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Application

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Please correct errors below

Warning: Undefined variable $firstName in /home/famiqkma/public_html/app_personal_form.php on line 5
"" placeholder="First Name" oninput="RemoveTextInputError(this.getAttribute('id'), /^[\'\-a-zA-Z ]*$/, 'Invalid Characters')" /> Warning: Undefined variable $inputClass in /home/famiqkma/public_html/app_personal_form.php on line 6
>
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Warning: Undefined variable $lastName in /home/famiqkma/public_html/app_personal_form.php on line 9
"" placeholder="Last Name" oninput="RemoveTextInputError(this.getAttribute('id'), /^[\'\-a-zA-Z ]*$/, 'Invalid Characters')" /> Warning: Undefined variable $inputClass in /home/famiqkma/public_html/app_personal_form.php on line 10
>
Warning: Undefined variable $lastNameErr in /home/famiqkma/public_html/app_personal_form.php on line 10

Warning: Undefined variable $streetAddress in /home/famiqkma/public_html/app_personal_form.php on line 13
"" placeholder="Street Address" oninput="RemoveTextInputError(this.getAttribute('id'), /^[\'\-a-zA-Z0-9 ]*$/)" />
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Warning: Undefined variable $city in /home/famiqkma/public_html/app_personal_form.php on line 17
"" placeholder="City" oninput="RemoveTextInputError(this.getAttribute('id'))" />
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Warning: Undefined variable $stateErr in /home/famiqkma/public_html/app_personal_form.php on line 39

Warning: Undefined variable $zip in /home/famiqkma/public_html/app_personal_form.php on line 45
"" placeholder="Zip Code" oninput="RemoveTextInputError(this.getAttribute('id'))" />
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Warning: Undefined variable $email in /home/famiqkma/public_html/app_personal_form.php on line 49
"" placeholder="Email" oninput="RemoveTextInputError(this.getAttribute('id'))" />
Warning: Undefined variable $emailErr in /home/famiqkma/public_html/app_personal_form.php on line 50

Warning: Undefined variable $email2 in /home/famiqkma/public_html/app_personal_form.php on line 53
"" placeholder="Email" oninput="RemoveTextInputError(this.getAttribute('id'))" />
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Warning: Undefined variable $phone in /home/famiqkma/public_html/app_personal_form.php on line 57
"" placeholder="Phone Number" oninput="RemoveTextInputError(this.getAttribute('id'))" />
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Warning: Undefined variable $ssn in /home/famiqkma/public_html/app_personal_form.php on line 61
"" placeholder="SSN" oninput="RemoveTextInputError(this.getAttribute('id'))" />
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Birthday: Warning: Undefined variable $bday in /home/famiqkma/public_html/app_personal_form.php on line 66
"" >
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Earliest start date:
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Warning: Undefined variable $validDlnChecked in /home/famiqkma/public_html/app_personal_form.php on line 75
onclick="RemoveCheckboxInputError(this.getAttribute('id'))" > Have Valid Indiana Drivers License

Warning: Undefined variable $validDlnCheckedErr in /home/famiqkma/public_html/app_personal_form.php on line 77

Warning: Undefined variable $dln in /home/famiqkma/public_html/app_personal_form.php on line 80
"" placeholder="Drivers License Number" oninput="RemoveTextInputError(this.getAttribute('id'), 'dln')" />
Warning: Undefined variable $dlnErr in /home/famiqkma/public_html/app_personal_form.php on line 81

Warning: Undefined variable $workEligibleChecked in /home/famiqkma/public_html/app_personal_form.php on line 84
onclick="RemoveCheckboxInputError(this.getAttribute('id'))" > Eligible to work in the US

Warning: Undefined variable $workEligibleCheckedErr in /home/famiqkma/public_html/app_personal_form.php on line 86

Warning: Undefined variable $convictedChecked in /home/famiqkma/public_html/app_personal_form.php on line 89
> Been convicted of a felony
Warning: Undefined variable $convictedCheckedErr in /home/famiqkma/public_html/app_personal_form.php on line 91

Warning: Undefined variable $convictedReason in /home/famiqkma/public_html/app_personal_form.php on line 94
"" placeholder="Brief explanation of conviction" oninput="RemoveTextInputError(this.getAttribute('id'))" />
Warning: Undefined variable $convictedReasonErr in /home/famiqkma/public_html/app_personal_form.php on line 95

Warning: Undefined variable $cprCertifiedChecked in /home/famiqkma/public_html/app_personal_form.php on line 98
> CPR certified
Warning: Undefined variable $cprCertifiedCheckedErr in /home/famiqkma/public_html/app_personal_form.php on line 100

Warning: Undefined variable $firstAidCertifiedChecked in /home/famiqkma/public_html/app_personal_form.php on line 103
> First aid certified
Warning: Undefined variable $firstAidCertifiedCheckedErr in /home/famiqkma/public_html/app_personal_form.php on line 105

Attach Resume Below:
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