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First Name

Last Name

Password

Organizational affiliation

Zip Code (required)

Military Status (required)

Age (required)

Race/Ethnicity

Level of Education (required)

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Or sign up with

<script>
$( document ).ready(function() {
if($("body").hasClass("my-account-page") || $("body").hasClass("social-sign-up-page")){
    if($("body").hasClass("social-sign-up-page")){
        //fix formatting
        var btn = $('#social-sign-up').parent().html();
        $('form').append("<div class='form__group'>"+btn+"</div>");
        $('#social-sign-up').parent().html("");
    }
    
        
        
            $("label").each(function(){
               var label_text = $(this).text();
               var lfor = $(this).attr("for");
               if(label_text.indexOf("Military Status") !== -1){
                  var next_input = $( "input[name='"+lfor+"']" );
                  var current_value = $(next_input).val();
                  var input_html = next_input.prop('outerHTML').replace('input type="text"', "select");
                  var options_html = ""
                  var selected = "";
                  
                  
                    if(current_value=="-Select Military Status-"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">-Select Military Status-</option>";
                  
                    if(current_value=="I previously served in the military"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I previously served in the military</option>";
                  
                    if(current_value=="I am currently serving"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I am currently serving</option>";
                  
                    if(current_value=="I am a current military spouse"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I am a current military spouse</option>";
                  
                    if(current_value=="I am a spouse of a Veteran or a surviving spouse"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I am a spouse of a Veteran or a surviving spouse</option>";
                  
                    if(current_value=="I am a military child (I grew up with a parent in the military)"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I am a military child (I grew up with a parent in the military)</option>";
                  
                    if(current_value=="I provide care for someone who is on active duty"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I provide care for someone who is on active duty</option>";
                  
                    if(current_value=="I provide care for someone who has served"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I provide care for someone who has served</option>";
                  
                    if(current_value=="I have a family member who is on Active-Duty or has served"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I have a family member who is on Active-Duty or has served</option>";
                  
                    if(current_value=="I have friends who are Veterans, Active Duty, or Reservists"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">I have friends who are Veterans, Active Duty, or Reservists</option>";
                  
                  var end_select = "</select>";
                  $(next_input).replaceWith(input_html+options_html+end_select)
                  console.log("html",input_html)
               }
               
            });     
        
        
    
        
        
            $("label").each(function(){
               var label_text = $(this).text();
               var lfor = $(this).attr("for");
               if(label_text.indexOf("Age") !== -1){
                  var next_input = $( "input[name='"+lfor+"']" );
                  var current_value = $(next_input).val();
                  var input_html = next_input.prop('outerHTML').replace('input type="text"', "select");
                  var options_html = ""
                  var selected = "";
                  
                  
                    if(current_value=="-Select Age-"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">-Select Age-</option>";
                  
                    if(current_value=="18 - 25 years old"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">18 - 25 years old</option>";
                  
                    if(current_value=="26 - 35 years old"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">26 - 35 years old</option>";
                  
                    if(current_value=="36 - 45 years old"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">36 - 45 years old</option>";
                  
                    if(current_value=="46 - 55 years old"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">46 - 55 years old</option>";
                  
                    if(current_value=="56 - 65 years old"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">56 - 65 years old</option>";
                  
                    if(current_value=="66 - 75 years old"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">66 - 75 years old</option>";
                  
                    if(current_value=="Older than 75"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Older than 75</option>";
                  
                  var end_select = "</select>";
                  $(next_input).replaceWith(input_html+options_html+end_select)
                  console.log("html",input_html)
               }
               
            });     
        
        
    
        
        
            $("label").each(function(){
               var label_text = $(this).text();
               var lfor = $(this).attr("for");
               if(label_text.indexOf("Level of Education") !== -1){
                  var next_input = $( "input[name='"+lfor+"']" );
                  var current_value = $(next_input).val();
                  var input_html = next_input.prop('outerHTML').replace('input type="text"', "select");
                  var options_html = ""
                  var selected = "";
                  
                  
                    if(current_value=="-Select Level of Education-"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">-Select Level of Education-</option>";
                  
                    if(current_value=="Less than high school"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Less than high school</option>";
                  
                    if(current_value=="High school diploma or equivalent"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">High school diploma or equivalent</option>";
                  
                    if(current_value=="Some college, no degree"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Some college, no degree</option>";
                  
                    if(current_value=="Associate degree"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Associate degree</option>";
                  
                    if(current_value=="Bachelor's degree"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Bachelor's degree</option>";
                  
                    if(current_value=="Master's degree"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Master's degree</option>";
                  
                    if(current_value=="Doctorate degree"){
                      selected = "selected";
                    } else {
                      selected="";
                    }
                    options_html += "<option "+selected+">Doctorate degree</option>";
                  
                  var end_select = "</select>";
                  $(next_input).replaceWith(input_html+options_html+end_select)
                  console.log("html",input_html)
               }
               
            });     
        
        
    
}
if( $("body").hasClass("complete-signup-page")){

$('label:contains("Military Status*")').each(function() {
          var input = $(this).next('input');
          var required = input.attr('required');
          var name = input.attr('name');
          var id = input.attr('id');
          
          var select = $('<select>', {
              'name': name,
              'id': id,
              'class': 'form__control',
              'required': required
          });

var options = [];
          
                
            options.push("-Select Military Status-");    
                
            options.push("I previously served in the military");    
                
            options.push("I am currently serving");    
                
            options.push("I am a current military spouse");    
                
            options.push("I am a spouse of a Veteran or a surviving spouse");    
                
            options.push("I am a military child (I grew up with a parent in the military)");    
                
            options.push("I provide care for someone who is on active duty");    
                
            options.push("I provide care for someone who has served");    
                
            options.push("I have a family member who is on Active-Duty or has served");    
                
            options.push("I have friends who are Veterans, Active Duty, or Reservists");    
          
          options.forEach(function(option) {
              select.append($('<option>', {
                  value: option,
                  text: option
              }));
          });

input.replaceWith(select);
      });

$('label:contains("Age*")').each(function() {
          var input = $(this).next('input');
          var required = input.attr('required');
          var name = input.attr('name');
          var id = input.attr('id');
          
          var select = $('<select>', {
              'name': name,
              'id': id,
              'class': 'form__control',
              'required': required
          });

var options = [];
          
                
            options.push("-Select Age-");    
                
            options.push("18 - 25 years old");    
                
            options.push("26 - 35 years old");    
                
            options.push("36 - 45 years old");    
                
            options.push("46 - 55 years old");    
                
            options.push("56 - 65 years old");    
                
            options.push("66 - 75 years old");    
                
            options.push("Older than 75");    
          
          options.forEach(function(option) {
              select.append($('<option>', {
                  value: option,
                  text: option
              }));
          });

input.replaceWith(select);
      });

$('label:contains("Level of Education*")').each(function() {
          var input = $(this).next('input');
          var required = input.attr('required');
          var name = input.attr('name');
          var id = input.attr('id');
          
          var select = $('<select>', {
              'name': name,
              'id': id,
              'class': 'form__control',
              'required': required
          });

var options = [];
          
                
            options.push("-Select Level of Education-");    
                
            options.push("Less than high school");    
                
            options.push("High school diploma or equivalent");    
                
            options.push("Some college, no degree");    
                
            options.push("Associate degree");    
                
            options.push("Bachelor's degree");    
                
            options.push("Master's degree");    
                
            options.push("Doctorate degree");    
          
          options.forEach(function(option) {
              select.append($('<option>', {
                  value: option,
                  text: option
              }));
          });

input.replaceWith(select);
      });

}
});
</script>