mda.donordrive.com
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Submitted URL: https://click.comms.mdausa.org/?qs=abc3ee290e678be1f57afb13d46f3d3c25f94b7ecb0e252621e4cd1dfb8fc2dc5410c6c8c8a588ed3545181318e4...
Effective URL: https://mda.donordrive.com/index.cfm?fuseaction=donate.event&eventID=1166&referrer=20211223_YearEnd_E5_Active_DA&utm_source...
Submission: On December 23 via api from US — Scanned from DE
Effective URL: https://mda.donordrive.com/index.cfm?fuseaction=donate.event&eventID=1166&referrer=20211223_YearEnd_E5_Active_DA&utm_source...
Submission: On December 23 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: donate — POST index.cfm?
<form name="donate" id="donate" class="js-payment-form" action="index.cfm?" method="post" novalidate="novalidate">
<input type="hidden" name="donationData" id="donation-data">
<input type="hidden" name="recurring" id="recurring" value="1">
<input type="hidden" name="fulfillmentNoteExists" value="0">
<input type="hidden" name="formSubmit" value="1">
<input type="hidden" name="fuseaction" id="fuseaction" value="donate.ajaxConfirmValidate">
<h2></h2>
<fieldset class="dd-u-mb-40">
<legend>Your Donation</legend>
<input type="hidden" name="incentiveID" value="">
<input type="hidden" name="fulfillmentNote" value="">
<div class="control-group js-donation-option" style="display:none;">
<label class="control-label" for="donationOption"><strong class="required" aria-required="true">Donation Option<span>*</span></strong></label>
<div class="controls">
<div class="dd-u-tabs-gray-700 dd-u-flex dd-u-items-center">
<label class="dd-u-mb-0 js-recurring-monthly">
<input class="dd-u-sr-only" name="donationOption" type="radio" value="monthly">
<strong> Monthly </strong>
<div class="js-recurring-monthly" style="display:none;">
<span style="font-size: 20px; color: #888">per month</span>
</div>
</label>
</div>
</div>
</div>
<div class="control-group suggested-donation-option-group js-recurring-check-target js-processing-fee-check-target js-recurring-input-target">
<label class="control-label" for="donation-amount-input"><strong class="required" aria-required="true">Donation Amount per Month<span>*</span></strong></label>
<div class="controls">
<div class="js-amount-div post input-big" data-activity-label="Pledge Amount per " data-standard-label="Donation Amount" data-monthly-label="Donation Amount per Month">
<input type="hidden" name="donationAmount" id="donation-amount-input" value="0.00" aria-required="true">
<input type="hidden" name="suggestedDonationID" value="">
<input type="hidden" name="currency" id="currency" value="USD">
<input type="hidden" name="currencySymbol" id="currencysymbol" value=" $">
<div class="row-fluid js-option-container js-option-monthly" style="">
<div class="span12 js-donation-options" style="float: none;"><span class="js-option-simple dd-sda-option-simple">
<button type="button" class="dd-btn js-option js-option-title">$19</button>
</span><span class="js-option-simple dd-sda-option-simple">
<button type="button" class="dd-btn js-option js-option-title">$25</button>
</span><span class="js-option-simple dd-sda-option-simple">
<button type="button" class="dd-btn js-option js-option-title">$50</button>
</span><span class="js-option-simple dd-sda-option-simple">
<button type="button" class="dd-btn js-option js-option-title">$100</button>
</span><span class="js-option-simple dd-sda-option-simple">
<button type="button" class="dd-btn js-option js-option-title">$250</button>
</span><span class="js-option-simple dd-sda-option-simple">
<button type="button" class="dd-btn js-option js-option-title js-option-other">Your Best Gift</button>
</span></div>
</div>
</div>
</div>
</div>
<div class="control-group js-activity-pledge-max-amount js-processing-fee-check-target" style="display: none;">
<label class="control-label" for="activity-pledge-max-amount"><strong>Maximum Amount to Donate (Optional)</strong></label>
<div class="controls">
<div class="row-fluid">
<div class="pre post span8 input-big">
<span class="addon js-currency-symbol"> $</span>
<input type="text" placeholder="0" name="activityPledgeMaxAmount" id="activity-pledge-max-amount" class="span12 no-ms-clear" pattern="[0-9]*" inputmode="decimal" autocomplete="new-password">
<span class="addon" style="right: 15px">Total</span>
</div>
</div>
</div>
</div>
<div class="control-group js-processing-fee-check">
<div class="controls">
<label class="checkbox" style="padding-top: 0;">
<input type="checkbox" name="coverProcessingFee" value="1"> Yes! I’d like to cover processing costs. (<span class="js-processing-fee-amount">$0.00</span><span class="js-processing-fee-currency"></span><span
class="js-processing-fee-recurring-monthly" style="display: none;"> per month</span><span class="js-processing-fee-recurring-annual" style="display: none;"> per year</span><span class="js-processing-fee-activity-pledge"
style="display: none;"> per </span>) </label>
</div>
</div>
<div class="js-form-questions">
<input type="hidden" name="formID" value="3B81FFCF-CA40-C107-ADFCC8D01F88BEDB">
<fieldset class="control-group question" data-display-question-option-id="" data-question-type="radio" aria-hidden="false">
<legend class="control-label dd-c-legend">
<strong class="required" aria-required="true">Would you like to receive a tote bag? (a monthly donation of $19 or more is required)<span>*</span></strong>
</legend>
<input type="hidden" name="formQuestionID1" value="3BAD903E-9876-153D-5EB69820030E87CA">
<div class="controls">
<label class="radio">
<input type="radio" name="formQuestionOptionID1" id="formquestionoptionid1_1" value="3BAD911D-B50D-19D1-A1E5BCE16769EC80" data-question="receive_incentive" data-option="yes"> Yes - send me the tote bag! </label>
<label class="radio">
<input type="radio" name="formQuestionOptionID1" id="formquestionoptionid1_2" value="3BAD918C-A8AD-6FA1-B6A7509BA0FE65FA" data-question="receive_incentive" data-option="no"> No </label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="3BAD911D-B50D-19D1-A1E5BCE16769EC80" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote2"> Shipping Address (No PO Boxes) </label>
<input type="hidden" name="formQuestionID2" value="3BB332F3-FF2A-09FB-96E466C9E5F8734B">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID2" value="3BB333E1-0A9F-5C0B-CC71EAFFA51336D5">
<input type="text" maxlength="100" name="formQuestionNote2" id="formquestionnote2" data-question="shipping_address" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="3BAD911D-B50D-19D1-A1E5BCE16769EC80" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote3"> Shipping City </label>
<input type="hidden" name="formQuestionID3" value="3BBA1254-06B4-A799-04E7451CC4A64DC9">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID3" value="3BBA133B-E906-2AF8-0CB59B3C393E3F5C">
<input type="text" maxlength="100" name="formQuestionNote3" id="formquestionnote3" data-question="shipping_city" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="3BAD911D-B50D-19D1-A1E5BCE16769EC80" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote4"> Shipping State </label>
<input type="hidden" name="formQuestionID4" value="3BBF5F48-A804-87A3-343508E4A3B7137F">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID4" value="3BBF6044-B6DD-B2B0-4CA9E1B38B72872A">
<input type="text" maxlength="100" name="formQuestionNote4" id="formquestionnote4" data-question="shipping_state" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="3BAD911D-B50D-19D1-A1E5BCE16769EC80" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote5"> Shipping Zip Code </label>
<input type="hidden" name="formQuestionID5" value="3BC1F7C8-DB9C-A2AF-B9C3C36D2B372044">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID5" value="3BC1F899-9EDB-4E47-2010EDA03AFE35F4">
<input type="text" maxlength="100" name="formQuestionNote5" id="formquestionnote5" data-question="shipping_zip_code" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="" data-question-type="radio" aria-hidden="false">
<legend class="control-label dd-c-legend"> Would you like to make this donation in honor or memory of someone? </legend>
<input type="hidden" name="formQuestionID6" value="3B820055-0B01-B8E3-99D58C773AD25AF9">
<div class="controls">
<label class="radio">
<input type="radio" name="formQuestionOptionID6" id="formquestionoptionid6_1" value="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question="is_this_a_tribute_gift_" data-option="tribute"> Yes </label>
<label class="radio">
<input type="radio" name="formQuestionOptionID6" id="formquestionoptionid6_2" value="5FFCAEBE-AE6D-4FB0802F-2DE8356FA6E9" data-question="is_this_a_tribute_gift_" data-option="n"> No </label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="select" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionoptionid7"> Select type </label>
<input type="hidden" name="formQuestionID7" value="3B8200AC-DE57-4998-3AA06C1EC2DA6712">
<div class="controls">
<label class="select">
<select data-question="honor_gift_type" id="formquestionoptionid7" name="formQuestionOptionID7">
<option value="">[Select...]</option>
<option data-option="memorial" value="A1041B5A-AEB9-4AD685FE-D9656EED4A36">In Memory of</option>
<option data-option="honor" value="E950D12C-655C-476D95E1-1FAF273BE666">In Honor of</option>
</select>
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote8"> Honoree First Name </label>
<input type="hidden" name="formQuestionID8" value="3B820146-DDFE-F047-8D6B257033D7DE77">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID8" value="738CD08A-2E6B-41C6A625-62AF803F7C1F">
<input type="text" maxlength="100" name="formQuestionNote8" id="formquestionnote8" data-question="honoree_first_name" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote9"> Honoree Last Name </label>
<input type="hidden" name="formQuestionID9" value="3B820286-0B82-998E-5EC2090E84FBBD53">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID9" value="5C60E881-A8DC-40669ED9-BDABAF443B42">
<input type="text" maxlength="100" name="formQuestionNote9" id="formquestionnote9" data-question="honoree_last_name" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote10"> Notification Recipient Name </label>
<input type="hidden" name="formQuestionID10" value="3B820322-E5EF-01FA-1AF05E849B77F2C2">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID10" value="D559E07A-D48A-44278DC6-01B3E9A050D0">
<input type="text" maxlength="100" name="formQuestionNote10" id="formquestionnote10" data-question="notification_recipient_na" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote11"> Notification Recipient Address 1 </label>
<input type="hidden" name="formQuestionID11" value="3B8203B9-E6B7-BF79-9050448B83082B3D">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID11" value="6F778252-DA1F-4924A3BD-886937039F8F">
<input type="text" maxlength="100" name="formQuestionNote11" id="formquestionnote11" data-question="notification_recipient_ad" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote12"> Notification Recipient Address 2 </label>
<input type="hidden" name="formQuestionID12" value="3B820450-BDD5-B447-8A1C412D8CDF27EB">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID12" value="FF237798-5247-40B7B3CE-7A35B53240E1">
<input type="text" maxlength="100" name="formQuestionNote12" id="formquestionnote12" data-question="notification_ad2" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote13"> Notification Recipient City </label>
<input type="hidden" name="formQuestionID13" value="3B8204E7-9281-77A7-DB88B0520C68071C">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID13" value="C655E21D-C1A3-4526B903-FCAC24F8E98B">
<input type="text" maxlength="100" name="formQuestionNote13" id="formquestionnote13" data-question="notification_recipient_ci" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote14"> Notification Recipient State </label>
<input type="hidden" name="formQuestionID14" value="3B82057C-D9A3-891B-A212DF9B6A7A6268">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID14" value="A29BA103-1BDA-41E98151-D847D59DD775">
<input type="text" maxlength="100" name="formQuestionNote14" id="formquestionnote14" data-question="notification_recipient_st" value="">
</label>
</div>
</fieldset>
<fieldset class="control-group question" data-display-question-option-id="D3E98D7C-CFE9-4BEFA150-FA798BD49291" data-question-type="text" style="display:none;" aria-hidden="true">
<label class="control-label dd-u-font-700" for="formquestionnote15"> Notification Recipient Zip Code </label>
<input type="hidden" name="formQuestionID15" value="3B820618-910D-EA8E-F20B2A7E9E6BEF2F">
<div class="controls">
<label>
<input type="hidden" name="formQuestionOptionID15" value="8A2C3659-DFA8-4C33A9E1-AF7A63C2BA22">
<input type="text" maxlength="100" name="formQuestionNote15" id="formquestionnote15" data-question="notification_recipient_zi" value="">
</label>
</div>
</fieldset>
</div>
<fieldset class="control-group dd-matching-gifts dd-u-mb-0">
<legend class="control-label legend-label" style="margin-top: 0;">Corporate Giving</legend>
<div class="controls">
<label class="radio inline phone-block">
<input type="radio" name="giftType" value="matchingGift" selected="selected">
<strong>Individual Gift</strong>
</label>
<label class="radio inline phone-block">
<input type="radio" name="giftType" value="behalfOfCompany">
<strong>Gift on behalf of my company</strong>
</label>
</div>
<div class="control-group dd-matching-gifts dd-u-mt-0">
<div class="controls">
<div id="employer-matching" class="row-fluid" style="">
<p class="dd-u-mb-5 dd-u-mt-10" style="line-height: 20px;">See if your company will match your donation!</p>
<div class="js-append-company-name-input dd-u-w-full dd-u-relative" style="margin-left: 0;">
<input class="dd-u-w-full" type="text" name="matchingEmployer" id="matching-employer" maxlength="80" placeholder="Find your Employer" style="display: none;">
<button class="js-clear-matching-company dd-u-absolute dd-u-bg-none dd-u-border-none dd-u-cursor-pointer dd-u-flex dd-u-h-full dd-u-items-center dd-u-px-20 dd-u-right-0 dd-u-top-0" style="display: none;"><span class="dd-u-sr-only">Clear
matching company</span><i class="icon-remove icon dd-u-m-0" aria-hidden="true"></i> </button>
<div id="dd-company-name-input" data-doublethedonation-widget-id="G__2">
<div class="dtd-streamlined-plugin"><input type="hidden" name="doubledonation_status" value="no_interaction"><input type="hidden" name="doublethedonation_status" value="no_interaction"><input type="hidden"
name="doublethedonation_entered_text" value=""><input type="hidden" name="doubledonation_company_id" value=""><input type="hidden" name="doublethedonation_company_id" value=""><input type="hidden"
name="doubledonation_company_name" value=""><input type="hidden" name="doublethedonation_company_name" value="">
<div class="dtd-search-box" style="width: 100%; margin-bottom: 0px;">
<div aria-live="assertive" style="display: block; font-size: 0px; color: rgb(255, 255, 255); opacity: 0; position: absolute; height: 0px; margin: 0px; z-index: -99999;"></div>
<div aria-live="polite" style="display: block; font-size: 0px; color: rgb(255, 255, 255); opacity: 0; position: absolute; height: 0px; margin: 0px; z-index: -99999;"></div><input role="listbox" aria-expanded="false"
name="doublethedonation_company_name_input" type="text" id="dd-input" class="dtd-search-input form-control" autocomplete="off" aria-label="Search company" placeholder="Search company name..." style="width: 100%;">
</div>
</div>
</div>
</div>
</div>
<div class="new-user dd-u-mt-10" id="company-name-div" style="display:none;">
<label for="company-name">Company Name</label>
<input class="dd-u-w-full" type="text" name="companyName" id="company-name" maxlength="80" autocomplete="new-password">
</div>
<div class="js-selected-company-message dd-u-mt-20"></div>
</div>
</div>
</fieldset>
</fieldset>
<fieldset class="dd-u-mb-40">
<legend>Payment</legend>
<div class="control-group js-payment-type payment-options-group dd-u-mb-0">
<label class="control-label" for=""><strong class="required" aria-required="true">Payment Method<span>*</span></strong></label>
<div class="controls">
<label aria-label="Apple Pay" class="radio payment-type-option" style="display: none;" data-payment-type="APPLEPAY">
<input type="radio" name="paymentType" value="APPLEPAY" disabled="">
<img alt="Apple Pay" class="paymenttype" src="https://assets.donordrive.com/resources/img/apple-pay-mark.svg?v=202112211115">
</label>
<label aria-label="Credit Card" class="radio payment-type-option js-currency-usd" style="" data-payment-type="CC">
<input type="radio" name="paymentType" value="CC">
<span class="payment-type-option-icon" data-payment-state="new">
<img alt="Credit Card" class="paymenttype" src="https://assets.donordrive.com/resources/img/cc_gen.svg?v=202112211115"> <img style="display: none" alt="Visa" class="paymenttype visa"
src="https://assets.donordrive.com/resources/img/cc_visa.svg?v=202112211115"> <img style="display: none" alt="Mastercard" class="paymenttype mc" src="https://assets.donordrive.com/resources/img/cc_mc.svg?v=202112211115"> <img
style="display: none" alt="American Express" class="paymenttype amex" src="https://assets.donordrive.com/resources/img/cc_amex.svg?v=202112211115"> <img style="display: none" alt="Discover" class="paymenttype discover"
src="https://assets.donordrive.com/resources/img/cc_discover.svg?v=202112211115">
</span>
</label>
<label aria-label="PayPal" class="radio payment-type-option" style="display: none;" data-payment-type="PAYPAL">
<input type="radio" name="paymentType" value="PAYPAL" disabled="">
<img alt="PayPal" id="paypal" class="paymenttype" src="https://assets.donordrive.com/resources/img/paypal.svg?v=202112211115">
</label>
<label aria-label="Bank Account" class="radio payment-type-option js-currency-usd" style="" data-payment-type="ACH">
<input type="radio" name="paymentType" value="ACH">
<span class="payment-type-option-icon" data-payment-state="new">
<img alt="Bank Account" id="ach" class="paymenttype" src="https://assets.donordrive.com/resources/img/bank-account-en.svg?v=202112211115">
</span>
</label>
<label aria-label="Amazon Pay" class="radio payment-type-option" style="display: none;" data-payment-type="AMAZONPAY">
<input type="radio" name="paymentType" value="AMAZONPAY" disabled="">
<img alt="Amazon Pay" class="paymenttype" src="https://assets.donordrive.com/resources/img/amazon-pay.svg?v=202112211115">
</label>
<label aria-label="Venmo" class="radio payment-type-option" style="display: none;" data-payment-type="VENMO">
<input type="radio" name="paymentType" value="VENMO" disabled="">
<img alt="Venmo" class="paymenttype" src="https://assets.donordrive.com/resources/img/blue_venmo_acceptance_mark.svg?v=202112211115">
</label>
<div class="payment-type-pod js-saved-payments" data-payment-state="saved" style="display: none;">
<label aria-label="Saved Bank Account" class="payment-saved js-saved-ach js-currency-usd" style="" data-payment-type="ACH">
<input type="radio" name="savedPaymentType" value="ACH" class="pull-left">
<img alt="Saved Bank Account" class="pull-left paymenttype" src="https://assets.donordrive.com/resources/img/bank-account-en.svg?v=202112211115">
<div class="payment-saved-details">
<span class="js-saved-name"></span>
<span class="js-saved-institution"><br><span class="js-saved-institution-name"></span></span>
<br>
<span class="js-saved-summary">{accountType} ending in {accountLastFour}</span>
</div>
<div class="clr"></div>
<div class="option-check">
<i class="icon-ok" aria-hidden="true" style="margin: 10px 0 0 0;"></i>
</div>
</label>
<label aria-label="Saved Credit Card" class="payment-saved js-saved-cc js-currency-usd" style="" data-payment-type="CC">
<input type="radio" name="savedPaymentType" value="CC" class="pull-left">
<img src="data:image/gif;base64,R0lGODlhAQABAAD/ACwAAAAAAQABAAACADs=" alt="Saved Card" class="pull-left paymenttype">
<div class="pull-left">
<span class="js-saved-name"></span>
<span class="js-saved-institution"><br><span class="js-saved-institution-name"></span></span>
<br>
<span class="js-saved-summary">{accountType} ending in {accountLastFour}</span>
</div>
<div class="clr"></div>
<div class="option-check">
<i class="icon-ok" aria-hidden="true" style="margin: 10px 0 0 0;"></i>
</div>
</label>
<div class="clr"></div>
<a href="#" class="js-saved-discard">Choose a different way to pay</a>
</div>
</div>
</div>
</fieldset>
<fieldset class="contact-fieldset dd-u-mb-40">
<legend>Contact Details</legend>
<div class="beenherebefore" id="welcome-back" style="display:none;">
<i class="icon-ok" aria-hidden="true"></i> <strong id="welcome-back-msg"></strong>
</div>
<div class="inline-login" id="beenhereblock">
<span class="icon-stack">
<i class="icon-circle icon-stack-base"></i>
<i class="icon-user icon icon-light" aria-hidden="true"></i>
</span>
<h1>Been here before?</h1>
<p>
<a href="#" class="forgotpasswordhide beenhereloginshow">Login to your account</a> to prefill the fields below with your information.
</p>
<div id="beenherelogin" style="display: none;">
<div class="row-fluid">
<div class="span6">
<label for="emaillogin">
<strong class="required" aria-required="true">Email Address<span>*</span></strong>
<input type="email" name="emaillogin" id="emaillogin" maxlength="60">
</label>
</div>
<div class="span6">
<label for="passwordlogin">
<strong class="required" aria-required="true">Password<span>*</span></strong>
<input type="password" name="passwordlogin" id="passwordlogin" maxlength="60" autocomplete="new-password">
</label>
</div>
</div>
<br>
<div id="formbtns" class="row-fluid">
<div class="span6">
<input class="btn-form inline-login-submit" type="button" value="Login">
<span class="hidden-mobile"> </span>
<a href="#" class="cancel beenhereloginhide">Cancel</a>
</div>
<div class="span6">
<a href="#" class="beenhereloginhide forgotpasswordshow">Forgot Password?</a>
</div>
</div>
</div>
<div id="forgotpasswordbox" style="display: none;">
<div class="row-fluid">
<div class="span6">
<label for="emailpassword">
<strong class="required" aria-required="true">Email Address<span>*</span></strong>
<input type="email" name="emailpassword" id="emailpassword" maxlength="60">
</label>
</div>
</div>
<br>
<div class="row-fluid">
<div class="span6">
<span id="sendpasswordbtns">
<input class="btn-form inline-login-forgot-password" type="button" value="Reset My Password">
<span class="hidden-mobile"> </span>
<a href="#" class="cancel forgotpasswordhide beenherelogintoggle">Cancel</a>
</span>
</div>
</div>
</div>
</div>
<fieldset class="dd-u-mb-0">
<div class="control-group" data-payment-field="accountName" style="margin-top: 0 !important;">
<label class="control-label"><strong class="required" aria-required="true">Name<span>*</span></strong></label>
<div class="controls new-user" id="constituent-name">
<div class="dd-u-w-full js-name-fields">
<div class="inline-block" style="width: 48%;">
<label class="dd-u-sr-only" for="first-name"> First Name </label>
<input class="dd-u-w-full" type="text" name="firstName" id="first-name" maxlength="40" placeholder="First Name" autocomplete="given-name">
</div>
<div class="inline-block pull-right" style="width: 48%">
<label class="dd-u-sr-only" for="last-name"> Last Name </label>
<input class="dd-u-w-full" type="text" name="lastName" id="last-name" maxlength="60" placeholder="Last Name" autocomplete="family-name">
</div>
</div>
<div class="clr"></div>
</div>
</div>
</fieldset>
<div class="control-group js-display-name-container">
<label class="control-label" for="displayname"><strong>Show my name as (Optional)</strong></label>
<div class="controls">
<input type="text" class="span12" name="displayName" id="displayname" maxlength="101" placeholder="Ex: Grandma, The Smith Family, ABC Corporation" autocomplete="">
</div>
</div>
<input type="hidden" name="isAnonymous" id="is-anonymous" value="0">
<div class="control-group" data-payment-field="email">
<label class="control-label" for="email">
<strong class="required" aria-required="true">Email Address<span>*</span></strong>
</label>
<div class="controls new-user" id="constituent-email">
<input class="dd-u-w-full dd-u-mr-5" type="email" name="email" id="email" maxlength="60" autocomplete="email">
<span class="inline-block dd-u-mt-10">
<a class="privacy fancybox" href="#privacy-text" tabindex="-1">Privacy</a>
</span>
</div>
</div>
<div id="company-name-after-login" style="display:none;"></div>
<span class="new-user">
<input type="hidden" name="constituent_formID" value="CONSTITUENT">
</span>
</fieldset>
<div class="form-actions dd-u-my-0">
<span data-payment-submit="APPLEPAY" style="display: none;"></span>
<span data-payment-submit="CC" style=""><button type="button" class="dd-btn"><i class="icon-credit-card" aria-hidden="true"></i> Donate with Credit Card</button> </span>
<div data-payment-submit="PAYPAL" class="pp-btn" style="display: none;"></div>
<div data-payment-submit="AMAZONPAY" class="ap-btn" style="display: none;"><button type="button" style="width: 100%; display: block;" class="dd-btn"> Donate {amount}</button> </div>
<span data-payment-submit="ACH" style="display: none;"><button type="button" class="dd-btn"><svg style="margin-right: 8px; margin-left: 3px; position: relative; top: 1px" xmlns="http://www.w3.org/2000/svg" width="15" height="15"
viewBox="0 0 18 18">
<g fill="none">
<g fill="currentColor">
<path
d="M9 0L18 3.5 18 4.6 16.8 4.6C16.8 4.9 16.5 5.2 16.2 5.2L1.8 5.2C1.5 5.2 1.2 4.9 1.2 4.6L0 4.6 0 3.5 9 0ZM2.4 6.2L4.3 6.2 4.3 13.3 6.2 13.3 6.2 6.2 8.1 6.2 8.1 13.3 9.9 13.3 9.9 6.2 11.8 6.2 11.8 13.3 13.7 13.3 13.7 6.2 15.6 6.2 15.6 13.3 16.4 13.3C16.8 13.3 17.1 13.7 17.1 14.1L17.1 14.7 0.9 14.7 0.9 14.1C0.9 13.7 1.2 13.3 1.6 13.3L2.4 13.3 2.4 6.2ZM17.4 15.6C17.7 15.6 18 15.9 18 16.3L18 17.5 0 17.5 0 16.3C0 15.9 0.3 15.6 0.6 15.6L17.4 15.6Z">
</path>
</g>
</g>
</svg>Donate with Bank Account</button> </span>
<span data-payment-submit="VENMO" class="venmo-btn" style="display: none;">
<button type="button" class="dd-btn"> Venmo</button>
<small class="text-center block" style="margin: 10px 0"></small>
</span>
</div>
</form>Text Content
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YOUR MONTHLY GIFT TRANSFORMS LIVES
Monthly donors provide a steady stream of revenue that allows us to help the
people who need MDA the most. From telehealth appointments to lifesaving
treatment at MDA Care Centers, your monthly gift helps transform the lives of
people living with neuromuscular disease. Become a monthly donor now and reserve
your MDA tote bag.*
*Your MDA tote bag will be sent to you with your monthly donation of $19 or
more. Please allow up to eight weeks for tote bag fulfillment to the address you
provide with your gift.
Your Donation
Donation Option*
Monthly
per month
Donation Amount per Month*
$19 $25 $50 $100 $250 Your Best Gift
Maximum Amount to Donate (Optional)
$ Total
Yes! I’d like to cover processing costs. ($0.00 per month per year per )
Would you like to receive a tote bag? (a monthly donation of $19 or more is
required)*
Yes - send me the tote bag! No
Shipping Address (No PO Boxes)
Shipping City
Shipping State
Shipping Zip Code
Would you like to make this donation in honor or memory of someone?
Yes No
Select type
[Select...] In Memory of In Honor of
Honoree First Name
Honoree Last Name
Notification Recipient Name
Notification Recipient Address 1
Notification Recipient Address 2
Notification Recipient City
Notification Recipient State
Notification Recipient Zip Code
Corporate Giving
Individual Gift Gift on behalf of my company
See if your company will match your donation!
Clear matching company
Company Name
Payment
Payment Method*
{accountType} ending in {accountLastFour}
{accountType} ending in {accountLastFour}
Choose a different way to pay
Contact Details
BEEN HERE BEFORE?
Login to your account to prefill the fields below with your information.
Email Address*
Password*
Cancel
Forgot Password?
Email Address*
Cancel
Name*
First Name
Last Name
Show my name as (Optional)
Email Address*
Privacy
Donate with Credit Card
Donate {amount}
Donate with Bank Account Venmo
PRIVACY POLICY
This is the privacy policy (“Privacy Policy”) for the Muscular Dystrophy
Association and all web pages and websites associated therewith together with
any other features, functionality, documentation and services offered by us on
or through the Site (e.g., online giving, posting features, blogs, apps, badges,
etc.) (collectively, the “Services”). The Site and the Services are directed
towards residents of the United States and its territories. Please review
our Terms of Use Agreement which governs your use of the Services. Any
capitalized terms that are not defined in this Privacy Policy shall have the
meaning ascribed in the Terms of Use Agreement. By accessing, interacting with
and/or otherwise using the Services and providing and/or otherwise making
available your information to us, (a) you expressly choose to receive certain
communications from us and, unless you otherwise indicate, third parties as
described in this Privacy Policy and (b) you expressly agree to the privacy
practices described herein.
1. INTRODUCTION; GENERAL TERMS.
1.1 This Privacy Policy explains what information we collect in connection with
your access to and/or use of the Services, how the information is used, and how
and when we disclose such information. Please take a few minutes to read this
Privacy Policy so that you understand how we treat your information.
1.2 This Privacy Policy will remain in full force and effect, even if your
access to, use of and/or participation in connection with the Services or any
other particular service, feature, function or promotional activity offered on
or through the Services terminates, expires, is suspended or deactivated for any
reason. If you do not agree with this Privacy Policy, please do not participate
in or use any Services. This Privacy Policy applies regardless of the device you
use to access the Services and whether you are accessing the Services as a
registered user (i.e., an end user with a User Account) or otherwise.
1.3 This Privacy Policy governs only the information collected by us on or
through your use of the Services and does not cover any other information
collected in any other manner or collected by any other third party, unless
specifically stated. Where you have provided any of your information to third
parties, including, but not limited to, marketing companies, advertisers and
product/service providers, we may obtain such personal information and combine
it with your Information (as defined in Section 1.4 below).
1.4 For purposes of this Privacy Policy, (a) when we use the term “Personal
Information” we mean any information that we collect on or through the Services
that would allow someone to identify you or contact you, such as your full name,
address, e-mail address, physical address, payment card information, telephone
number(s), etc., and (b) when we use the term “Additional Information”, we mean
any information that we collect about you on or through the Services other than
Personal Information (Personal Information and Additional Information shall be
collectively referred to herein as “Information”).
2. INFORMATION WE COLLECT ABOUT YOU
2.1 Registration, Features, Functionality and Communications. In order to access
and/or use the Services and certain content, features and functionality thereof
(e.g., care services, communication/networking features, online giving, account
registration, newsletters, etc.), we may require that you provide and/or
otherwise make available to us certain Information, which may include, among
other things, your legal name, email address, physical address/location,
diagnosis and other descriptive information, and, in order to conduct fee-based
transactions and other activities, your payment data (e.g., payment card data,
PayPal account details, etc.), demographic information, authentication data and
other information. Further, access to and/or use of certain content, features
and functionality of the Services may be subject to Additional Terms, including,
but not limited to, notices, requirements and settings, which may require that
you provide certain Information about yourself in order to personalize and/or
allow you to use these Services. In addition, you may be presented with the
opportunity to sign up to receive additional newsletters, email communications,
or other communications from us in order for us to provide up-to-date
information and other news about the Services, and to publicize and promote
certain events, content, initiatives and services offered by us, our
business/organizational partners and other third parties, which may require that
you provide, among other things, contact information such as name and email
address, and, sometimes, demographic and other profile information.
2.2 Automatic Additional Information Collection; Tracking Technologies. When you
access and/or use the Services, we automatically collect certain Additional
Information, such as a unique device identifier assigned to your device
(“UDID”), anonymous identifiers, your Internet protocol (IP) address, location
data and other Additional Information regarding your access to and/or use of the
Services, which may, among other things, assist us in authenticating your usage
and/or device, keeping track of your preferences, creating a more tailored user
experience, better serving your particular interests and needs, etc. In
addition, the Services and/or third parties may use “cookies” (which are small
data files containing information about you that is stored on your device),
“embedded scripts”, web beacons and other similar tracking technologies
(collectively, “Tracking Technologies”) to collect Additional Information
automatically as you interact with the Services. Tracking Technologies enable
us, among other things, to track your interaction with the Services, and target
your interests to enhance your experience with the Services. We may also use
Tracking Technologies to collect “clickstream” data, such as your device type,
operating system and platform, the average time spent using the Services,
content viewed and searched for, access times and other relevant statistics, and
may assign unique identifiers to your device or other credentials you use to
access and/or use the Services for the same purposes. We may associate the
information obtained through these Tracking Technologies and your UDID,
anonymous identifiers and other identifiers and data with your Personal
Information so we can better customize your experience using the Services and
provide tailored recommendations, advertisements, promotions and other content
related to your specific interests, activities and/or profile.
2.3 EXPRESS CONSENT AND AGREEMENT. BY ACCESSING AND/OR USING THE SERVICES,
WHETHER AS A REGISTERED USER OR OTHERWISE, YOU AFFIRMATIVELY ACKNOWLEDGE,
UNDERSTAND AND HEREBY AGREE THAT YOU ARE GIVING US YOUR CONSENT TO TRACK YOUR
ACTIVITIES AND YOUR USE OF THE SERVICES AS DESCRIBED IN THIS PRIVACY POLICY.
3. HOW WE USE INFORMATION
3.1 We may use your Personal Information for the following purposes:
* Providing any information, services or products that you request or purchase
on through the Services;
* Contacting you regarding the administration of any features or functions of
the Services;
* Sending you marketing, promotional and other e-mails and correspondence;
* Allowing you to participate in the support and other features of the
Services;
* Responding to your questions or other requests;
* Tailoring your experience with the Services and/or otherwise customizing what
you see when you use the Services;
* Saving your User Account, registration and profile data or other Personal
Information (so you are not required to have to re-enter it each time you use
and/or access the Services);
* Providing and/or otherwise making available the Services and any other
information, products and services of enhanced value to you;
* Marketing and promoting the Services, including promotions and other
initiatives and activities;
* Where you order goods or services, performing credit checking where relevant;
* For the prevention and detection of fraud or infringement of our or any third
party’s rights;
* Tracking your return visits to and use of the Services;
* To comply with legal obligations or legal process; and
* For any other purposes described in this Privacy Policy or disclosed at the
time you provide us with the Personal Information or which are reasonably
necessary to provide the Service or other related information, product and/or
service requested.
3.2 In addition, we may use your Additional Information for the following
purposes:
* For research purposes, marketing/promotional purposes and/or to provide
anonymous de-identified reporting for internal and external clients, business
partners, third party organizations, etc.;
* Accumulating and reporting aggregate, statistical information in connection
with the Services and user activity;
* Determining which features, functionality and portions of the Services users
like best to help us operate the Services, enhance and improve the Services
and display advertising and marketing information;
* Tracking your return visits to and use of the Services in order to enhance
your experience while visiting the Site; and
* For other purposes disclosed to you at the time you provide us with the
Additional Information or which are reasonably necessary to provide the
service requested.
4. USER CHOICE, WITHDRAWAL OF CONSENT AND OPT-OUT
4.1 Preferences. You may change your privacy preferences (e.g., ask us not to
share your Personal Information with a particular third party) by sending an
email to us at privacyofficer@mdausa.org detailing your privacy request. Other
privacy preferences (e.g., limiting location services), depending on the nature
of the specific feature, functionality or offering, may be designated by
modifying your account privacy, permission and/or account options on the
Services (if applicable) or your device (if applicable). If you ask us to stop
using your Personal Information, we will honor that request while retaining a
record of any Personal Information as necessary to comply with applicable
foreign, federal, state or local law, and/or to conduct legitimate business
activities; provided, however, that you may be unable to continue to use the
Services (in whole or in part), if you require us to stop using your Personal
Information. You always have the right to review and correct the Personal
Information you have provided to us and generally you may update or delete
(subject to our rights above) certain Personal Information by contacting us as
described in Section 12.
4.2 Marketing and Promotional Communications. From time to time, you may be
presented with the option of whether to receive, or you may be automatically
entered to receive, certain marketing, promotional and/or fund raising
communications from us and others that we think will be of interest to you. You
can unsubscribe to receive certain such communications by either following the
specific instructions included in such communications or you may “opt-out” of
receiving certain marketing and promotional e-mails from us by sending an email
to us at privacyofficer@mdausa.org detailing your privacy request. Please note
that “opt-out” and “unsubscribe” requests may not take effect immediately and
may take a reasonable amount of time to receive, process and apply, during which
time your Personal Information shall remain subject to the prior privacy
settings. Additionally, you should be aware that any Personal Information
provided to third parties prior to your election to opt out or unsubscribe
cannot be retrieved or rescinded by us unless required by applicable law, and
you cannot retroactively opt out or unsubscribe with respect to such third
parties. Further, also please note that in order to keep you informed about the
operation of the Services, we may always send you emails, notifications and
announcements that are needed for the proper functioning and administration of
the Services, including, without limitation, for the purposes described
in Section 3 above, in connection with your use thereof. We may also have
features that allow you to submit information, questions or feedback to us. In
those instances, we may retain your emails and other information you submit to
us for our internal purposes, and to help us, our service providers and
affiliates serve you better.
5. SHARING AND DISCLOSURE OF INFORMATION
5.1 Disclosure to Third Parties. We reserve the right to use, share, exchange,
sell, rent, lease and/or disclose to third parties any of your Information for
any lawful purpose, including, but not limited to, for the purpose of furthering
our charitable mission and as may otherwise be described in Section 3 above, and
your access to and/or use of the Services shall be deemed your express,
affirmative “opt-in” consent to the foregoing. You can choose to opt-out of
certain such uses as described in Section 4 above.
5.2 Co-Branded Services and Features. The Services may offer co-branded services
and features, such as fund raising events, initiatives and promotions provided
by us and/or our affiliated organizations and entities or other third party
partners, and these co-branded services may be hosted on the Services and/or our
co-branded partner's platform or website or service. The co-branded partner will
be identified on the co-branded feature or service, along with the co-branded
partner's privacy policy and use of your Information is subject to that
co-branded partner's privacy policy. If you wish to opt-out of a co-branded
partner's future use of your Personal Information for marketing or other
purposes, you must contact the co-branded partner directly.
5.3 Service Providers. We may also disclose your Information to third parties
for the purpose of administering and maintaining the Services (“MDA Service
Providers”). We use MDA Service Providers to efficiently provide the full range
of content, activities, services, features and functions we bring you and we
disclose your Information to MDA Service Providers for the purpose of providing
services to us and our affiliated companies, organizations and initiatives.
5.4 Additional Disclosures. There may be instances when we may access and/or
disclose Information without providing you a choice in the following
circumstances: (a) to protect or defend our legal rights or property, or those
of our affiliated companies, organizations and initiatives, and their employees,
agents and contractors (including enforcement of our agreements); (b) to protect
the safety and security of the Services and our users; (c) protect against fraud
or for risk management purposes; (d) if we believe your actions violate
the Terms of Use Agreement, this Privacy Policy or any Additional Terms; or (e)
to comply with law or legal process. In addition, if we sell or transfer all or
a part of our business, organization and/or assets (or those of an affiliated
company, organization or initiative), or all or a part of our business,
organization and/or assets (or those of an affiliated company, organization or
initiative) are otherwise involved in a merger or any other similar transaction,
we may transfer your Information to the party or parties involved in the
transaction as part of that transaction.
6. MINORS
We do not knowingly collect Personal Information from minors under 18 years of
age without written consent from a parent or guardian. If you are under the age
of 18 do not submit your Personal Information through the Site.
7. SECURITY
While no data transmission over the Internet is 100% secure from intrusion, we
maintain commercially reasonable physical, electronic and procedural safeguards
to protect your Personal Information. Our server uses Secure Socket Layer
(“SSL”) encryption to protect information submitted via the forms on this site.
SSL is the industry standard security protocol. All credit card information is
protected in accordance with PCI standards. All off-line information is securely
stored and is accessible only by authorized staff. However, regardless of our
efforts, the network, and the device you use to access the Services, it is
possible that third parties may unlawfully intercept or access transmissions or
private communications over an unsecured transmission.
8. INTEGRATION AND INTERACTION WITH THIRD PARTY PLATFORMS AND SERVICES
The Services may be linked to, rely on and/or be integrated with websites,
applications, interfaces, services and platforms operated by other companies,
including Third Party Services. The Services may also feature advertisements
from other third parties. We are not responsible for the privacy practices of
such websites, applications, interfaces, services and platforms operated by
third parties that are linked to, rely on and/or integrated with the Services or
for the privacy practices of third party advertising companies or otherwise.
Once you leave the Services via such a link, access a third party application,
interface, service or platform or click on or navigate to an advertisement, you
should check the applicable privacy policy to determine, among other things, how
they will handle any personally identifiable or other information that they may
collect from you.
MDA obtains contact details and other personal information regarding media
contacts and influencers from a variety of sources including Cision. If you wish
to know more about how such information is collected and used, please refer to
Cision’s privacy notice at www.cision.com/us/legal/privacy-policy/.
9. PRIVACY POLICY CHANGES
From time to time, we may modify this Privacy Policy to reflect industry
initiatives, third party requirements or changes in the law, our Information
collection, use and disclosure practices, the features and functionality of the
Services, or technology, and such modifications shall be effective upon posting.
Your continued use of the Services after we post a revised Privacy Policy
signifies your acceptance of the revised Privacy Policy. It is therefore
important that you review this Privacy Policy regularly to ensure you are
updated as to any changes. If we materially change our practices regarding
collection, use or disclosure of your Personal Information, your Personal
Information will continue to be governed by the privacy policy under which it
was collected unless you have been provided notice of, and have not objected to,
the change.
10. ACCURACY
It is your responsibility to give us current, complete, truthful and accurate
information, including Personal Information, and to keep such information up to
date. We cannot and will not be responsible for any problems or liability that
may arise if you do not give us accurate, truthful or complete information or
Personal Information or you fail to update such information or Personal
Information. We will reject and delete any entry that we believe in good faith
to be false, fraudulent or inconsistent with this Privacy Policy or our Terms of
Use.
11. INTERNATIONAL USAGE
The Services are controlled, operated and administered entirely within the
United States of America and its territories. If you do not reside in the United
States and its territories, do not submit your Information through the Site. If
you do visit, access, interact with and/or otherwise use the Services from a
location outside the United States, please be advised that any Information you
provide in connection with any such activity will be processed in and/or
transferred to the United States of America, where privacy protections may not
be as comprehensive as those in the territory or location where you interact
with or otherwise use the Services. By using the Services, you affirmatively
consent to this transfer, use and other administration of your Information as
described herein.
12. CONTACT US
If you have any questions about our privacy practices, concerns regarding misuse
of personal data, or other inquiries related to the terms or conditions of this
Privacy Policy, please feel free to contact us as follows:
Email: privacyofficer@mdausa.org
OR
Mail: Muscular Dystrophy Association
Attn: c/o Privacy Matters
161 N. Clark
Suite 3550
Chicago, IL 60601
13. SOLE STATEMENT
This document is the sole statement of the Privacy Policy for the Services and
no summary, restatement or other version thereof, or other privacy statement or
policy, in any form, including, without limitation, machine-generated, is valid.
View our full Donor Privacy Policy here.
This Privacy Policy was last modified July 9, 2020 and is effective immediately.
© 2021 Privacy Contact
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