologize for this inconvenience.

Autofill: It is not recommended to use autofill capabilities with this form. It is best to type your information out fully for each field. If you do choose to use autofill, please make sure and "tab" to the next field after each autofill. Please watch for the "autosave" message at the top of your screen after each autofill and tab. If you use autofill on this form, some of your information may not autosave properly.

reCAPTCHA: At the end of the form, you will find a reCAPTCHA verification box. It is important that you input the information you see there EXACTLY as it appears. If you have difficulty reading the reCAPTCHA message, please hit the "refresh" button inside the reCAPTCHA box - not the "refresh" button on your browser.

reCAPTCHA errors: If you enter the reCAPTCHA and hit submit, you may see one of two errors.

The first is if you failed to fill out a required field in the form correctly. If this is the case, the error message will instruct you as to which field is incorrect or blank and give you a "back" button to return to the form. After correcting your form information, scroll to the bottom and "refresh" the reCAPTCHA with the button in the reCAPTCHA box before attempting to resubmit.

The second reCAPTCHA error you may encounter is if your have input the reCAPTCHA message incorrectly. Again, you will be instructed to "go back" (this time use the "back" button on your browser). It is again recommended to "refresh" the reCAPTCHA image with the button provided in the reCAPTCHA box before attempting to submit the form again.

If you encounter any reCAPTCHA errors other than the ones described here, please feel free to contact us.

Hardcopy for your records: Before hitting the "submit" button at the end of the form, please make sure and print a copy for your records.

Disclaimer: We have attempted to make this form as user-friendly as possible, but a form of this length has inherent difficulties when scripting for a wide variety of platforms and browsers. If you have any difficulties in using, saving, reloading or submitting this form, please feel free to contact us.