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give.secure.donateright.com Open in urlscan Pro
18.224.118.88  Public Scan

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URL: https://give.secure.donateright.com/team-asa-jfc/donate
Submission: On August 17 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST https://give.secure.donateright.com//?id=231

<form class="ui small form" action="https://give.secure.donateright.com//?id=231" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="authenticity_token"
    value="9sKXUXTw5ixToSGYrhT6+HYF0zYqLd7cl/AHaW/IAN37JvPy0In5ocECw3n/QfdfoGnJ+qD75szCkg1vvt0e8w==">
  <div class="field donation-form-header-image size-medium">
    <img src="https://mystique-bucket-prod.s3.us-east-2.amazonaws.com/donation_page/231/form_header_image/small_7a9372c9-0c55-4141-9e7c-be660fa9a147.png">
  </div>
  <!--media-->
  <h2 class="sub-header"></h2>
  <div class="donation-body"></div>
  <div class="field donation-form-header">
    <p style="text-align:center;"><span style="color:#354b70;"><span style="font-size:16px;"><strong>Donate TODAY to support<br> Asa Hutchinson for President!</strong></span></span></p>
    <p style="text-align:center;"><span style="color:#354b70;"><span style="font-size:16px;"><em>"I am optimistic about the future of America because together, we can move our nation in the right direction -&nbsp;an America that is strong and free."
            -</em>&nbsp;Gov. Asa Hutchinson</span></span></p>
  </div>
  <h3>Select Amount</h3>
  <input id="amount-initial" type="hidden" name="payment[amount_initial]" value="0">
  <input id="amount-to-donate" type="hidden" name="payment[amount]" value="">
  <input id="amount-prefill" type="hidden" name="payment[amount-prefill]" value="">
  <div id="amounts-container">
    <div class="four fields">
      <div id="donation-amount-50" class="four wide field donation-amount" data-amount="50">
        <div class="ui button">
          <span>$50</span>
        </div>
      </div>
      <div id="donation-amount-100" class="four wide field donation-amount" data-amount="100">
        <div class="ui button">
          <span>$100</span>
        </div>
      </div>
      <div id="donation-amount-250" class="four wide field donation-amount" data-amount="250">
        <div class="ui button">
          <span>$250</span>
        </div>
      </div>
      <div id="donation-amount-1000" class="four wide field donation-amount" data-amount="1000">
        <div class="ui button">
          <span>$1,000</span>
        </div>
      </div>
    </div>
    <div class="four fields">
      <div id="donation-amount-3300" class="four wide field donation-amount" data-amount="3300">
        <div class="ui button">
          <span>$3,300</span>
        </div>
      </div>
      <div id="donation-amount-6600" class="four wide field donation-amount" data-amount="6600">
        <div class="ui button">
          <span>$6,600</span>
        </div>
      </div>
      <div id="donation-amount-11600" class="four wide field donation-amount" data-amount="11600">
        <div class="ui button">
          <span>$11,600</span>
        </div>
      </div>
      <div class="four wide field custom-amount">
        <div class="ui labeled input">
          <div class="ui basic label">$</div>
          <input placeholder="Other" name="donation-amount-custom" id="donation-amount-custom" type="number" pattern="\d*" step=".01">
        </div>
      </div>
    </div>
  </div>
  <input id="minimum-amount" type="hidden" value="1">
  <input id="maximum-amount" type="hidden">
  <div class="field recurring-donation-wrapper" id="recurring-donation-wrapper">
    <div id="donation-frequency-text">
      <p>Join donors who power this movement each month.</p>
    </div>
    <div id="recurring-donation" class="" style="background-color:#FBFF65">
      <label for="payment[recurring_donation]"> Make this contribution <strong>monthly</strong><strong></strong>? </label>
      <div class="inline fields">
        <div class="field">
          <div class="ui radio checkbox">
            <input id="recurring-radio-yes" type="radio" name="payment[recurring_donation]" value="true" class="hidden" tabindex="0">
            <label for="recurring-radio-yes">Yes</label>
          </div>
        </div>
        <div class="field">
          <div class="ui radio checkbox">
            <input id="recurring-radio-no" type="radio" name="payment[recurring_donation]" value="false" checked="checked" class="hidden" tabindex="0">
            <label for="recurring-radio-no">No</label>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div id="full-view-container" style="">
    <div id="cc-billing-information">
      <h3 id="billing-information">Billing Information</h3>
      <div class="two fields">
        <div class="field">
          <input type="text" id="first-name" name="payment[first_name]" placeholder="First Name" value="">
        </div>
        <div class="field">
          <input type="text" id="last-name" name="payment[last_name]" placeholder="Last Name" value="">
        </div>
      </div>
      <div class="two fields">
        <div class="twelve wide field">
          <input type="text" id="street-address" name="payment[street_address]" placeholder="Street Address" value="">
        </div>
        <div class="four wide field">
          <input type="text" id="apartment" name="payment[apt]" placeholder="Apt. #" value="">
        </div>
      </div>
      <div class="three fields">
        <div class="four wide field">
          <input type="tel" id="zip-code" name="payment[zip_code]" placeholder="ZIP" value="" pattern="(\d{5}([\-]\d{4})?)" maxlength="10">
        </div>
        <div class="seven wide field">
          <input type="text" id="city" name="payment[city]" placeholder="City" value="">
        </div>
        <div class="five wide field">
          <input type="hidden" id="prefill-state" name="prefill-state" value="">
          <div class="ui search dropdown selection"><select id="state" name="payment[state]">
              <option value="">State</option>
              <option value="AL">Alabama</option>
              <option value="AK">Alaska</option>
              <option value="AZ">Arizona</option>
              <option value="AR">Arkansas</option>
              <option value="CA">California</option>
              <option value="CO">Colorado</option>
              <option value="CT">Connecticut</option>
              <option value="DE">Delaware</option>
              <option value="DC">District of Columbia</option>
              <option value="FL">Florida</option>
              <option value="GA">Georgia</option>
              <option value="HI">Hawaii</option>
              <option value="ID">Idaho</option>
              <option value="IL">Illinois</option>
              <option value="IN">Indiana</option>
              <option value="IA">Iowa</option>
              <option value="KS">Kansas</option>
              <option value="KY">Kentucky</option>
              <option value="LA">Louisiana</option>
              <option value="ME">Maine</option>
              <option value="MD">Maryland</option>
              <option value="MA">Massachusetts</option>
              <option value="MI">Michigan</option>
              <option value="MN">Minnesota</option>
              <option value="MS">Mississippi</option>
              <option value="MO">Missouri</option>
              <option value="MT">Montana</option>
              <option value="NE">Nebraska</option>
              <option value="NV">Nevada</option>
              <option value="NH">New Hampshire</option>
              <option value="NJ">New Jersey</option>
              <option value="NM">New Mexico</option>
              <option value="NY">New York</option>
              <option value="NC">North Carolina</option>
              <option value="ND">North Dakota</option>
              <option value="OH">Ohio</option>
              <option value="OK">Oklahoma</option>
              <option value="OR">Oregon</option>
              <option value="PA">Pennsylvania</option>
              <option value="RI">Rhode Island</option>
              <option value="SC">South Carolina</option>
              <option value="SD">South Dakota</option>
              <option value="TN">Tennessee</option>
              <option value="TX">Texas</option>
              <option value="UT">Utah</option>
              <option value="VT">Vermont</option>
              <option value="VA">Virginia</option>
              <option value="WA">Washington</option>
              <option value="WV">West Virginia</option>
              <option value="WI">Wisconsin</option>
              <option value="WY">Wyoming</option>
              <option value="spacer-0" disabled="disabled">——————————————————————</option>
              <option value="AS">American Samoa</option>
              <option value="FM">Federated States of Micronesia</option>
              <option value="GU">Guam</option>
              <option value="MH">Marshall Islands</option>
              <option value="MP">Northern Mariana Islands</option>
              <option value="PW">Palau</option>
              <option value="PR">Puerto Rico</option>
              <option value="VI">Virgin Islands</option>
              <option value="spacer-1" disabled="disabled">——————————————————————</option>
              <option value="AA">Armed Forces Americas</option>
              <option value="AE">Armed Forces Europe, Middle East, &amp; Canada</option>
              <option value="AP">Armed Forces Pacific</option>
            </select><i class="dropdown icon"></i><input class="search" autocomplete="off" tabindex="0">
            <div class="default text">State</div>
            <div class="menu" tabindex="-1">
              <div class="item" data-value="AL">Alabama</div>
              <div class="item" data-value="AK">Alaska</div>
              <div class="item" data-value="AZ">Arizona</div>
              <div class="item" data-value="AR">Arkansas</div>
              <div class="item" data-value="CA">California</div>
              <div class="item" data-value="CO">Colorado</div>
              <div class="item" data-value="CT">Connecticut</div>
              <div class="item" data-value="DE">Delaware</div>
              <div class="item" data-value="DC">District of Columbia</div>
              <div class="item" data-value="FL">Florida</div>
              <div class="item" data-value="GA">Georgia</div>
              <div class="item" data-value="HI">Hawaii</div>
              <div class="item" data-value="ID">Idaho</div>
              <div class="item" data-value="IL">Illinois</div>
              <div class="item" data-value="IN">Indiana</div>
              <div class="item" data-value="IA">Iowa</div>
              <div class="item" data-value="KS">Kansas</div>
              <div class="item" data-value="KY">Kentucky</div>
              <div class="item" data-value="LA">Louisiana</div>
              <div class="item" data-value="ME">Maine</div>
              <div class="item" data-value="MD">Maryland</div>
              <div class="item" data-value="MA">Massachusetts</div>
              <div class="item" data-value="MI">Michigan</div>
              <div class="item" data-value="MN">Minnesota</div>
              <div class="item" data-value="MS">Mississippi</div>
              <div class="item" data-value="MO">Missouri</div>
              <div class="item" data-value="MT">Montana</div>
              <div class="item" data-value="NE">Nebraska</div>
              <div class="item" data-value="NV">Nevada</div>
              <div class="item" data-value="NH">New Hampshire</div>
              <div class="item" data-value="NJ">New Jersey</div>
              <div class="item" data-value="NM">New Mexico</div>
              <div class="item" data-value="NY">New York</div>
              <div class="item" data-value="NC">North Carolina</div>
              <div class="item" data-value="ND">North Dakota</div>
              <div class="item" data-value="OH">Ohio</div>
              <div class="item" data-value="OK">Oklahoma</div>
              <div class="item" data-value="OR">Oregon</div>
              <div class="item" data-value="PA">Pennsylvania</div>
              <div class="item" data-value="RI">Rhode Island</div>
              <div class="item" data-value="SC">South Carolina</div>
              <div class="item" data-value="SD">South Dakota</div>
              <div class="item" data-value="TN">Tennessee</div>
              <div class="item" data-value="TX">Texas</div>
              <div class="item" data-value="UT">Utah</div>
              <div class="item" data-value="VT">Vermont</div>
              <div class="item" data-value="VA">Virginia</div>
              <div class="item" data-value="WA">Washington</div>
              <div class="item" data-value="WV">West Virginia</div>
              <div class="item" data-value="WI">Wisconsin</div>
              <div class="item" data-value="WY">Wyoming</div>
              <div class="disabled item" data-value="spacer-0">——————————————————————</div>
              <div class="item" data-value="AS">American Samoa</div>
              <div class="item" data-value="FM">Federated States of Micronesia</div>
              <div class="item" data-value="GU">Guam</div>
              <div class="item" data-value="MH">Marshall Islands</div>
              <div class="item" data-value="MP">Northern Mariana Islands</div>
              <div class="item" data-value="PW">Palau</div>
              <div class="item" data-value="PR">Puerto Rico</div>
              <div class="item" data-value="VI">Virgin Islands</div>
              <div class="disabled item" data-value="spacer-1">——————————————————————</div>
              <div class="item" data-value="AA">Armed Forces Americas</div>
              <div class="item" data-value="AE">Armed Forces Europe, Middle East, &amp; Canada</div>
              <div class="item" data-value="AP">Armed Forces Pacific</div>
            </div>
          </div>
        </div>
      </div>
      <div class="two fields">
        <div class="field">
          <input type="email" id="email-address" name="payment[email]" placeholder="Email" value="">
          <label for="email" type="hidden" id="email_error" style="color: rgb(159, 58, 56); display: none;"></label>
        </div>
        <div class="field">
          <input type="tel" id="phone" name="payment[phone]" placeholder="Phone" value="" pattern="\(?\d{3}[\)\-]? ?\d{3}[\-]?\d{4}" maxlength="12">
        </div>
      </div>
      <input id="phone_number_required" type="hidden" value="true">
      <input id="one_click_token_status" type="hidden" value="enable">
      <input id="phone_field_required" type="hidden" value="true">
    </div>
    <h3>Complete this section if making a joint contribution</h3>
    <div id="custom-field-description">
      <p>Spouse Name</p>
    </div>
    <div class="field">
      <input type="text" name="payment[custom_field_value_1]" placeholder="Spouse Name " value="" autocomplete="off" id="custom1">
    </div>
    <h3></h3>
    <div id="custom-field-description">
      <p>Spouse Employer and Occupation</p>
    </div>
    <div class="field">
      <input type="text" name="payment[custom_field_value_2]" placeholder="Spouse Employer and Occupation" value="" autocomplete="off" id="custom2">
    </div>
    <h3>Employment Information</h3>
    <div class="single-form-text">
      <p>Campaign finance law requires us to obtain and report your occupation and the name of your employer.</p>
    </div>
    <div class="field">
      <div class="ui checkbox">
        <input type="hidden" name="payment[retired]" value="false" tabindex="-1">
        <input type="checkbox" id="retired" name="payment[retired]" value="true" tabindex="0" class="hidden">
        <label>Check here if you are <strong>retired</strong>.</label>
      </div>
    </div>
    <div id="retired-fields" class="two fields">
      <div class="field">
        <input type="text" id="employer" name="payment[employer]" placeholder="Employer Name" value="">
      </div>
      <div class="field">
        <input type="text" id="occupation" name="payment[occupation]" placeholder="Occupation" value="">
      </div>
    </div>
    <h3 id="payment-information">Payment Information</h3>
    <div id="payment-tabs" style="display: none;">
      <div id="tab-cc" class="tab active" data-method="cc" data-processor="stripe" data-support-recurring="true" data-support-cover-processing="true" data-active="true">Credit Card</div>
      <div id="tab-wallet" class="tab" data-method="wallet" data-processor="stripe" data-support-recurring="true" data-support-cover-processing="true" data-active="false"></div>
    </div>
    <div id="cc-payment-information">
      <input id="cc-exp" type="hidden" class="paymentInput cc-exp" name="cc-exp" placeholder="MM / YY" autocomplete="off">
      <input id="expiration-month" name="payment[expiration_month]" type="hidden" value="0">
      <input id="expiration-year" name="payment[expiration_year]" type="hidden" value="0">
      <input id="card-last-4" name="payment[card_number]" type="hidden">
      <input id="card-type" name="payment[card_type]" type="hidden">
      <input id="cvv" name="payment[cvv]" type="hidden" value="123">
      <div id="payment-element" class="StripeElement">
        <div class="__PrivateStripeElement"
          style="margin: -4px 0px !important; padding: 0px !important; border: none !important; display: block !important; background: transparent !important; position: relative !important; opacity: 1 !important; clear: both !important; transition: height 0.35s ease 0s !important;">
          <iframe name="__privateStripeFrame25614" frameborder="0" allowtransparency="true" scrolling="no" role="presentation" allow="payment *"
            src="https://js.stripe.com/v3/elements-inner-payment-d516c84137de910390d2a5bdb856b854.html#wait=false&amp;rtl=false&amp;publicOptions[fields][billingDetails][address][country]=never&amp;publicOptions[fields][billingDetails][address][postalCode]=never&amp;componentName=payment&amp;keyMode=live&amp;apiKey=pk_live_51KgZLKItl8ymKSVHom9HBZkAA8nYhsGYSPGcU6f380SiGrl95FRaEelHaUCKu0oC7xkOVA1EpqTMOYv4yWnel9fo00UsLjM5NW&amp;referrer=https%3A%2F%2Fgive.secure.donateright.com%2Fteam-asa-jfc%2Fdonate&amp;controllerId=__privateStripeController2561"
            title="Secure payment input frame"
            style="border: none !important; margin: -4px; padding: 0px !important; width: calc(100% + 8px); min-width: 100% !important; overflow: hidden !important; display: block !important; user-select: none !important; transform: translate(0px) !important; color-scheme: light only !important; height: 138.375px; opacity: 1; transition: opacity 0.4s ease 0.1s;"></iframe>
        </div>
      </div>
      <div id="card-errors"></div>
    </div>
  </div>
  <div class="field">
    <input type="hidden" id="source-code" name="payment[source_code]" value="">
    <input type="hidden" id="sku" name="payment[product_sku]" value="">
    <input type="hidden" id="fundraiser-id" name="payment[fundraiser_id]" value="">
    <input type="hidden" id="payment-processor" name="payment[processor]" value="stripe">
    <input type="hidden" id="donation-page-id" name="donation_page_id" value="231">
    <input type="hidden" id="nonce" name="nonce" value="d095088c-3c97-11ee-8ab4-0a58a9feac02">
    <input type="hidden" id="verify-email" name="verify_email" value="true">
    <input type="hidden" id="brite_verify_status" name="payment[brite_verify_status]" value="Not Verified">
    <input type="hidden" id="brite_verify_error_code" name="payment[brite_verify_error_code]" value="">
    <input type="hidden" id="brite_verify_disposable" name="payment[brite_verify_disposable]" value="false">
    <input type="hidden" id="brite_verify_roles_address" name="payment[brite_verify_roles_address]" value="false">
    <input type="hidden" id="verify_email_prompt_to_user" name="verify_email_prompt_to_user" value="false">
  </div>
  <div id="payment-buttons" class="field">
    <div class="payment-button-container" id="pay-cc">
      <button id="contribute-button" class="ui fluid blue submit button" value="contribute-button">Contribute <span id="contribution-amount"></span></button>
    </div>
    <div class="payment-button-container" id="pay-wallet">
      <div id="payment-request-button" class="StripeElement">
        <div class="__PrivateStripeElement" style="margin: 0px !important; padding: 0px !important; border: none !important; display: block !important; background: transparent !important; position: relative !important; opacity: 1 !important;"><iframe
            name="__privateStripeFrame25611" frameborder="0" allowtransparency="true" scrolling="no" role="presentation" allow="payment *"
            src="https://js.stripe.com/v3/elements-inner-payment-request-78936400431c2a78681bd298aef270b4.html#deferredIntent[mode]=payment&amp;deferredIntent[currency]=usd&amp;deferredIntent[amount]=1099&amp;wait=false&amp;mids[guid]=NA&amp;mids[muid]=NA&amp;mids[sid]=NA&amp;paymentMethodCreation=manual&amp;rtl=false&amp;componentName=paymentRequestButton&amp;keyMode=live&amp;apiKey=pk_live_51KgZLKItl8ymKSVHom9HBZkAA8nYhsGYSPGcU6f380SiGrl95FRaEelHaUCKu0oC7xkOVA1EpqTMOYv4yWnel9fo00UsLjM5NW&amp;referrer=https%3A%2F%2Fgive.secure.donateright.com%2Fteam-asa-jfc%2Fdonate&amp;controllerId=__privateStripeController2561"
            title="Secure payment button frame"
            style="border: none !important; margin: 0px !important; padding: 0px !important; width: 1px !important; min-width: 100% !important; overflow: hidden !important; display: block !important; user-select: none !important; transform: translate(0px) !important; color-scheme: light only !important; height: 40px; min-height: auto;"></iframe><input
            class="__PrivateStripeElement-input" aria-hidden="true" aria-label=" " autocomplete="false" maxlength="1"
            style="border: none !important; display: block !important; position: absolute !important; height: 1px !important; top: -1px !important; left: 0px !important; padding: 0px !important; margin: 0px !important; width: 100% !important; opacity: 0 !important; background: transparent !important; pointer-events: none !important; font-size: 16px !important;">
        </div>
      </div>
    </div>
    <div id="payment-request-amount-outer" style="display: none;">
      <div id="payment-request-amount-container"> Contribute <span id="payment-request-amount"></span>
      </div>
    </div>
  </div>
</form>

Text Content

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Your donation could not be processed because of the following errors:
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Donate TODAY to support
Asa Hutchinson for President!

"I am optimistic about the future of America because together, we can move our
nation in the right direction - an America that is strong and free." - Gov. Asa
Hutchinson


SELECT AMOUNT

$50
$100
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$1,000
$3,300
$6,600
$11,600
$

Join donors who power this movement each month.

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BILLING INFORMATION



State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware
District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas
Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi
Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York
North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West
Virginia Wisconsin Wyoming —————————————————————— American Samoa Federated
States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto
Rico Virgin Islands —————————————————————— Armed Forces Americas Armed Forces
Europe, Middle East, & Canada Armed Forces Pacific
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
——————————————————————
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
——————————————————————
Armed Forces Americas
Armed Forces Europe, Middle East, & Canada
Armed Forces Pacific



COMPLETE THIS SECTION IF MAKING A JOINT CONTRIBUTION

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EMPLOYMENT INFORMATION

Campaign finance law requires us to obtain and report your occupation and the
name of your employer.

Check here if you are retired.



PAYMENT INFORMATION

Credit Card



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Team Asa, Inc. is a joint fundraising committee comprised of and authorized by
Asa For America, Inc. and Asa PAC, Inc. Joint fundraising proceeds shall be
allocated among the committees as follows:

1. The first $3,300 ($5,000) to Asa For America, Inc. primary election account;
2. The next $5,000 ($5,000) to Asa PAC, Inc;
3. The remainder, up to $3,300 ($5,000) to Asa For America, Inc. general
election account.


Notwithstanding this allocation method set forth above, any contributor may
designate his or her contribution for a particular participant. In addition, the
allocation formula may change if a contributor makes a contribution which would
exceed the maximum legal amount that a contributor may give to a particular
participant.

The maximum amount an individual or non-multicandidate PAC (multicandidate PAC
in parenthesis) may contribute to Team Asa, Inc. is $11,600 ($15,000).

Contributions to Team Asa, Inc. are not tax deductible as charitable
contributions for federal income tax purposes. Contributions by corporations,
labor unions, foreign nationals, and federal government contractors are
prohibited.

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authorized by Asa For America, Inc. and Asa PAC, Inc.
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