"Family Name (Last Name)",
"icon" => "fas fa-users",
"name" => "familyname",
"maxlength" => 100,
"value" => $familyname,
"error" => "Enter your last name."
],
[
"label" => "Father's Name",
"icon" => "fas fa-male",
"name" => "fathername",
"maxlength" => 255,
"value" => $fathername,
"error" => "Enter the father's name."
],
[
"label" => "Mother's Name",
"icon" => "fas fa-female",
"name" => "mothername",
"maxlength" => 255,
"value" => $mothername,
"error" => "Enter the mother's name."
],
[
"label" => "Street Address",
"icon" => "fas fa-home",
"name" => "streetaddress",
"maxlength" => 500,
"value" => $streetaddress,
"error" => "Enter your address."
],
[
"label" => "City",
"icon" => "fas fa-city",
"name" => "city",
"maxlength" => 255,
"width" => 3,
"value" => $city,
"error" => "Enter your city."
],
[
"label" => "State",
"icon" => "fas fa-flag",
"name" => "state",
"type" => "select",
"value" => $state,
"error" => "Choose a state.",
"options" => [
'MT' => 'Montana',
'AL' => 'Alabama',
'AK' => 'Alaska',
'AZ' => 'Arizona',
'AR' => 'Arkansas',
'CA' => 'California',
'CO' => 'Colorado',
'CT' => 'Connecticut',
'DE' => 'Delaware',
'DC' => 'District of Columbia',
'FL' => 'Florida',
'GA' => 'Georgia',
'HI' => 'Hawaii',
'ID' => 'Idaho',
'IL' => 'Illinois',
'IN' => 'Indiana',
'IA' => 'Iowa',
'KS' => 'Kansas',
'KY' => 'Kentucky',
'LA' => 'Louisiana',
'ME' => 'Maine',
'MD' => 'Maryland',
'MA' => 'Massachusetts',
'MI' => 'Michigan',
'MN' => 'Minnesota',
'MS' => 'Mississippi',
'MO' => 'Missouri',
'MT' => 'Montana',
'NE' => 'Nebraska',
'NV' => 'Nevada',
'NH' => 'New Hampshire',
'NJ' => 'New Jersey',
'NM' => 'New Mexico',
'NY' => 'New York',
'NC' => 'North Carolina',
'ND' => 'North Dakota',
'OH' => 'Ohio',
'OK' => 'Oklahoma',
'OR' => 'Oregon',
'PA' => 'Pennsylvania',
'RI' => 'Rhode Island',
'SC' => 'South Carolina',
'SD' => 'South Dakota',
'TN' => 'Tennessee',
'TX' => 'Texas',
'UT' => 'Utah',
'VT' => 'Vermont',
'VA' => 'Virginia',
'WA' => 'Washington',
'WV' => 'West Virginia',
'WI' => 'Wisconsin',
'WY' => 'Wyoming'
],
"width" => 2
],
[
"label" => "ZIP/Postal Code",
"icon" => "fas fa-mail-bulk",
"name" => "zip",
"maxlength" => 10,
"width" => 3,
"value" => $zip,
"pattern" => "[0-9]{5}(-?[0-9]{4})?",
"error" => "Enter a valid 5 or 9 digit ZIP code."
],
[
"label" => "Phone Number",
"icon" => "fas fa-phone",
"name" => "phone",
"type" => "tel",
"maxlength" => 20,
"value" => $phone,
"pattern" => "[0-9]{10}",
"error" => "Enter a 10-digit phone number (numbers only)."
],
[
"label" => "Email",
"icon" => "fas fa-at",
"name" => "email",
"maxlength" => 255,
"type" => "email",
"value" => $email,
"error" => "Enter your email address."
],
[
"label" => "Newsletter Preference",
"icon" => "fas fa-newspaper",
"name" => "newsletter_method",
"type" => "select",
"value" => $newsletter_method,
"options" => [
"1" => "Email ($25)",
"2" => "Paper ($35)",
"3" => "Email and Paper ($35)"
],
"error" => "Choose a newsletter option."
]
];
foreach ($textboxes as $item) {
?>
The membership fees (determined by your newsletter
preference) cover costs of the following:
phone; website; postage; distribution of newsletters and
directories; publication of materials; library; and other
HACHE related activities. Dues are reduced as of March 1st.
HACHE will not restrict membership based on inability to
pay. HACHE does not mandate curriculum choices or the
manner in which curriculum is administered. We do encourage
all members to follow and adhere to MT laws governing home
schooling.