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<!doctype html>
<html>
<head>
<meta charset="utf-8">
<title>UTI | Form 3</title>
<link rel="stylesheet" type="text/css" href="css/bootstrap.min.css">
<link rel="stylesheet" type="text/css" href="css/bootstrap-theme.min.css">
<link rel="stylesheet" type="text/css" href="css/style.css">
<!--<script src="http://ajax.googleapis.com/ajax/libs/jquery/1.11.1/jquery.min.js"></script>
<script src="http://utiforms.s3.amazonaws.com/scripts/jquery.validate.min.js"></script>-->
</head>
<body>
<form id="utiForm" method="post" class="bbq">
<header class="container">
<div class="col-md-2"></div>
<div class="col-md-2"> <img src="img/logos/uti.jpg" alt="UTI" /> </div>
<div class="col-md-2"> <img src="img/logos/mmi.jpg" class="hidden-sm hidden-xs" alt="UTI" /> </div>
<div class="col-md-2"> <img src="img/logos/nascar.jpg" class="hidden-sm hidden-xs" alt="UTI" /> </div>
<div class="col-md-2"> <img src="img/logos/marinemi.jpg" class="hidden-sm hidden-xs" alt="UTI" /> </div>
<div class="col-md-2"></div>
</header>
<div class="container form-wrapper">
<div class="row">
<div class="col-md-6 form-container">
<div id="fieldWrapper">
<h1>A New Career Path Starts Here</h1>
<div class="progressbar-subtitle">It only takes a few minutes to learn about technician training opportunities.</div>
<div class="row">
<div class="col-md-8">
<div class="progress">
<div class="progress-bar progress-bar-striped active" role="progressbar" aria-valuenow="45" aria-valuemin="0" aria-valuemax="100" style="width: 25%;"> <span class="sr-only">45% Complete</span> </div>
</div>
</div>
</div>
<div class="step" id="step1">
<div class="row form-group">
<div class="col-md-8">
<label for="interest">What type of training are you interested in?</label>
<select id="interest" name="Interest" class="form-control" required>
<option value="">Select...</option>
<option selected="selected" value="AU">Automotive Technician Training</option>
<option value="MO">Motorcycle Mechanic Training</option>
<option value="DI">Diesel / Industrial Training</option>
<option value="CR">Collision and Auto Body Repair</option>
<option value="NASCAR">NASCAR Technician and Pit Crew Training</option>
<option value="MA">Marine Mechanic Training</option>
</select>
</div>
<div class="col-md-6"> </div>
</div>
</div>
<div id="step2" class="step"> <div class="row form-group">
<div class="col-md-12">
<label for="ddlCountryPre">* Country:</label>
<select id="ddlCountryPre" name="countrypre" class="form-control error" required="" aria-required="true" aria-invalid="true">
<option value="">Select...</option>
<option value="US">United States</option>
</select>
<label id="ddlCountryPre-error" class="error" for="ddlCountryPre" style="display: none;"></label>
</div>
</div>
<div class="row form-group">
<div class="col-md-3 col-sm-3">
<label for="zipCodePre">Zip: *</label>
<input id="zipCodePre" name="zipCodepre1" type="text" class="form-control error" required aria-required="true">
<label id="zipCodePre-error" class="error" for="zipCodePre" style="display: none;"></label>
</div>
<div class="col-md-4 col-sm-4">
<label for="txtCityPre">City: *</label>
<input id="txtCityPre" name="citypre1" class="form-control error" type="text" required aria-required="true">
<label id="txtCityPre-error" class="error" for="txtCityPre" style="display: none;"></label>
</div>
<div class="col-md-5 col-sm-5">
<label for="ddlStatePre">State: *</label>
<select id="ddlStatePre" name="statepre1" class="form-control error" required="" aria-required="true">
<option selected="selected" value="">Select a State</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</option>
<option value="AZ">Arizona</option>
</select>
<label id="ddlStatePre-error" class="error" for="ddlStatePre" style="display: none;"></label>
</div>
</div> </div>
<div id="step3" class="step"> <div class="row form-group">
<div class="col-md-12">
<label>* Highest Level of Education</label>
</div>
</div>
<div class="row form-group">
<div class="col-md-6">
<select name="EducationLevel" id="ddlEducation" class="form-control">
<option selected="selected" value="">Select...</option>
<option value="HS Grad">High School Student or Graduate</option>
<option value="Home School">Home School</option>
<option value="GED">GED</option>
<option value="No Equivalent">None of the above</option>
</select>
</div>
</div></div>
<div id="step4" class="step">
<div class="row form-group">
<div class=" col-md-6 col-sm-6">
<label for="firstName">First Name: *</label>
<input id="firstName" type="text" class="form-control valid" value="UTI-TEST" name="firstName" required aria-required="true" aria-invalid="false">
<label id="firstName-error" class="valid" for="firstName"></label>
<label id="firstName-error" class="valid" for="firstName"></label>
</div>
<div class="col-md-6 col-sm-6">
<label for="lastName">Last Name: *</label>
<input id="lastName" type="text" class="form-control" value="CORS" name="lastName" required aria-required="true">
</div>
</div>
<!-- Address -->
<div class="row form-group">
<div class="col-md-6 col-sm-6">
<label for="txtAddress">Address: *</label>
<input id="txtAddress" name="address1" class="form-control" type="text" required aria-required="true">
</div>
<div class="col-md-6 col-sm-6">
<label for="ddlCountry">* Country:</label>
<select id="ddlCountry" name="country" class="form-control" required="" aria-required="true">
<option value="">Select...</option>
<option value="US">United States</option>
</select>
</div>
</div>
<!-- State/ZipCode -->
<div class="row form-group">
<div class="col-md-3 col-sm-3">
<label for="zipCode">Zip Code: *</label>
<input id="zipCode" name="zipCode1" type="text" class="form-control" required aria-required="true">
</div>
<div class="col-md-4 col-sm-4">
<label for="txtCity">City: *</label>
<input id="txtCity" name="city1" class="form-control" type="text" required aria-required="true">
</div>
<div class="col-md-5 col-sm-5">
<label for="ddlState">State: *</label>
<select id="ddlState" name="state1" class="form-control" required="" aria-required="true">
<option selected="selected" value="">Select a State</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</option>
<option value="AZ">Arizona</option>
</select>
</div>
</div>
<!-- Country/Date of Birth -->
<div class="row form-group">
<div class="input-row form-group">
<div class="col-md-12">
<label for="dob">* Date of Birth:</label>
</div>
</div>
<div class="col-md-3 col-sm-3 form-group">
<select id="dob" name="dobMonth" class="form-control">
<option selected="selected" value="">Month</option>
<option value="01">Jan</option>
<option value="02">Feb</option>
<option value="03">Mar</option>
<option value="04">Apr</option>
<option value="05">May</option>
<option value="06">Jun</option>
<option value="07">Jul</option>
<option value="08">Aug</option>
<option value="09">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
</div>
<div class="col-md-3 col-sm-3 form-group">
<select name="dobDay" class="form-control">
<option selected="selected" value="">Day</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
</div>
<div class="col-md-3 col-sm-3 form-group">
<select id="select-choice-dob-year" name="dobYear" class="form-control">
<option selected="selected" value="">Year</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
</select>
</div>
</div>
<!-- High School Info -->
<div class="row form-group education">
<div class="col-md-12 gradDate">
<label for="gradDateLabel"> <span id="gradDateLabel">When will/did you graduate? *</span> </label>
</div>
<div class="gradDate">
<div class="col-md-3">
<select id="gradMonth" name="GradDate[month]" class="form-control">
<option selected="selected" value="">Month</option>
<option value="01">Jan</option>
<option value="02">Feb</option>
<option value="03">Mar</option>
<option value="04">Apr</option>
<option value="05">May</option>
<option value="06">Jun</option>
<option value="07">Jul</option>
<option value="08">Aug</option>
<option value="09">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
</div>
<div class="col-md-3">
<select id="gradYear" name="GradDate[year]" class="form-control">
<option value="" selected="selected">Year</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
</select>
</div>
</div>
</div>
<div class="row form-group education">
<div class="col-md-4 col-sm-4 hsCity">
<label for="high-school-city"> <span id="highschoolCityLabel">High School City: *</span> </label>
<select id="high-school-city" name="HighSchoolCity" class="form-control">
<option value="" selected="selected">Select...</option>
<option value="Ajo">Ajo</option>
<option value="Anthem">Anthem</option>
<option value="Apache Junction">Apache Junction</option>
<option value="Ash Fork">Ash Fork</option>
<option value="Avondale">Avondale</option>
<option value="Bagdad">Bagdad</option>
<option value="Bapchule">Bapchule</option>
<option value="Benson">Benson</option>
<option value="Bisbee">Bisbee</option>
<option value="Bowie">Bowie</option>
<option value="Buckeye">Buckeye</option>
<option value="Bullhead City">Bullhead City</option>
<option value="Camp Verde">Camp Verde</option>
<option value="Casa Grande">Casa Grande</option>
<option value="Cashion">Cashion</option>
<option value="Cave Creek">Cave Creek</option>
<option value="Chandler">Chandler</option>
<option value="Chinle">Chinle</option>
<option value="Chino Valley">Chino Valley</option>
<option value="Cibecue">Cibecue</option>
<option value="Clarkdale">Clarkdale</option>
<option value="Clifton">Clifton</option>
<option value="CLIFTON">CLIFTON</option>
<option value="Colorado City">Colorado City</option>
<option value="Concho">Concho</option>
<option value="Coolidge">Coolidge</option>
<option value="Cottonwood">Cottonwood</option>
<option value="Dewey">Dewey</option>
<option value="Dolan Springs">Dolan Springs</option>
<option value="Douglas">Douglas</option>
<option value="Duncan">Duncan</option>
<option value="Eagar">Eagar</option>
<option value="Ehrenberg">Ehrenberg</option>
<option value="El Mirage">El Mirage</option>
<option value="Elfrida">Elfrida</option>
<option value="Eloy">Eloy</option>
<option value="Flagstaff">Flagstaff</option>
<option value="Florence">Florence</option>
<option value="Fort Defiance">Fort Defiance</option>
<option value="Fort Mohave">Fort Mohave</option>
<option value="Fort Thomas">Fort Thomas</option>
<option value="Fountain Hills">Fountain Hills</option>
<option value="Fredonia">Fredonia</option>
<option value="Ganado">Ganado</option>
<option value="Gila Bend">Gila Bend</option>
<option value="Gilbert">Gilbert</option>
<option value="Glendale">Glendale</option>
<option value="Globe">Globe</option>
<option value="Golden Valley">Golden Valley</option>
<option value="Goodyear">Goodyear</option>
<option value="Grand Canyon">Grand Canyon</option>
<option value="Green Valley">Green Valley</option>
<option value="Guadalupe">Guadalupe</option>
<option value="Heber">Heber</option>
<option value="Hereford">Hereford</option>
<option value="Higley">Higley</option>
<option value="Holbrook">Holbrook</option>
<option value="Joseph City">Joseph City</option>
<option value="Kayenta">Kayenta</option>
<option value="Kearny">Kearny</option>
<option value="Kingman">Kingman</option>
<option value="Lake Havasu City">Lake Havasu City</option>
<option value="Lakeside">Lakeside</option>
<option value="Laveen">Laveen</option>
<option value="Litchfield Park">Litchfield Park</option>
<option value="Littlefield">Littlefield</option>
<option value="Many Farms">Many Farms</option>
<option value="Marana">Marana</option>
<option value="Maricopa">Maricopa</option>
<option value="Mayer">Mayer</option>
<option value="Mesa">Mesa</option>
<option value="Miami">Miami</option>
<option value="Mohave Valley">Mohave Valley</option>
<option value="Morenci">Morenci</option>
<option value="Nogales">Nogales</option>
<option value="Oro Valley">Oro Valley</option>
<option value="Page">Page</option>
<option value="Paradise Valley">Paradise Valley</option>
<option value="Parker">Parker</option>
<option value="Patagonia">Patagonia</option>
<option value="Payson">Payson</option>
<option value="Peach Springs">Peach Springs</option>
<option value="Peoria">Peoria</option>
<option value="Peridot">Peridot</option>
<option value="Phoenix">Phoenix</option>
<option value="Pima">Pima</option>
<option value="Pinetop">Pinetop</option>
<option value="Pinon">Pinon</option>
<option value="Polacca">Polacca</option>
<option value="Prescott">Prescott</option>
<option value="Prescott Valley">Prescott Valley</option>
<option value="Queen Creek">Queen Creek</option>
<option value="Red Valley">Red Valley</option>
<option value="Rimrock">Rimrock</option>
<option value="Rio Rico">Rio Rico</option>
<option value="Rock Point">Rock Point</option>
<option value="Sacaton">Sacaton</option>
<option value="Safford">Safford</option>
<option value="Sahuarita">Sahuarita</option>
<option value="Saint David">Saint David</option>
<option value="Saint Johns">Saint Johns</option>
<option value="Saint Michaels">Saint Michaels</option>
<option value="Salome">Salome</option>
<option value="San Carlos">San Carlos</option>
<option value="San Luis">San Luis</option>
<option value="San Manuel">San Manuel</option>
<option value="San Simon">San Simon</option>
<option value="San Tan Valley">San Tan Valley</option>
<option value="Sanders">Sanders</option>
<option value="Scottsdale">Scottsdale</option>
<option value="Sedona">Sedona</option>
<option value="Seligman">Seligman</option>
<option value="Sells">Sells</option>
<option value="Shonto">Shonto</option>
<option value="Show Low">Show Low</option>
<option value="Sierra Vista">Sierra Vista</option>
<option value="Snowflake">Snowflake</option>
<option value="Somerton">Somerton</option>
<option value="Springerville">Springerville</option>
<option value="Sun City">Sun City</option>
<option value="Superior">Superior</option>
<option value="Surprise">Surprise</option>
<option value="Taylor">Taylor</option>
<option value="Teec Nos Pos">Teec Nos Pos</option>
<option value="Tempe">Tempe</option>
<option value="Thatcher">Thatcher</option>
<option value="Tolleson">Tolleson</option>
<option value="Tombstone">Tombstone</option>
<option value="Tonalea">Tonalea</option>
<option value="Tonopah">Tonopah</option>
<option value="Tuba City">Tuba City</option>
<option value="Tucson">Tucson</option>
<option value="Vail">Vail</option>
<option value="Wellton">Wellton</option>
<option value="Whiteriver">Whiteriver</option>
<option value="Wickenburg">Wickenburg</option>
<option value="Willcox">Willcox</option>
<option value="Williams">Williams</option>
<option value="Winkelman">Winkelman</option>
<option value="Winslow">Winslow</option>
<option value="Young">Young</option>
<option value="Yuma">Yuma</option>
</select>
</div>
<div class="col-md-4 col-sm-4 hsState">
<label for="high-school-state"> <span id="highschoolStateLabel">* High School State:</span> </label>
<select id="high-school-state" name="HighSchoolState" class="form-control">
<option value="" selected="selected">Select...</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="AA">Armed Forces Americas (Except Canada)</option>
<option value="AE">Armed Forces Europe, Middle East, Africa</option>
<option value="AP">Armed Forces Pacific</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FM">Federated States of Micronesia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MH">Marshall Islands</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NS">No State</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="MP">Northern Mariana Islands</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PW">Palau</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VI">Virgin Islands</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
</div>
</div>
<div class="row form-group">
<div class="col-md-6 hsName">
<label>If your school is not listed, please type it here:</label>
<input id="txtHighSchoolNotListed" name="txtHighSchoolNotListed" class="form-control" type="text">
</div>
</div>
<div class="row form-group">
<div class="col-md-6"> <!-- Email/Phone -->
<div class="row">
<div class="col-md-12">
<label for="phone">Phone Number: *</label>
</div>
</div>
<div class="row form-group">
<div class="col-md-4 col-sm-4 form-group">
<input id="phone1" name="phone1" type="text" width="40px" class="form-control" value="602" required aria-required="true">
</div>
<div class="col-md-4 col-sm-4 form-group">
<input id="phone2" name="phone2" type="text" width="40px" class="form-control" value="315" required aria-required="true">
</div>
<div class="col-md-4 col-sm-4 form-group">
<input id="phone3" name="phone3" type="text" width="60px" class="form-control" value="4874" required aria-required="true">
</div>
</div>
</div>
<div class="col-md-6">
<div class="row">
<div class="col-md-12">
<label for="phoneAlt1">Phone Number: *</label>
</div>
</div>
<div class="row form-group">
<div class="col-md-4 col-sm-4 form-group">
<input id="phoneAlt1" name="phoneAlt1" type="text" width="40px" class="form-control" value="602" required aria-required="true">
</div>
<div class="col-md-4 col-sm-4 form-group">
<input id="phoneAlt2" name="phoneAlt2" type="text" width="40px" class="form-control" value="315" required aria-required="true">
</div>
<div class="col-md-4 col-sm-4 form-group">
<input id="phone3" name="phoneAlt3" type="text" width="60px" class="form-control" value="4874" required aria-required="true">
</div>
</div>
</div>
</div>
<div class="row form-group">
<div class="col-md-6 col-sm-6">
<label for="email">Email Address: *</label>
<input id="email" name="email1" type="text" class="form-control" value="[email protected]" required aria-required="true">
</div>
<div class="col-md-6 col-sm-6">
<label for="email2">Confirm Email Address: *</label>
<input id="email2" name="email2" type="text" class="form-control" value="[email protected]" required aria-required="true">
</div>
</div>
<!-- Military -->
<div class="military">
<!-- Current or Former Military? -->
<div class="row form-group">
<div class="col-md-12">
<label>* Current or Former Military:</label>
<div class="isMilitary">
<div class="btn-group" data-toggle="buttons">
<label class="btn btn-primary">
<input type="radio" name="options" id="option1" value="true">
Yes </label>
<label class="btn btn-primary">
<input type="radio" name="options" id="option2" value="false">
No </label>
</div>
</div>
</div>
</div>
<!-- Date of Military Separation -->
<div class="row form-group militarySeparation">
<div class="col-md-12">
<label>Date of Military Separation: *</label>
</div>
<div class="col-md-6">
<select class="form-control" name="MilitarySeparationMonth">
<option selected="selected" value="">Month</option>
<option value="01">Jan</option>
<option value="02">Feb</option>
<option value="03">Mar</option>
<option value="04">Apr</option>
<option value="05">May</option>
<option value="06">Jun</option>
<option value="07">Jul</option>
<option value="08">Aug</option>
<option value="09">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
</div>
<div class="col-md-6">
<select id="select-choice-military-year" class="form-control" name="MilitarySeparationYear">
<option selected="selected" value="">Year</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
</select>
</div>
</div>
<!-- Military Installation or Base -->
<div class="row form-group militaryInstallationOrBase">
<div class="col-md-6">
<label>* Military Installation or Base</label>
<input id="militaryInstallation" type="text" class="form-control">
</div>
</div>
</div>
</div>
</div>
<div id="navigation">
<input class="navigation_button" id="back" value="Back" type="reset" />
<input class="navigation_button" id="next" value="Next Step" type="submit" />
</div>
</div>
<div class="col-md-6"><img src="img/hands-on.jpg" alt="Hands On" class="img-responsive hidden-sm hidden-xs">
<div class="row">
<div class="col-md-12">
<div class="HalogenContentHeader"> Here are just a few of the benefits you can get from Universal Technical Institute! </div>
<ul>
<li>Fun Hands-On Learning</li>
<li>You Can Start & Finish Fast</li>
<li>Certified Instructors with Real-World Experience</li>
<li>Manufacturer-Specific Advanced Training</li>
<li>11 Campuses Nationwide</li>
<li>UTI is Industry's Choice for Technician Training</li>
<li>Approximately 4 out of 5 graduates get jobs in their field of study</li>
</ul>
<p>So why not check it out? It's easy... just fill out the form and find out about great career opportunities with great rewards!</p>
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