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<option value="Tajikistan"> Tajikistan </option> <option value="Tanzania"> Tanzania </option> <option value="Thailand"> Thailand </option> <option value="Timor-Leste"> Timor-Leste </option> <option value="Togo"> Togo </option> <option value="Tokelau"> Tokelau </option> <option value="Tonga"> Tonga </option> <option value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie </option> <option value="Trinidad and Tobago"> Trinidad and Tobago </option> <option value="Tristan da Cunha"> Tristan da Cunha </option> <option value="Tunisia"> Tunisia </option> <option value="Turkey"> Turkey </option> <option value="Turkmenistan"> Turkmenistan </option> <option value="Turks and Caicos Islands"> Turks and Caicos Islands </option> <option value="Tuvalu"> Tuvalu </option> <option value="Uganda"> Uganda </option> <option value="Ukraine"> Ukraine </option> <option value="United Arab Emirates"> United Arab Emirates </option> <option value="United Kingdom"> United Kingdom </option> <option value="Uruguay"> Uruguay </option> <option value="Uzbekistan"> Uzbekistan </option> <option value="Vanuatu"> Vanuatu </option> <option value="Vatican City"> Vatican City </option> <option value="Venezuela"> Venezuela </option> <option value="Vietnam"> Vietnam </option> <option value="British Virgin Islands"> British Virgin Islands </option> <option value="Isle of Man"> Isle of Man </option> <option value="US Virgin Islands"> US Virgin Islands </option> <option value="Wallis and Futuna"> Wallis and Futuna </option> <option value="Western Sahara"> Western Sahara </option> <option value="Yemen"> Yemen </option> <option value="Zambia"> Zambia </option> <option value="Zimbabwe"> Zimbabwe </option> </select> </div> </li> <li id="cid_7" class="form-input-wide" data-type="control_head"> <div class="form-header-group "> <div class="header-text httal htvam"> <h2 id="header_7" class="form-header" data-component="header"> Proposed programme overview </h2> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_8"> <label class="form-label form-label-top form-label-auto" id="label_8" for="input_8"> Programme Title </label> <div id="cid_8" class="form-input-wide"> <input type="text" id="input_8" name="q8_programmeTitlenbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbsp" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_8" /> </div> </li> <li class="form-line" data-type="control_textbox" id="id_9"> <label class="form-label form-label-top form-label-auto" id="label_9" for="input_9"> Programme Duration </label> <div id="cid_9" class="form-input-wide"> <input type="text" id="input_9" name="q9_programmeDurationnbspnbspnbspnbspnbsp" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_9" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_10"> <label class="form-label form-label-top form-label-auto" id="label_10" for="input_10"> Indicative Programme Level </label> <div id="cid_10" class="form-input-wide"> <select class="form-dropdown" id="input_10" name="q10_indicativeProgramme" style="width:150px" data-component="dropdown" aria-labelledby="label_10"> <option value=""> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </div> </li> <li class="form-line" data-type="control_textbox" id="id_11"> <label class="form-label form-label-top form-label-auto" id="label_11" for="input_11"> Where will this programme be delivered, Geographically? </label> <div id="cid_11" class="form-input-wide"> <input type="text" id="input_11" name="q11_whereWill" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_11" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_12"> <label class="form-label form-label-top form-label-auto" id="label_12" for="input_12"> Is this programme accredited by a regulatory authority, or validated by a validating body? </label> <div id="cid_12" class="form-input-wide"> <select class="form-dropdown" id="input_12" name="q12_isThis" style="width:150px" data-component="dropdown" aria-labelledby="label_12"> <option value=""> </option> <option value="Yes"> Yes </option> <option value="No"> No </option> </select> </div> </li> <li class="form-line" data-type="control_textbox" id="id_13"> <label class="form-label form-label-top form-label-auto" id="label_13" for="input_13"> If yes, please name: </label> <div id="cid_13" class="form-input-wide"> <input type="text" id="input_13" name="q13_ifYes" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_13" /> </div> </li> <li class="form-line" data-type="control_textbox" id="id_14"> <label class="form-label form-label-top form-label-auto" id="label_14" for="input_14"> Programme aim s </label> <div id="cid_14" class="form-input-wide"> <input type="text" id="input_14" name="q14_programmeAims" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_14" /> </div> </li> <li id="cid_15" class="form-input-wide" data-type="control_head"> <div class="form-header-group "> <div class="header-text httal htvam"> <h2 id="header_15" class="form-header" data-component="header"> Programme Contents </h2> </div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_16"> <label class="form-label form-label-top form-label-auto" id="label_16" for="input_16"> Programme learning outcomes/ objectives </label> <div id="cid_16" class="form-input-wide"> <textarea id="input_16" class="form-textarea" name="q16_programmeLearning" cols="40" rows="6" data-component="textarea" aria-labelledby="label_16"></textarea> </div> </li> <li class="form-line" data-type="control_matrix" id="id_17"> <label class="form-label form-label-top form-label-auto" id="label_17" for="input_17"> Programme structure (including units or modules that make up the programme) </label> <div id="cid_17" class="form-input-wide"> <table summary="" cellPadding="4" cellSpacing="0" class="form-matrix-table" data-component="matrix"> <tbody> <tr> <th style="border:none"> </th> <th class="form-matrix-column-headers form-matrix-column_0"> <label id="label_17_col_0"> Unit Title </label> </th> <th class="form-matrix-column-headers form-matrix-column_1"> <label id="label_17_col_1"> Level </label> </th> <th class="form-matrix-column-headers form-matrix-column_2"> <label id="label_17_col_2"> Credit </label> </th> <th class="form-matrix-column-headers form-matrix-column_3"> <label id="label_17_col_3"> GLH </label> </th> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_0"> 1 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_0_0" class="form-textbox" size="5" name="q17_programmeStructure[0][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_0 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_0_1" class="form-dropdown" name="q17_programmeStructure[0][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_0 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_0_2" class="form-textbox" size="5" name="q17_programmeStructure[0][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_0 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_0_3" class="form-textbox" size="5" name="q17_programmeStructure[0][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_0 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_1"> 2 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_1_0" class="form-textbox" size="5" name="q17_programmeStructure[1][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_1 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_1_1" class="form-dropdown" name="q17_programmeStructure[1][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_1 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_1_2" class="form-textbox" size="5" name="q17_programmeStructure[1][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_1 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_1_3" class="form-textbox" size="5" name="q17_programmeStructure[1][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_1 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_2"> 3 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_2_0" class="form-textbox" size="5" name="q17_programmeStructure[2][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_2 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_2_1" class="form-dropdown" name="q17_programmeStructure[2][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_2 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_2_2" class="form-textbox" size="5" name="q17_programmeStructure[2][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_2 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_2_3" class="form-textbox" size="5" name="q17_programmeStructure[2][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_2 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_3"> 4 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_3_0" class="form-textbox" size="5" name="q17_programmeStructure[3][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_3 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_3_1" class="form-dropdown" name="q17_programmeStructure[3][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_3 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_3_2" class="form-textbox" size="5" name="q17_programmeStructure[3][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_3 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_3_3" class="form-textbox" size="5" name="q17_programmeStructure[3][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_3 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_4"> 5 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_4_0" class="form-textbox" size="5" name="q17_programmeStructure[4][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_4 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_4_1" class="form-dropdown" name="q17_programmeStructure[4][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_4 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_4_2" class="form-textbox" size="5" name="q17_programmeStructure[4][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_4 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_4_3" class="form-textbox" size="5" name="q17_programmeStructure[4][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_4 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_5"> 6 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_5_0" class="form-textbox" size="5" name="q17_programmeStructure[5][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_5 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_5_1" class="form-dropdown" name="q17_programmeStructure[5][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_5 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_5_2" class="form-textbox" size="5" name="q17_programmeStructure[5][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_5 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_5_3" class="form-textbox" size="5" name="q17_programmeStructure[5][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_5 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_6"> 7 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_6_0" class="form-textbox" size="5" name="q17_programmeStructure[6][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_6 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_6_1" class="form-dropdown" name="q17_programmeStructure[6][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_6 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_6_2" class="form-textbox" size="5" name="q17_programmeStructure[6][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_6 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_6_3" class="form-textbox" size="5" name="q17_programmeStructure[6][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_6 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_7"> 8 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_7_0" class="form-textbox" size="5" name="q17_programmeStructure[7][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_7 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_7_1" class="form-dropdown" name="q17_programmeStructure[7][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_7 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_7_2" class="form-textbox" size="5" name="q17_programmeStructure[7][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_7 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_7_3" class="form-textbox" size="5" name="q17_programmeStructure[7][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_7 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_8"> 9 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_8_0" class="form-textbox" size="5" name="q17_programmeStructure[8][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_8 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_8_1" class="form-dropdown" name="q17_programmeStructure[8][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_8 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_8_2" class="form-textbox" size="5" name="q17_programmeStructure[8][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_8 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_8_3" class="form-textbox" size="5" name="q17_programmeStructure[8][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_8 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_9"> 10 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_9_0" class="form-textbox" size="5" name="q17_programmeStructure[9][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_9 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_9_1" class="form-dropdown" name="q17_programmeStructure[9][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_9 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_9_2" class="form-textbox" size="5" name="q17_programmeStructure[9][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_9 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_9_3" class="form-textbox" size="5" name="q17_programmeStructure[9][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_9 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_10"> 11 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_10_0" class="form-textbox" size="5" name="q17_programmeStructure[10][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_10 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_10_1" class="form-dropdown" name="q17_programmeStructure[10][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_10 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_10_2" class="form-textbox" size="5" name="q17_programmeStructure[10][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_10 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_10_3" class="form-textbox" size="5" name="q17_programmeStructure[10][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_10 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_11"> 12 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_11_0" class="form-textbox" size="5" name="q17_programmeStructure[11][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_11 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_11_1" class="form-dropdown" name="q17_programmeStructure[11][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_11 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_11_2" class="form-textbox" size="5" name="q17_programmeStructure[11][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_11 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_11_3" class="form-textbox" size="5" name="q17_programmeStructure[11][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_11 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_12"> 13 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_12_0" class="form-textbox" size="5" name="q17_programmeStructure[12][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_12 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_12_1" class="form-dropdown" name="q17_programmeStructure[12][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_12 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_12_2" class="form-textbox" size="5" name="q17_programmeStructure[12][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_12 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_12_3" class="form-textbox" size="5" name="q17_programmeStructure[12][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_12 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_13"> 14 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_13_0" class="form-textbox" size="5" name="q17_programmeStructure[13][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_13 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_13_1" class="form-dropdown" name="q17_programmeStructure[13][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_13 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_13_2" class="form-textbox" size="5" name="q17_programmeStructure[13][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_13 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_13_3" class="form-textbox" size="5" name="q17_programmeStructure[13][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_13 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_14"> 15 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_14_0" class="form-textbox" size="5" name="q17_programmeStructure[14][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_14 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_14_1" class="form-dropdown" name="q17_programmeStructure[14][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_14 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_14_2" class="form-textbox" size="5" name="q17_programmeStructure[14][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_14 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_14_3" class="form-textbox" size="5" name="q17_programmeStructure[14][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_14 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_15"> 16 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_15_0" class="form-textbox" size="5" name="q17_programmeStructure[15][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_15 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_15_1" class="form-dropdown" name="q17_programmeStructure[15][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_15 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_15_2" class="form-textbox" size="5" name="q17_programmeStructure[15][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_15 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_15_3" class="form-textbox" size="5" name="q17_programmeStructure[15][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_15 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_16"> 17 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_16_0" class="form-textbox" size="5" name="q17_programmeStructure[16][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_16 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_16_1" class="form-dropdown" name="q17_programmeStructure[16][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_16 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_16_2" class="form-textbox" size="5" name="q17_programmeStructure[16][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_16 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_16_3" class="form-textbox" size="5" name="q17_programmeStructure[16][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_16 label_17_col_3" /> </td> </tr> <tr> <th style="text-align:left" class="form-matrix-row-headers"> <label id="label_17_row_17"> 18 </label> </th> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_17_0" class="form-textbox" size="5" name="q17_programmeStructure[17][0]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_17 label_17_col_0" /> </td> <td style="text-align:center" class="form-matrix-values"> <select id="input_17_17_1" class="form-dropdown" name="q17_programmeStructure[17][1]" style="width:100%;box-sizing:border-box" aria-labelledby="label_17 label_17_row_17 label_17_col_1"> <option> </option> <option value="Level 2"> Level 2 </option> <option value="Level 3"> Level 3 </option> <option value="Level 4"> Level 4 </option> <option value="Level 5"> Level 5 </option> <option value="Level 6"> Level 6 </option> <option value="Level 7"> Level 7 </option> <option value="Level 8"> Level 8 </option> </select> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_17_2" class="form-textbox" size="5" name="q17_programmeStructure[17][2]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_17 label_17_col_2" /> </td> <td style="text-align:center" class="form-matrix-values"> <input type="text" id="input_17_17_3" class="form-textbox" size="5" name="q17_programmeStructure[17][3]" style="width:100%;box-sizing:border-box" value="" aria-labelledby="label_17 label_17_row_17 label_17_col_3" /> </td> </tr> </tbody> </table> </div> </li> <li class="form-line" data-type="control_fullname" id="id_18"> <label class="form-label form-label-top form-label-auto" id="label_18" for="first_18"> Total </label> <div id="cid_18" class="form-input-wide"> <div data-wrapper-react="true"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="first_18" name="q18_total[first]" class="form-textbox" size="10" value="" data-component="first" aria-labelledby="label_18 sublabel_18_first" /> <label class="form-sub-label" for="first_18" id="sublabel_18_first" style="min-height:13px"> Credit </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="last_18" name="q18_total[last]" class="form-textbox" size="15" value="" data-component="last" aria-labelledby="label_18 sublabel_18_last" /> <label class="form-sub-label" for="last_18" id="sublabel_18_last" style="min-height:13px"> GLH </label> </span> </div> </div> </li> <li class="form-line" data-type="control_text" id="id_19"> <div id="cid_19" class="form-input-wide"> <div id="text_19" class="form-html" data-component="text"> <p>Please continue on a separate sheet as necessary. If programme syllabus / unit content is available, please include in your submission and provide a summary of the learning outcomes and structure only.</p> </div> </div> </li> <li id="cid_20" class="form-input-wide" data-type="control_head"> <div class="form-header-group "> <div class="header-text httal htvam"> <h2 id="header_20" class="form-header" data-component="header"> Programme Delivery and Assessment </h2> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_21"> <label class="form-label form-label-top form-label-auto" id="label_21" for="input_21"> Method of Delivery </label> <div id="cid_21" class="form-input-wide"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="input_21" name="q21_methodOf21" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_21 sublabel_input_21" /> <label class="form-sub-label" for="input_21" id="sublabel_input_21" style="min-height:13px"> (e.g. classroom, work-based, e-learning, distance learning, blended) </label> </span> </div> </li> <li class="form-line" data-type="control_textbox" id="id_22"> <label class="form-label form-label-top form-label-auto" id="label_22" for="input_22"> Assessment Method </label> <div id="cid_22" class="form-input-wide"> <input type="text" id="input_22" name="q22_assessmentMethod" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_22" /> </div> </li> <li class="form-line" data-type="control_textbox" id="id_23"> <label class="form-label form-label-top form-label-auto" id="label_23" for="input_23"> Learning Materials and Resources used in Delivery </label> <div id="cid_23" class="form-input-wide"> <input type="text" id="input_23" name="q23_learningMaterials" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_23" /> </div> </li> <li id="cid_24" class="form-input-wide" data-type="control_head"> <div class="form-header-group "> <div class="header-text httal htvam"> <h2 id="header_24" class="form-header" data-component="header"> Please provide details of all staffs involved in delivery, assessment and quality assurance processes. </h2> </div> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_25"> <label class="form-label form-label-top form-label-auto" id="label_25" for="input_25"> Staff (1) </label> <div id="cid_25" class="form-input-wide"> <select class="form-dropdown" id="input_25" name="q25_staff1" style="width:150px" data-component="dropdown" aria-labelledby="label_25"> <option value=""> </option> <option value="Delivery"> Delivery </option> <option value="Assessment"> Assessment </option> <option value="QA Processes"> QA Processes </option> <option value="Administration"> Administration </option> </select> </div> </li> <li class="form-line" data-type="control_fullname" id="id_26"> <label class="form-label form-label-top form-label-auto" id="label_26" for="first_26"> Name </label> <div id="cid_26" class="form-input-wide"> <div data-wrapper-react="true"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="first_26" name="q26_name[first]" class="form-textbox" size="10" value="" data-component="first" aria-labelledby="label_26 sublabel_26_first" /> <label class="form-sub-label" for="first_26" id="sublabel_26_first" style="min-height:13px"> First Name </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="last_26" name="q26_name[last]" class="form-textbox" size="15" value="" data-component="last" aria-labelledby="label_26 sublabel_26_last" /> <label class="form-sub-label" for="last_26" id="sublabel_26_last" style="min-height:13px"> Last Name </label> </span> </div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_27"> <label class="form-label form-label-top form-label-auto" id="label_27" for="input_27"> Experience/qualifications: </label> <div id="cid_27" class="form-input-wide"> <textarea id="input_27" class="form-textarea" name="q27_experiencequalifications" cols="40" rows="6" data-component="textarea" aria-labelledby="label_27"></textarea> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_28"> <label class="form-label form-label-top form-label-auto" id="label_28" for="input_28"> Staff (2) </label> <div id="cid_28" class="form-input-wide"> <select class="form-dropdown" id="input_28" name="q28_staff2" style="width:150px" data-component="dropdown" aria-labelledby="label_28"> <option value=""> </option> <option value="Delivery"> Delivery </option> <option value="Assessment"> Assessment </option> <option value="QA Processes"> QA Processes </option> <option value="Administration"> Administration </option> </select> </div> </li> <li class="form-line" data-type="control_fullname" id="id_31"> <label class="form-label form-label-top form-label-auto" id="label_31" for="first_31"> Name </label> <div id="cid_31" class="form-input-wide"> <div data-wrapper-react="true"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="first_31" name="q31_name31[first]" class="form-textbox" size="10" value="" data-component="first" aria-labelledby="label_31 sublabel_31_first" /> <label class="form-sub-label" for="first_31" id="sublabel_31_first" style="min-height:13px"> First Name </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="last_31" name="q31_name31[last]" class="form-textbox" size="15" value="" data-component="last" aria-labelledby="label_31 sublabel_31_last" /> <label class="form-sub-label" for="last_31" id="sublabel_31_last" style="min-height:13px"> Last Name </label> </span> </div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_36"> <label class="form-label form-label-top form-label-auto" id="label_36" for="input_36"> Experience/qualifications: </label> <div id="cid_36" class="form-input-wide"> <textarea id="input_36" class="form-textarea" name="q36_experiencequalifications36" cols="40" rows="6" data-component="textarea" aria-labelledby="label_36"></textarea> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_29"> <label class="form-label form-label-top form-label-auto" id="label_29" for="input_29"> Staff (3) </label> <div id="cid_29" class="form-input-wide"> <select class="form-dropdown" id="input_29" name="q29_staff3" style="width:150px" data-component="dropdown" aria-labelledby="label_29"> <option value=""> </option> <option value="Delivery"> Delivery </option> <option value="Assessment"> Assessment </option> <option value="QA Processes"> QA Processes </option> <option value="Administration"> Administration </option> </select> </div> </li> <li class="form-line" data-type="control_fullname" id="id_32"> <label class="form-label form-label-top form-label-auto" id="label_32" for="first_32"> Name </label> <div id="cid_32" class="form-input-wide"> <div data-wrapper-react="true"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="first_32" name="q32_name32[first]" class="form-textbox" size="10" value="" data-component="first" aria-labelledby="label_32 sublabel_32_first" /> <label class="form-sub-label" for="first_32" id="sublabel_32_first" style="min-height:13px"> First Name </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="last_32" name="q32_name32[last]" class="form-textbox" size="15" value="" data-component="last" aria-labelledby="label_32 sublabel_32_last" /> <label class="form-sub-label" for="last_32" id="sublabel_32_last" style="min-height:13px"> Last Name </label> </span> </div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_34"> <label class="form-label form-label-top form-label-auto" id="label_34" for="input_34"> Experience/qualifications: </label> <div id="cid_34" class="form-input-wide"> <textarea id="input_34" class="form-textarea" name="q34_experiencequalifications34" cols="40" rows="6" data-component="textarea" aria-labelledby="label_34"></textarea> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_30"> <label class="form-label form-label-top form-label-auto" id="label_30" for="input_30"> Staff (4) </label> <div id="cid_30" class="form-input-wide"> <select class="form-dropdown" id="input_30" name="q30_staff4" style="width:150px" data-component="dropdown" aria-labelledby="label_30"> <option value=""> </option> <option value="Delivery"> Delivery </option> <option value="Assessment"> Assessment </option> <option value="QA Processes"> QA Processes </option> <option value="Administration"> Administration </option> </select> </div> </li> <li class="form-line" data-type="control_fullname" id="id_33"> <label class="form-label form-label-top form-label-auto" id="label_33" for="first_33"> Name </label> <div id="cid_33" class="form-input-wide"> <div data-wrapper-react="true"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="first_33" name="q33_name33[first]" class="form-textbox" size="10" value="" data-component="first" aria-labelledby="label_33 sublabel_33_first" /> <label class="form-sub-label" for="first_33" id="sublabel_33_first" style="min-height:13px"> First Name </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="last_33" name="q33_name33[last]" class="form-textbox" size="15" value="" data-component="last" aria-labelledby="label_33 sublabel_33_last" /> <label class="form-sub-label" for="last_33" id="sublabel_33_last" style="min-height:13px"> Last Name </label> </span> </div> </div> </li> <li class="form-line" data-type="control_textarea" id="id_35"> <label class="form-label form-label-top form-label-auto" id="label_35" for="input_35"> Experience/qualifications: </label> <div id="cid_35" class="form-input-wide"> <textarea id="input_35" class="form-textarea" name="q35_experiencequalifications35" cols="40" rows="6" data-component="textarea" aria-labelledby="label_35"></textarea> </div> </li> <li id="cid_37" class="form-input-wide" data-type="control_head"> <div class="form-header-group "> <div class="header-text httal htvam"> <h2 id="header_37" class="form-header" data-component="header"> Programme Review </h2> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_38"> <label class="form-label form-label-top form-label-auto" id="label_38" for="input_38"> Detail how the programme is quality assured: </label> <div id="cid_38" class="form-input-wide"> <input type="text" id="input_38" name="q38_detailHow" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_38" /> </div> </li> <li class="form-line" data-type="control_textbox" id="id_39"> <label class="form-label form-label-top form-label-auto" id="label_39" for="input_39"> Detail how the programme is reviewed: </label> <div id="cid_39" class="form-input-wide"> <input type="text" id="input_39" name="q39_detailHow39" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_39" /> </div> </li> <li id="cid_40" class="form-input-wide" data-type="control_head"> <div class="form-header-group "> <div class="header-text httal htvam"> <h2 id="header_40" class="form-header" data-component="header"> Applicant Declaration </h2> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_41"> <label class="form-label form-label-top form-label-auto" id="label_41" for="input_41"> Centre Name </label> <div id="cid_41" class="form-input-wide"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" id="input_41" name="q41_centreName41" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_41 sublabel_input_41" /> <label class="form-sub-label" for="input_41" id="sublabel_input_41" style="min-height:13px"> By submitting this Form I can confirm that the above programme is developed by us and the programme is the sole property of </label> </span> </div> </li> <li class="form-line" data-type="control_textbox" id="id_42"> <label class="form-label form-label-top form-label-auto" id="label_42" for="input_42"> Form Completed by </label> <div id="cid_42" class="form-input-wide"> <input type="text" id="input_42" name="q42_formCompleted" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_42" /> </div> </li> <li class="form-line" data-type="control_textbox" id="id_43"> <label class="form-label form-label-top form-label-auto" id="label_43" for="input_43"> Job Title </label> <div id="cid_43" class="form-input-wide"> <input type="text" id="input_43" name="q43_jobTitlenbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbspnbsp" data-type="input-textbox" class="form-textbox" size="20" value="" data-component="textbox" aria-labelledby="label_43" /> </div> </li> <li class="form-line" data-type="control_datetime" id="id_44"> <label class="form-label form-label-top form-label-auto" id="label_44" for="lite_mode_44"> Date </label> <div id="cid_44" class="form-input-wide"> <div data-wrapper-react="true"> <div style="display:none"> <span class="form-sub-label-container" style="vertical-align:top"> <input type="tel" class="form-textbox validate[limitDate]" id="month_44" name="q44_date[month]" size="2" data-maxlength="2" value="" aria-labelledby="label_44 sublabel_44_month" /> <span class="date-separate" aria-hidden="true"> - </span> <label class="form-sub-label" for="month_44" id="sublabel_44_month" style="min-height:13px"> Month </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="tel" class="form-textbox validate[limitDate]" id="day_44" name="q44_date[day]" size="2" data-maxlength="2" value="" aria-labelledby="label_44 sublabel_44_day" /> <span class="date-separate" aria-hidden="true"> - </span> <label class="form-sub-label" for="day_44" id="sublabel_44_day" style="min-height:13px"> Day </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <input type="tel" class="form-textbox validate[limitDate]" id="year_44" name="q44_date[year]" size="4" data-maxlength="4" value="" aria-labelledby="label_44 sublabel_44_year" /> <label class="form-sub-label" for="year_44" id="sublabel_44_year" style="min-height:13px"> Year </label> </span> </div> <span class="form-sub-label-container" style="vertical-align:top"> <input type="text" class="form-textbox validate[limitDate, validateLiteDate]" id="lite_mode_44" size="12" data-maxlength="12" data-age="" value="" data-format="mmddyyyy" data-seperator="-" placeholder="mm-dd-yyyy" aria-labelledby="label_44 sublabel_44_litemode" /> <img alt="Pick a Date" id="input_44_pick" src="https://cdn.jotfor.ms/images/calendar.png" style="vertical-align:middle;margin-left:5px" data-component="datetime" aria-hidden="true" /> <label class="form-sub-label" for="lite_mode_44" id="sublabel_44_litemode" style="min-height:13px"> Date </label> </span> <span class="form-sub-label-container" style="vertical-align:top"> <label class="form-sub-label" for="input_44_pick" style="border:0;clip:rect(0 0 0 0);height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px;white-space:nowrap"> Date Picker Icon </label> </span> </div> </div> </li> <li class="form-line" data-type="control_button" id="id_2"> <div id="cid_2" class="form-input-wide"> <div style="margin-left:156px" class="form-buttons-wrapper "> <button id="input_2" type="submit" class="form-submit-button" data-component="button"> Submit </button> </div> </div> </li> <li class="form-line" data-type="control_text" id="id_45"> <div id="cid_45" class="form-input-wide"> <div id="text_45" class="form-html" data-component="text"> <p>Once completed please email to: [email protected]</p> </div> </div> </li> <li style="display:none"> Should be Empty: <input type="text" name="website" value="" /> </li> </ul> </div> <!-- [et_pb_line_break_holder] --></form>