casportsmay2023.securelinx.us
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URL:
https://casportsmay2023.securelinx.us/
Submission: On May 16 via automatic, source certstream-suspicious — Scanned from US
Submission: On May 16 via automatic, source certstream-suspicious — Scanned from US
Form analysis 1 forms found in the DOM
Name: builder-form —
<form id="_builder-form"
style="background-color:#FFFFFF;color:#undefined;border:1px dashed #CDE0EC;border-radius:4px;max-width:550px;width:100%;margin-top:;border-color:#CDE0EC;padding-top:21px;padding-bottom:0px;padding-left:30px;padding-right:30px;box-shadow:0px 0px 0px 0px #FFFFFF;"
name="builder-form" class="ghl-survey-form" data-v-35cf6ca8=""><!---->
<div class="ghl-question-set" data-v-35cf6ca8=""><!--[-->
<div class="ghl-page-current form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-first_name" class="form-builder--item form-builder--item-input"><!----><label>First Name <span>*</span></label><input type="text" placeholder="First Name" name="first_name" class="form-control" id="first_name"
data-required="true"><!----></div>
</div>
</div><!---->
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-odd form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-last_name" class="form-builder--item form-builder--item-input"><!----><label>Last Name <span>*</span></label><input type="text" placeholder="Last Name" name="last_name" class="form-control" id="last_name"
data-required="true"><!----></div>
</div>
</div><!---->
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-phone" class="form-builder--item form-builder--item-input"><!----><label>Phone <span>*</span></label><input type="tel" name="phone" placeholder="Phone" autocomplete="off" class="form-control" id="phone"
data-required="true"><!----></div>
</div>
</div><!----><!---->
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item heading-element" data-v-35cf6ca8="">
<div class="text-element" style="color:#000000;font-family:inherit;font-size:18px;font-weight:400;text-align:center;line-height:1.2;">
<div>Our church will reach out to you with a link via text or we will call you for pay over phone. </div>
</div>
</div><!---->
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-odd form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-35cf6ca8=""><!----><label>I will Donate the following amount: <!----></label>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="$5-24_C4923qNs3v06qje5eQmQ_0_8l52zjvxd8g" type="radio" data-required="false" value="$5-24"><label for="$5-24_C4923qNs3v06qje5eQmQ_0_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">$5-24</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="$25-49_C4923qNs3v06qje5eQmQ_1_8l52zjvxd8g" type="radio" data-required="false" value="$25-49"><label for="$25-49_C4923qNs3v06qje5eQmQ_1_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">$25-49</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="$51-99_C4923qNs3v06qje5eQmQ_2_8l52zjvxd8g" type="radio" data-required="false" value="$51-99"><label for="$51-99_C4923qNs3v06qje5eQmQ_2_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">$51-99</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="$100 or Greater (Free Trip Voucher!)_C4923qNs3v06qje5eQmQ_3_8l52zjvxd8g" type="radio" data-required="false"
value="$100 or Greater (Free Trip Voucher!)"><label for="$100 or Greater (Free Trip Voucher!)_C4923qNs3v06qje5eQmQ_3_8l52zjvxd8g" style="margin-left: 10px; margin-bottom: 0px;">$100 or Greater (Free Trip Voucher!)</label></div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="option-radio-image" data-v-35cf6ca8="">
<div class="form-builder--item form-builder--item-input"><!----><label>Select Your Vacation Destination (For Donors $100 or greater) <!----></label></div>
<div class="row container-group-image p-0">
<div class="option-radio col-md-3 col-sm-6 col-6 px-2">
<div><input id="Jerusalem 5 Days/ 4 Nights Retail Value $986 Est Tax:$157.64 _Uc5oowwNxsrNPkOYtb4G_0_8l52zjvxd8g" name="Uc5oowwNxsrNPkOYtb4G" type="radio" data-required="false"
value="Jerusalem 5 Days/ 4 Nights Retail Value $986 Est Tax:$157.64 ">
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<div class="opt-container-img-label">
<picture class="hl-image-picture radio-image-option-set-image py-2">
<source media="(max-width:900px) and (min-width: 768px)"
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<source media="(max-width:768px) and (min-width: 640px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_768/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F4a7b1ece-6728-415f-9f70-b2b3ec2b211a.png?alt=media&token=d6110f2b-72e4-4222-a711-8cd1ec8753f7">
<source media="(max-width:640px) and (min-width: 480px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_640/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F4a7b1ece-6728-415f-9f70-b2b3ec2b211a.png?alt=media&token=d6110f2b-72e4-4222-a711-8cd1ec8753f7">
<source media="(max-width:480px) and (min-width: 320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_480/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F4a7b1ece-6728-415f-9f70-b2b3ec2b211a.png?alt=media&token=d6110f2b-72e4-4222-a711-8cd1ec8753f7">
<source media="(max-width:320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_320/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F4a7b1ece-6728-415f-9f70-b2b3ec2b211a.png?alt=media&token=d6110f2b-72e4-4222-a711-8cd1ec8753f7">
<img
src="https://images.leadconnectorhq.com/img/f_webp/q_100/r_1200/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F4a7b1ece-6728-415f-9f70-b2b3ec2b211a.png?alt=media&token=d6110f2b-72e4-4222-a711-8cd1ec8753f7"
class="hl-optimized" loading="lazy" style="height: auto !important; width: auto !important;">
</picture>
</div>
</label>
<div class="img-opt-title">Jerusalem 5 Days/ 4 Nights Retail Value $986 Est Tax:$157.64 </div>
</div>
</div>
</div>
<div class="option-radio col-md-3 col-sm-6 col-6 px-2">
<div><input id="Cancun 6 Days/4 Nights Retail Value $1,294 Est Tax:$154.48_Uc5oowwNxsrNPkOYtb4G_1_8l52zjvxd8g" name="Uc5oowwNxsrNPkOYtb4G" type="radio" data-required="false"
value="Cancun 6 Days/4 Nights Retail Value $1,294 Est Tax:$154.48">
<div class="radio-image-option-set"><label for="Cancun 6 Days/4 Nights Retail Value $1,294 Est Tax:$154.48_Uc5oowwNxsrNPkOYtb4G_1_8l52zjvxd8g" class="pl-0">
<div class="opt-container-img-label">
<picture class="hl-image-picture radio-image-option-set-image py-2">
<source media="(max-width:900px) and (min-width: 768px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_900/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F65db58f6-7ab9-4b09-8493-71b76b55e897.png?alt=media&token=b135209e-35f1-408e-923d-bbee995f9a21">
<source media="(max-width:768px) and (min-width: 640px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_768/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F65db58f6-7ab9-4b09-8493-71b76b55e897.png?alt=media&token=b135209e-35f1-408e-923d-bbee995f9a21">
<source media="(max-width:640px) and (min-width: 480px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_640/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F65db58f6-7ab9-4b09-8493-71b76b55e897.png?alt=media&token=b135209e-35f1-408e-923d-bbee995f9a21">
<source media="(max-width:480px) and (min-width: 320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_480/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F65db58f6-7ab9-4b09-8493-71b76b55e897.png?alt=media&token=b135209e-35f1-408e-923d-bbee995f9a21">
<source media="(max-width:320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_320/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F65db58f6-7ab9-4b09-8493-71b76b55e897.png?alt=media&token=b135209e-35f1-408e-923d-bbee995f9a21">
<img
src="https://images.leadconnectorhq.com/img/f_webp/q_100/r_1200/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F65db58f6-7ab9-4b09-8493-71b76b55e897.png?alt=media&token=b135209e-35f1-408e-923d-bbee995f9a21"
class="hl-optimized" loading="lazy" style="height: auto !important; width: auto !important;">
</picture>
</div>
</label>
<div class="img-opt-title">Cancun 6 Days/4 Nights Retail Value $1,294 Est Tax:$154.48</div>
</div>
</div>
</div>
<div class="option-radio col-md-3 col-sm-6 col-6 px-2">
<div><input id="Las Vegas 4 Days/3 Nights Retail Value $970 Est Tax:$99.69_Uc5oowwNxsrNPkOYtb4G_2_8l52zjvxd8g" name="Uc5oowwNxsrNPkOYtb4G" type="radio" data-required="false"
value="Las Vegas 4 Days/3 Nights Retail Value $970 Est Tax:$99.69">
<div class="radio-image-option-set"><label for="Las Vegas 4 Days/3 Nights Retail Value $970 Est Tax:$99.69_Uc5oowwNxsrNPkOYtb4G_2_8l52zjvxd8g" class="pl-0">
<div class="opt-container-img-label">
<picture class="hl-image-picture radio-image-option-set-image py-2">
<source media="(max-width:900px) and (min-width: 768px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_900/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F7e24af35-4e25-459c-b82a-72910ef03b90.jpeg?alt=media&token=5bdd43ba-dd3b-4268-9a24-006a58c0d429">
<source media="(max-width:768px) and (min-width: 640px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_768/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F7e24af35-4e25-459c-b82a-72910ef03b90.jpeg?alt=media&token=5bdd43ba-dd3b-4268-9a24-006a58c0d429">
<source media="(max-width:640px) and (min-width: 480px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_640/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F7e24af35-4e25-459c-b82a-72910ef03b90.jpeg?alt=media&token=5bdd43ba-dd3b-4268-9a24-006a58c0d429">
<source media="(max-width:480px) and (min-width: 320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_480/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F7e24af35-4e25-459c-b82a-72910ef03b90.jpeg?alt=media&token=5bdd43ba-dd3b-4268-9a24-006a58c0d429">
<source media="(max-width:320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_320/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F7e24af35-4e25-459c-b82a-72910ef03b90.jpeg?alt=media&token=5bdd43ba-dd3b-4268-9a24-006a58c0d429">
<img
src="https://images.leadconnectorhq.com/img/f_webp/q_100/r_1200/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F7e24af35-4e25-459c-b82a-72910ef03b90.jpeg?alt=media&token=5bdd43ba-dd3b-4268-9a24-006a58c0d429"
class="hl-optimized" loading="lazy" style="height: auto !important; width: auto !important;">
</picture>
</div>
</label>
<div class="img-opt-title">Las Vegas 4 Days/3 Nights Retail Value $970 Est Tax:$99.69</div>
</div>
</div>
</div>
<div class="option-radio col-md-3 col-sm-6 col-6 px-2">
<div><input id="Orlando 4 Days/3 Nights Retail Value $885 Est Tax:$115.00_Uc5oowwNxsrNPkOYtb4G_3_8l52zjvxd8g" name="Uc5oowwNxsrNPkOYtb4G" type="radio" data-required="false"
value="Orlando 4 Days/3 Nights Retail Value $885 Est Tax:$115.00">
<div class="radio-image-option-set"><label for="Orlando 4 Days/3 Nights Retail Value $885 Est Tax:$115.00_Uc5oowwNxsrNPkOYtb4G_3_8l52zjvxd8g" class="pl-0">
<div class="opt-container-img-label">
<picture class="hl-image-picture radio-image-option-set-image py-2">
<source media="(max-width:900px) and (min-width: 768px)"
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<source media="(max-width:768px) and (min-width: 640px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_768/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F1e8d07ba-84c1-44d9-916b-f52ec72601a4.jpeg?alt=media&token=687e9c3b-58f3-4c6d-a73a-fbc1cc2db4a0">
<source media="(max-width:640px) and (min-width: 480px)"
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<source media="(max-width:480px) and (min-width: 320px)"
srcset="https://images.leadconnectorhq.com/img/f_webp/q_100/r_480/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F1e8d07ba-84c1-44d9-916b-f52ec72601a4.jpeg?alt=media&token=687e9c3b-58f3-4c6d-a73a-fbc1cc2db4a0">
<source media="(max-width:320px)"
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<img
src="https://images.leadconnectorhq.com/img/f_webp/q_100/r_1200/u_https://firebasestorage.googleapis.com/v0/b/highlevel-backend.appspot.com/o/location%2FiQdNNyFNcG1QLn9c4lTW%2Fcustom-field-store%2F1e8d07ba-84c1-44d9-916b-f52ec72601a4.jpeg?alt=media&token=687e9c3b-58f3-4c6d-a73a-fbc1cc2db4a0"
class="hl-optimized" loading="lazy" style="height: auto !important; width: auto !important;">
</picture>
</div>
</label>
<div class="img-opt-title">Orlando 4 Days/3 Nights Retail Value $885 Est Tax:$115.00</div>
</div>
</div>
</div><!---->
</div>
</div>
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-odd form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item heading-element" data-v-35cf6ca8="">
<div class="text-element" style="color:#000000;font-family:inherit;font-size:16px;font-weight:400;text-align:center;line-height:1.2;">
<div>For a donation to your church of at least $100, you will receive a complimentary stay at a resort of your choice above. You are responsible for transportation & hotel taxes plus applicable fees. </div>
</div>
</div><!---->
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item field-container form-builder--item-input" data-v-35cf6ca8=""><!----><label>Email <span>*</span></label><input placeholder="Email" name="email" type="email" class="form-control" data-required="true"><!---->
</div><!---->
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-address" class="form-builder--item form-builder--item-input"><!----><label>Address <!----></label><input type="text" placeholder="Address" name="address" class="form-control" id="address" data-required="false"><!---->
</div>
</div>
</div><!---->
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-odd form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-city" class="form-builder--item form-builder--item-input"><!----><label>City <!----></label><input type="text" placeholder="City" name="city" class="form-control" id="city" data-required="false"><!----></div>
</div>
</div><!---->
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-state" class="form-builder--item form-builder--item-input"><!----><label>State <!----></label><input type="text" placeholder="State" name="state" class="form-control" id="state" data-required="false"><!----></div>
</div>
</div><!---->
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-odd form-field-container" data-v-35cf6ca8="">
<div data-v-35cf6ca8="">
<div class="field-container">
<div id="form-postal_code" class="form-builder--item form-builder--item-input"><!----><label>Postal code <!----></label><input type="text" placeholder="Postal Code" name="postal_code" class="form-control" id="postal_code"
data-required="false"><!----></div>
</div>
</div><!---->
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item heading-element" data-v-35cf6ca8="">
<div class="text-element" style="color:#000000;font-family:inherit;font-size:18px;font-weight:400;text-align:center;line-height:1.2;">
<div>Just a few more questions from our sponsors! Please support them as they help make this happen and 100% of all donations go to the church!</div>
</div>
</div><!---->
</div>
</div>
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-odd form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-35cf6ca8=""><!----><label>I'm interested in a free, no-obligation retirement check <span>*</span></label>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="Yes_v1KBHIC0jTlXqk9HsqLL_0_8l52zjvxd8g" type="radio" data-required="true" value="Yes"><label for="Yes_v1KBHIC0jTlXqk9HsqLL_0_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">Yes</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="No_v1KBHIC0jTlXqk9HsqLL_1_8l52zjvxd8g" type="radio" data-required="true" value="No"><label for="No_v1KBHIC0jTlXqk9HsqLL_1_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">No</label></div>
</div><!----><!---->
</div>
<div class="field-divider" data-v-35cf6ca8=""></div>
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-35cf6ca8=""><!----><label>I am interested in a free, no-obligation life insurance for myself or my children. <span>*</span></label>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="Yes_0OFLAzEnhx0D6mBzX7ut_0_8l52zjvxd8g" type="radio" data-required="true" value="Yes"><label for="Yes_0OFLAzEnhx0D6mBzX7ut_0_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">Yes</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="No_0OFLAzEnhx0D6mBzX7ut_1_8l52zjvxd8g" type="radio" data-required="true" value="No"><label for="No_0OFLAzEnhx0D6mBzX7ut_1_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">No</label></div>
</div><!----><!---->
</div><!---->
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-35cf6ca8=""><!----><label>I'm interested in buying, selling or refinancing a home <span>*</span></label>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="Yes_sxpeczm9zkV1BWiFnmow_0_8l52zjvxd8g" type="radio" data-required="true" value="Yes"><label for="Yes_sxpeczm9zkV1BWiFnmow_0_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">Yes</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="No_sxpeczm9zkV1BWiFnmow_1_8l52zjvxd8g" type="radio" data-required="true" value="No"><label for="No_sxpeczm9zkV1BWiFnmow_1_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">No</label></div>
</div><!----><!---->
</div><!---->
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-35cf6ca8=""><!----><label>I am interested in learning more about business funding, line of credit, or equipment loans. <span>*</span></label>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="Yes_KfmMEiKOXeizbLbhlD6S_0_8l52zjvxd8g" type="radio" data-required="true" value="Yes"><label for="Yes_KfmMEiKOXeizbLbhlD6S_0_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">Yes</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="No_KfmMEiKOXeizbLbhlD6S_1_8l52zjvxd8g" type="radio" data-required="true" value="No"><label for="No_KfmMEiKOXeizbLbhlD6S_1_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">No</label></div>
</div><!----><!---->
</div><!---->
</div>
</div><!--]-->
</div>
</div>
<div class="form-builder--wrap-questions ghl-question" data-v-35cf6ca8="">
<div class="fields-container row" data-v-35cf6ca8=""><!--[-->
<div class="menu-field-wrap col-12" data-v-35cf6ca8="">
<div class="f-even form-field-container" data-v-35cf6ca8=""><!---->
<div class="form-builder--item form-builder--item-input" data-v-35cf6ca8=""><!----><label>I'm interested in ZERO-DOWN solar for my home <span>*</span></label>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="Yes_WEtd6zzioOCVXcI88rGw_0_8l52zjvxd8g" type="radio" data-required="true" value="Yes"><label for="Yes_WEtd6zzioOCVXcI88rGw_0_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">Yes</label></div>
</div>
<div class="option-radio">
<div style="display: flex; align-items: center; margin-bottom: 5px;"><input id="No_WEtd6zzioOCVXcI88rGw_1_8l52zjvxd8g" type="radio" data-required="true" value="No"><label for="No_WEtd6zzioOCVXcI88rGw_1_8l52zjvxd8g"
style="margin-left: 10px; margin-bottom: 0px;">No</label></div>
</div><!----><!---->
</div><!---->
</div>
</div><!--]-->
</div>
</div><!--]-->
</div><!---->
<div class="ghl-footer" data-v-35cf6ca8=""><!---->
<div class="ghl-button-bar" data-v-35cf6ca8=""><!---->
<div class="ghl-btn-align ghl-next-prev" data-v-35cf6ca8=""><button type="button" role="button" class="ghl-button ghl-next-button ghl-mobile-next" aria-label="next button" style="display:block;" data-v-35cf6ca8=""><span
class="right-pointing-triangle" data-v-35cf6ca8=""></span></button></div><!---->
</div>
<div class="ghl-progress-bar" role="progressbar" aria-valuemin="0" aria-valuemax="100" aria-valuenow="0" data-v-35cf6ca8="">
<div class="ghl-progress-bar-text" data-v-35cf6ca8="">0% </div>
<div class="ghl-progress-bar-background" data-v-35cf6ca8="">
<div style="width:0%;" class="ghl-progress-bar-inner" data-v-35cf6ca8=""></div>
</div>
</div>
</div>
</form>Text Content
DONATE NOW [CHURCH NAME] NEEDS YOUR HELP! EVERY DOLLAR MAKES A DIFFERENCE. 100% OF THE PROCEEDS SUPPORTS OUR CHURCH. FILL OUT THE DONATION FORM AND HELP OUR SPONSORS WITH A FEW QUESTIONS. WITHOUT THEIR HELP WE WOULDN'T BE ABLE TO GIVE SUCH GREAT TRIPS FOR DONATIONS OVER $100! First Name * Last Name * Phone * Our church will reach out to you with a link via text or we will call you for pay over phone. I will Donate the following amount: $5-24 $25-49 $51-99 $100 or Greater (Free Trip Voucher!) Select Your Vacation Destination (For Donors $100 or greater) Jerusalem 5 Days/ 4 Nights Retail Value $986 Est Tax:$157.64 Cancun 6 Days/4 Nights Retail Value $1,294 Est Tax:$154.48 Las Vegas 4 Days/3 Nights Retail Value $970 Est Tax:$99.69 Orlando 4 Days/3 Nights Retail Value $885 Est Tax:$115.00 For a donation to your church of at least $100, you will receive a complimentary stay at a resort of your choice above. You are responsible for transportation & hotel taxes plus applicable fees. Email * Address City State Postal code Just a few more questions from our sponsors! Please support them as they help make this happen and 100% of all donations go to the church! I'm interested in a free, no-obligation retirement check * Yes No I am interested in a free, no-obligation life insurance for myself or my children. * Yes No I'm interested in buying, selling or refinancing a home * Yes No I am interested in learning more about business funding, line of credit, or equipment loans. * Yes No I'm interested in ZERO-DOWN solar for my home * Yes No 0% PRINCIPALS: CLAIM A SPORTS EQUIPMENT DONATION FOR YOUR SCHOOL! COMPLETE THIS FORM TO CLAIM THE SPORTS EQUIPMENT DONATION FOR YOUR SCHOOL! Principal/Contact Person First Name * Principal/Contact Person Last Name * Principal/Contact Person Email * Principal/Contact Person Cell Phone (for text confirmation) * School Name * Date for Staff Meeting * Time of Staff Meeting * Number of Staff Expected at Staff Meeting? * Submit Form QUESTIONS? You can reach Javier Rodriguez via call/text at (562) 237-3683. © 2023 Independent representative of Life Insurance Company of the Southwest (LSW). Approved vendor with the LAUSD. This campaign is NOT affiliated with nor endorsed by the LAUSD. 562-237-3683