[{"id":1154,"date":"2017-08-15T12:57:26","date_gmt":"2017-08-15T16:57:26","guid":{"rendered":"http:\/\/alumni.virginia.edu\/meadendowment\/?page_id=1154"},"modified":"2023-06-13T14:33:16","modified_gmt":"2023-06-13T18:33:16","slug":"home","status":"publish","type":"page","link":"https:\/\/meadendowment.org","title":{"rendered":"Home"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"author":535,"featured_media":0,"parent":0,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"https:\/\/meadendowment.org","_links_to_target":""},"class_list":["post-1154","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\nHome - Mead Endowment<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meadendowment.org\/\" \/>\n<meta property=\"og:locale\" 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Endowment Disbursement Request"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_4' style='display:none'>\n <div class='gform_heading'>\n <p class='gform_description'>Use this form to request disbursement of Mead Endowment funds.<\/p>\n <\/div><form method='post' enctype='multipart\/form-data' id='gform_4' action='\/meadendowment\/wp-json\/wp\/v2\/pages' data-formid='4' novalidate>\t\t\t\t\t<div style=\"display: none !important;\" class=\"akismet-fields-container gf_invisible\" data-prefix=\"ak_\">\n\t\t\t\t\t\t<label>Δ<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"222\" \/>\n\t\t\t\t\t\t<script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n\n\t\t\t\t\t<\/div>\n <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_4_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><legend class='gfield_label gform-field-label' >Please select your status from the following:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_23'>\n\t\t\t<div class=\"gchoice gchoice_4_23_0 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_23' type='radio' value='New faculty member (eligible for Boots Bucks)' id='choice_4_23_0' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_23_0' id='label_4_23_0' >New faculty member (eligible for Boots Bucks)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_4_23_1 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_23' type='radio' value='Mead Honored faculty' id='choice_4_23_1' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_23_1' id='label_4_23_1' >Mead Honored faculty<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_4_23_2 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_23' type='radio' value='Recently promoted faculty' id='choice_4_23_2' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_23_2' id='label_4_23_2' >Recently promoted faculty<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_4_23_3 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_23' type='radio' value='Dream On faculty' id='choice_4_23_3' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_23_3' id='label_4_23_3' >Dream On faculty<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_4_23_4 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_23' type='radio' value='Other' id='choice_4_23_4' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_23_4' id='label_4_23_4' >Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_24\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><p><em>If you are interested in being reimbursed for an engagement expense and you do not fall into one of the above categories, please email us at <a href=\"mailto:meadendowment@virginia.edu\">meadendowment@virginia.edu<\/a>.<\/em><\/p><\/div><div id=\"field_4_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Contact Information<\/h3><\/div><fieldset id=\"field_4_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_4_1'>\n \n <span id='input_4_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n <input class=\" form-control\" type='text' name='input_1.3' id='input_4_1_3' value='' aria-required='true' \/>\n <label for='input_4_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n <\/span>\n \n <span id='input_4_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n <input class=\" form-control\" type='text' name='input_1.6' id='input_4_1_6' value='' aria-required='true' \/>\n <label for='input_4_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n <\/span>\n \n <\/div><\/fieldset><fieldset id=\"field_4_22\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mailing Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend> \n <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_4_22' >\n <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_22_1_container' >\n <input class=\" form-control\" type='text' name='input_22.1' id='input_4_22_1' value='' aria-required='true' \/>\n <label for='input_4_22_1' id='input_4_22_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_4_22_2_container' >\n <input class=\" form-control\" type='text' name='input_22.2' id='input_4_22_2' value='' aria-required='false' \/>\n <label for='input_4_22_2' id='input_4_22_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_22_3_container' >\n <input class=\" form-control\" type='text' name='input_22.3' id='input_4_22_3' value='' aria-required='true' \/>\n <label for='input_4_22_3' id='input_4_22_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_22_4_container' >\n <input class=\" form-control\" type='text' name='input_22.4' id='input_4_22_4' value='' aria-required='true' \/>\n <label for='input_4_22_4' id='input_4_22_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_22_5_container' >\n <input class=\" form-control\" type='text' name='input_22.5' id='input_4_22_5' value='' aria-required='true' \/>\n <label for='input_4_22_5' id='input_4_22_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_4_22_6_container' >\n <select class=\"form-select\" name='input_22.6' id='input_4_22_6' aria-required='true' ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d'Ivoire' >C\u00f4te d'Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People's Republic of' >Korea, Democratic People's Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People's Democratic Republic' >Lao People's Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/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='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/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='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/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><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n <label for='input_4_22_6' id='input_4_22_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n <\/span>\n <div class='gf_clear gf_clear_complex'><\/div>\n <\/div><\/fieldset><div id=\"field_4_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_2'>Your Email Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class=\"ginput_container ginput_container_email input-group\" ><span class=\"input-group-text\"><i class=\"bi bi-envelope-at\" aria-hidden=\"true\"><\/i><\/span>\n <input class=\"medium form-control\" name='input_2' id='input_4_2' type='email' value='' aria-required=\"true\" aria-invalid=\"false\" \/>\n <\/div><\/div><div id=\"field_4_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_3'>Your Phone:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class=\"ginput_container ginput_container_phone input-group\" ><span class=\"input-group-text\"><i class=\"bi bi-telephone\" aria-hidden=\"true\"><\/i><\/span><input class=\"medium form-control\" name='input_3' id='input_4_3' type='tel' value='' placeholder='(###) ###-####' aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/div><div id=\"field_4_4\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_4'>Amount:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input class=\"medium form-control\" name='input_4' id='input_4_4' type='text' step='any' value='' aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/div><div id=\"field_4_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Reimbursement Information<\/h3><\/div><div id=\"field_4_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_28'>Pay to<\/label><div class='ginput_container ginput_container_text'><input class=\"medium form-control\" name='input_28' id='input_4_28' type='text' value='' aria-describedby=\"gfield_description_4_28\" aria-invalid=\"false\" \/><\/div><div class='gfield_description' id='gfield_description_4_28'>If left blank, payment will be made out to your name<\/div><\/div><div id=\"field_4_26\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_26'>Who is the reimbursement recipient?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select class=\"medium gfield_select form-select\" name='input_26' id='input_4_26' aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Select...<\/option><option value='Myself' >Myself<\/option><option value='Third-party vendor (e.g., honoraria, vendors, caterers, etc.)' >Third-party vendor (e.g., honoraria, vendors, caterers, etc.)<\/option><\/select><\/div><\/div><div id=\"field_4_29\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><p><strong>Delivery Method:<\/strong> Direct Deposit<br \/><em>Individual reimbursements are done via direct deposit. We will be in touch if we do not already have information on file for the selected recipient.<\/em><\/p><\/div><div id=\"field_4_27\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_27'>Payment Method<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select class=\"medium gfield_select form-select\" name='input_27' id='input_4_27' aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Select...<\/option><option value='Direct Deposit' >Direct Deposit<\/option><option value='Check' >Check<\/option><\/select><\/div><\/div><div id=\"field_4_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><p><strong>Delivery Method:<\/strong> Direct Deposit<br \/><em>We will be in touch if we do not already have information on file for the selected recipient.<\/em><\/p><\/div><fieldset id=\"field_4_30\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Vendor Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend> \n <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_4_30' >\n <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_30_1_container' >\n <input class=\" form-control\" type='text' name='input_30.1' id='input_4_30_1' value='' aria-required='true' \/>\n <label for='input_4_30_1' id='input_4_30_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_4_30_2_container' >\n <input class=\" form-control\" type='text' name='input_30.2' id='input_4_30_2' value='' aria-required='false' \/>\n <label for='input_4_30_2' id='input_4_30_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_30_3_container' >\n <input class=\" form-control\" type='text' name='input_30.3' id='input_4_30_3' value='' aria-required='true' \/>\n <label for='input_4_30_3' id='input_4_30_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_30_4_container' >\n <select class=\"form-select\" name='input_30.4' id='input_4_30_4' aria-required='true' ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' selected='selected'>Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n <label for='input_4_30_4' id='input_4_30_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_30_5_container' >\n <input class=\" form-control\" type='text' name='input_30.5' id='input_4_30_5' value='' aria-required='true' \/>\n <label for='input_4_30_5' id='input_4_30_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n <\/span><input type='hidden' class='gform_hidden' name='input_30.6' id='input_4_30_6' value='United States' \/>\n <div class='gf_clear gf_clear_complex'><\/div>\n <\/div><\/fieldset><div id=\"field_4_14\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='gform_browse_button_4_14'>Receipts:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_4_14' data-settings='{"runtimes":"html5,flash,html4","browse_button":"gform_browse_button_4_14","container":"gform_multifile_upload_4_14","drop_element":"gform_drag_drop_area_4_14","filelist":"gform_preview_4_14","unique_names":true,"file_data_name":"file","url":"https:\\\/\\\/uvaalumni.org\\\/meadendowment\\\/?gf_page=ae8076448a976ed","flash_swf_url":"https:\\\/\\\/uvaalumni.org\\\/meadendowment\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf","silverlight_xap_url":"https:\\\/\\\/uvaalumni.org\\\/meadendowment\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap","filters":{"mime_types":[{"title":"Allowed Files","extensions":"pdf,jpg,gif,png,bmp,doc,docx"}],"max_file_size":"1048576b"},"multipart":true,"urlstream_upload":false,"multipart_params":{"form_id":4,"field_id":14,"_gform_file_upload_nonce_4_14":"fe8c646b4e"},"gf_vars":{"max_files":0,"message_id":"gform_multifile_messages_4_14","disallowed_extensions":["php","asp","aspx","cmd","csh","bat","html","htm","hta","jar","exe","com","js","lnk","htaccess","phar","phtml","ps1","ps2","php3","php4","php5","php6","py","rb","tmp"]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_4_14' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button class=\"gform_button_select_files gform-theme-button gform-theme-button--control btn btn-outline-primary\" type='button' id='gform_browse_button_4_14' aria-describedby=\"gfield_upload_rules_4_14\" >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_4_14'>Accepted file types: pdf, jpg, gif, png, bmp, doc, docx, Max. file size: 1 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_4_14'><\/ul> <div id='gform_preview_4_14' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_4_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><legend class='gfield_label gform-field-label' >Are these expenses considered allowable under University and IRS guidelines?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_16'>\n\t\t\t<div class=\"gchoice gchoice_4_16_0 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_16' type='radio' value='Yes' id='choice_4_16_0' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_16_0' id='label_4_16_0' >Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class=\"gchoice gchoice_4_16_1 form-check\" >\n\t\t\t\t\t<input class=\"form-check-input\" name='input_16' type='radio' value='No' id='choice_4_16_1' onchange='gformToggleRadioOther( this )' \/>\n\t\t\t\t\t<label class=\"form-check-label\" for='choice_4_16_1' id='label_4_16_1' >No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_17\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_17'>Please explain why these expenses are not considered allowable.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea class=\"textarea medium form-control\" name='input_17' id='input_4_17' aria-required=\"true\" aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_18\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Comments<\/h3><\/div><div id=\"field_4_19\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><label class='gfield_label gform-field-label' for='input_4_19'>Enter any comments or additional information here.<\/label><div class='ginput_container ginput_container_textarea'><textarea class=\"textarea medium form-control\" name='input_19' id='input_4_19' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_4_20\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Authorization<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_20'><div class=\"gchoice gchoice_4_20_1 form-check\" >\n\t\t\t\t\t\t\t\t<input class=\"form-check-input\" name='input_20.1' type='checkbox' value='I affirm I am authorized to request this disbursement 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