secure.foldsofhonor.org
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216.235.194.209
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Submitted URL: https://em.hartenergy.com/NDMzLU9ESy04ODkAAAGTQN_9bblYNWX8IZty-KdmxiWVlAIjoRr2a-o_lk_K5GODFcCXYmH7t_0s3-qxCMGrCyTGls4=
Effective URL: https://secure.foldsofhonor.org/site/Donation2?df_id=5159&mfc_pref=T&5159.donation=form1&utm_source=subs_mktg&utm_medium=email&u...
Submission: On May 23 via manual from US — Scanned from DE
Effective URL: https://secure.foldsofhonor.org/site/Donation2?df_id=5159&mfc_pref=T&5159.donation=form1&utm_source=subs_mktg&utm_medium=email&u...
Submission: On May 23 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: process — POST https://secure.foldsofhonor.org/site/Donation2
<form name="process" id="ProcessForm" action="https://secure.foldsofhonor.org/site/Donation2" method="post" onsubmit="return checkDoubleClick();">
<div class="donation-form-container responsive">
<script type="text/javascript">
<!--
function reloadPage() {
window.location.reload(true);
}
function testAjax() {
var xmlHttp = null;
// Opera 8.0+, Firefox, Chrome, Safari
try {
xmlHttp = new XMLHttpRequest();
} catch (e) {
// Internet Explorer Browsers
try {
xmlHttp = new ActiveXObject("Msxml2.XMLHTTP");
} catch (e) {
try {
xmlHttp = new ActiveXObject("Microsoft.XMLHTTP");
} catch (e) {
return false;
}
}
}
xmlHttp.open('POST', 'AjaxHelper;jsessionid=00000000.app30116a?NONCE_TOKEN=F9DD7FD8D65126883A2F54C132D0F646', true);
xmlHttp.send();
}
addOnLoadHandler(testAjax);
//
-->
</script>
<div class="donation-form-content">
<input type="hidden" name="user_donation_amt" id="user_donation_amt" value="">
<input type="hidden" name="company_min_matching_amt" id="company_min_matching_amt" value="">
<input type="hidden" name="currency_locale" id="currency_locale" value="en_US">
<div class="form-row form-row-1">
<div class="html-caption-container html-caption-1 html-caption-container-1">
<h1 style="text-transform: uppercase;">Stand with us.</h1>
<p class="donation-form-subhead">Your donation faithfully supports the pursuit of education for the families of America’s fallen and disabled heroes.</p>
<p style="clear: both; text-align: right;"><img style="float: none; margin-top: -.5em; display: inline-block;" src="../images/required.png" alt="Required Asterisk Example"> = Required fields</p>
<a name="toggle"></a>
<h2 id="donation-frequency-header">Gift Frequency</h2>
<div id="toggle-btn-container">
<a id="one-time-gift-btn" class="donation-btn-toggle active-button" href="Donation2?df_id=5159&mfc_pref=T&5159.donation=form1#toggle" target="_parent">One-time Gift</a><a id="monthly-gift-btn" class="donation-btn-toggle" href="Donation2?df_id=5158&mfc_pref=T&5158.donation=form1" target="_parent">Join the Squadron</a>
</div>
<!--<p>Please join us as we honor those who serve us.</p>-->
<p class="monthly-callout"><span class="monthly-callout-text">Join the Squadron for $13 or more a month.</span> <img src="../images/content/pagebuilder/up-arrow.png" alt="Upward pointing arrow"></p>
<p id="edit-monthly-callout">Join the Squadron for $13 or more a month.</p>
</div>
</div>
<div id="level_standard_row">
<div class="don-standard-levels form-row form-row-2">
<div class="levels-label">
</div>
<div id="level_standard_row" class="form-row form-donation-level form-row-3">
<div class="form-content">
<span class="field-required"></span> <span class="aural-only">Field Is Required</span>
<span class="FormLabelText">Enter A Gift Amount:</span>
<div class="donation-level-general-ask">
</div>
<div class="donation-levels">
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8338" value="8338" onclick="evalMatchingGift('$13.00');
updateDonorCoverAmount('$13.00');">
</div>
<label for="level_standardexpanded8338" onclick="">
<div class="donation-level-amount-container">$13</div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8338expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8339" value="8339" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');">
</div>
<label for="level_standardexpanded8339" onclick="">
<div class="donation-level-amount-container">$50</div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8339expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8340" value="8340" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');">
</div>
<label for="level_standardexpanded8340" onclick="">
<div class="donation-level-amount-container">$100</div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8340expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8335" value="8335" onclick="evalMatchingGift('$250.00');
updateDonorCoverAmount('$250.00');">
</div>
<label for="level_standardexpanded8335" onclick="">
<div class="donation-level-amount-container">$250</div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8335expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input other-amount">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8337" value="8337" onclick="evalMatchingGift(document.getElementById('level_standardexpanded8337amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded8337amount').value);">
</div>
<div class="donation-level-user-entered">
<label for="level_standardexpanded8337amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded8337amount" id="level_standardexpanded8337amount" value="" size="12" maxlength="50"
onfocus="var el = document.getElementById ('level_standardexpanded8337');if (el) el.click(); fire_obs_comp_event('level_standardexpanded8337amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded8337amount', this, event);evalMatchingGift(value);" onkeyup="fire_obs_comp_event('level_standardexpanded8337amount', this, event);evalMatchingGift(value);"
onblur="fire_obs_comp_event('level_standardexpanded8337amount', this);updateDonorCoverAmount(value);" placeholder="Other $ Amount">
</div>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8337expandedsubmit" value="true">
</div>
</div>
</div>
</div>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observables
jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
var syncAction = function(obj) {
if (obj.is(':checked')) {
obj.closest('div.donation-level-container').addClass('selected');
} else {
obj.closest('div.donation-level-container').removeClass('selected');
};
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('div.donation-level-container').removeClass('selected');
syncAction(jQuery(this));
});
});
});
});
</script><noscript> </noscript>
</div>
<div class="levels-gift-aid">
</div>
<input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true">
<script type="text/javascript">
function updateDonorCoverAmount(gift) {
if (typeof updateAmount !== "undefined") {
updateAmount(gift);
}
};
function evalMatchingGift(gift) {}
</script><noscript> </noscript>
</div>
<script type="text/javascript">
// subscribe listeners to make an ajax call to the server to calculate the total amount
Y.use('jquery-noconflict', function() {
var fetchAmountFunc = function() {
// find all the select, textarea, input, etc... and format them into key=val pairs.
var params = jQuery('#level_standard_row :input').serialize();
// parse the path and append the key/value pairs above to the url
var url = 'https://secure.foldsofhonor.org/site/Donation2?idb=150017206&level_standardajaxfetch=true&df_id=5159&mfc_pref=T&5159.donation=form1&level_standardtotalcalculateBtn=true';
var index = url.indexOf("?");
var path = url.substring(0, index);
var args = url.substring(index + 1, url.length);
args += '&' + params;
var recurringGiftTermsContainer = jQuery('#recurring_gift_terms_acceptance_message_container');
if (recurringGiftTermsContainer && recurringGiftTermsContainer.length > 0) {
jQuery.ajax(path, {
data: args,
success: function(data) {
jQuery('#recurring_gift_terms_acceptance_message_container').trigger("recurringTermsChange");
}
});
}
};
jQuery('#level_standard_row :input[type=text]').blur(function() {
fetchAmountFunc();
});
jQuery('#level_standard_row input:checkbox, #level_standard_row input:radio').click(function() {
fetchAmountFunc();
});
jQuery('#level_standard_row select').change(function() {
fetchAmountFunc();
});
// call it on page load
fetchAmountFunc();
});
</script><noscript> </noscript>
</div>
<div class="custom-field-container form-row custom-field-1 form-row-4 custom-field-container-1">
<div class="form-content">
<div class="form-input-label-block">
<label for="donor_personal_note_input">Comments:</label>
</div>
<input type="text" name="donor_personal_note_input" id="donor_personal_note_input" value="" maxlength="255">
<input type="hidden" name="donor_personal_notesubmit" id="donor_personal_notesubmit" value="true">
</div>
</div>
<h2 class="section-header-container section-header-1"> Tribute Information </h2>
<div id="tribute_show_honor_fields_row" class="form-row form-checkbox form-row-5">
<div class="form-content">
<input type="checkbox" name="tribute_show_honor_fieldsname" id="tribute_show_honor_fieldsname" onclick="fire_obs_comp_event('tribute_show_honor_fields', this);">
<label for="tribute_show_honor_fieldsname">This gift is to honor or in memory of someone.</label>
<input type="hidden" name="tribute_show_honor_fieldssubmit" id="tribute_show_honor_fieldssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_show_honor_fields', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_show_honor_fields_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('tribute_show_honor_fieldsname')) {
document.getElementById('tribute_show_honor_fieldsname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('tribute_show_honor_fieldsname')) {
return document.getElementById('tribute_show_honor_fieldsname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_type_row" class="form-row form-selectlist form-row-6" style="display: none;">
<div class="form-content">
<label class="FormLabel" for="tribute_type">Honor Gift Type:</label>
<select name="tribute_type" id="tribute_type" size="1">
<option></option>
<option value="tribute_type_value1">In Memory of</option>
<option value="tribute_type_value2">In Honor of</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_type', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_type_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="tribute_typesubmit_skip" id="tribute_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_type', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_type_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_type'));
function tribute_type_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_type', src);
}
}
var el = document.getElementById('tribute_type');
if (el) {
Utils.addEvent(el, 'change', tribute_type_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div class="form-row form-row-7" id="honor-mem-type-btn-row" style="display: none;">
<div class="html-caption-container html-caption-2 html-caption-container-2">
<div id="toggle-honor-btn-container" style="display: none;"><button id="in-honor-btn" class="donation-btn-toggle">In Honor of</button><button id="in-memory-btn" class="donation-btn-toggle">In Memory of</button></div>
<style>
#tribute_type_row {
display: none !important;
}
</style>
</div>
</div>
<div id="honoree_title_row" class="form-row form-selectlist form-row-8" style="display: none;">
<div class="form-content">
<label class="FormLabel" for="honoree_title">Tribute Title:</label>
<select name="honoree_title" id="honoree_title" size="1">
<option></option>
<option value="Mr.">Mr.</option>
<option value="Ms.">Ms.</option>
<option value="Mrs.">Mrs.</option>
<option value="Miss">Miss</option>
<option value="Dr.">Dr.</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('honoree_title', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('honoree_title_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="honoree_titlesubmit_skip" id="honoree_titlesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('honoree_title', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('honoree_title_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('honoree_title'));
function honoree_title_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('honoree_title', src);
}
}
var el = document.getElementById('honoree_title');
if (el) {
Utils.addEvent(el, 'change', honoree_title_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_honoree_first_name_row" class="form-row form-text form-row-9" style="display: none;">
<div class="form-content">
<label for="tribute_honoree_first_namename">Tribute First Name:</label>
<input type="text" name="tribute_honoree_first_namename" id="tribute_honoree_first_namename" value="" maxlength="50">
<input type="hidden" name="tribute_honoree_first_namesubmit_skip" id="tribute_honoree_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_honoree_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_honoree_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_honoree_first_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_honoree_last_name_row" class="form-row form-text form-row-10" style="display: none;">
<div class="form-content">
<label for="tribute_honoree_last_namename">Tribute Last Name:</label>
<input type="text" name="tribute_honoree_last_namename" id="tribute_honoree_last_namename" value="" maxlength="50">
<input type="hidden" name="tribute_honoree_last_namesubmit_skip" id="tribute_honoree_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_honoree_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_honoree_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_honoree_last_name'));
</script><noscript> </noscript>
</div>
</div>
<h2 class="section-header-container section-header-2" id="notify-yes-no-header" style="display: none;"> Would you like to notify someone about this gift? </h2>
<div class="form-row form-row-11" id="notification-address-prompt" style="display: none;">
<div class="html-caption-container html-caption-3 html-caption-container-3">
<p>Please note that the notification address information below will only be used to send a notification and not used for any other purpose.</p>
</div>
</div>
<div class="form-row form-row-12" id="honor-mem-notif-btn-row" style="display: none;">
<div class="html-caption-container html-caption-4 html-caption-container-4">
<div id="toggle-notif-btn-container"><button id="postal-btn" class="donation-btn-toggle" type="button">By Mail</button><!--<button id="email-btn" class="donation-btn-toggle" type="button">By Email</button>--><button id="no-notif-btn"
class="donation-btn-toggle" type="button">No, Thank You</button></div>
</div>
</div>
<h2 class="section-header-container section-header-3" id="honor-notif-recipient-address-info-header" style="display: none;"> Recipient Address Information </h2>
<div id="tribute_notify_recip_name_row" class="form-row form-text form-row-13" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_namename">Notification Recipient Name:</label>
<input type="text" name="tribute_notify_recip_namename" id="tribute_notify_recip_namename" value="" maxlength="70">
<input type="hidden" name="tribute_notify_recip_namesubmit_skip" id="tribute_notify_recip_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_street1_row" class="form-row form-text form-row-14" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_street1name">Notification Street Address:</label>
<input type="text" name="tribute_notify_recip_street1name" id="tribute_notify_recip_street1name" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_street1submit_skip" id="tribute_notify_recip_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_street1_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_street1'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_street2_row" class="form-row form-text form-row-15" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_street2name">Notification Apt/Box/Unit/Suite:</label>
<input type="text" name="tribute_notify_recip_street2name" id="tribute_notify_recip_street2name" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_street2submit_skip" id="tribute_notify_recip_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_street2_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_street2'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_city_row" class="form-row form-text form-row-16" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_cityname">Notification City:</label>
<input type="text" name="tribute_notify_recip_cityname" id="tribute_notify_recip_cityname" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_citysubmit_skip" id="tribute_notify_recip_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_city_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_city'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_state_row" class="form-row form-selectlist form-row-17" style="display: none;">
<div class="form-content">
<label class="FormLabel" for="tribute_notify_recip_state">Notification State/Province:</label>
<select name="tribute_notify_recip_state" id="tribute_notify_recip_state" size="1" onchange="fire_obs_comp_event('tribute_notify_recip_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="tribute_notify_recip_statesubmit_skip" id="tribute_notify_recip_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_state_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_state'));
function tribute_notify_recip_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_notify_recip_state', src);
}
}
var el = document.getElementById('tribute_notify_recip_state');
if (el) {
Utils.addEvent(el, 'change', tribute_notify_recip_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_zip_row" class="form-row form-text form-row-18" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_zipname">Notification ZIP/Postal Code:</label>
<input type="text" name="tribute_notify_recip_zipname" id="tribute_notify_recip_zipname" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_zipsubmit_skip" id="tribute_notify_recip_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_zip_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_zip'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_message_body_row" class="form-row form-text form-row-19" style="display: none;">
<div class="form-content">
<label for="tribute_message_bodyname">Personal Message:</label>
<textarea cols="50" rows="4" name="tribute_message_bodyname" id="tribute_message_bodyname"></textarea>
<input type="hidden" name="tribute_message_bodysubmit_skip" id="tribute_message_bodysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_message_body', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_message_body_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_message_body'));
</script><noscript> </noscript>
</div>
</div>
<div class="custom-field-container form-row custom-field-2 form-row-20 custom-field-container-2" id="honor-notify-letter-option-row" style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<label for="honor_notify_letter_option_dropdown">How would you like your information to be shared in the notification letter?</label>
</div>
<select name="honor_notify_letter_option_dropdown" id="honor_notify_letter_option_dropdown" size="1">
<option value="Name Only">Name Only</option>
<option value="Name and Address">Name and Address</option>
<option value="Anonymous">Anonymous</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('honor_notify_letter_option_dropdown', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('honor_notify_letter_option_dropdown_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="honor_notify_letter_optionsubmit" id="honor_notify_letter_optionsubmit" value="true">
</div>
</div>
<div id="send_ecard_row" class="form-row form-checkbox form-row-21" style="display: none;">
<div class="form-content">
<span class="check-box-form-label-text">Please send an email notification on: </span>
<input type="checkbox" name="send_ecardname" id="send_ecardname" onclick="fire_obs_comp_event('send_ecard', this);">
<label for="send_ecardname">Yes, please send an email notification.</label>
<input type="hidden" name="send_ecardsubmit" id="send_ecardsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('send_ecard', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('send_ecard_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('send_ecardname')) {
document.getElementById('send_ecardname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('send_ecardname')) {
return document.getElementById('send_ecardname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div id="ecard_send_date_row" class="form-row form-date form-row-22" style="display: none;">
<div class="form-content">
<label for="ecard_send_date_MONTH">
<span class="label-text">Send email notification on:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="ecard_send_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<label for="ecard_send_date_MONTH"><span style="display:none;">Month</span></label>
<label for="ecard_send_date_DAY"><span style="display:none;">Day</span></label>
<label for="ecard_send_date_YEAR"><span style="display:none;">Year</span></label>
<select name="ecard_send_date_MONTH" id="ecard_send_date_MONTH" title="Month">
<option value="1">Jan</option>
<option value="2">Feb</option>
<option value="3">Mar</option>
<option value="4">Apr</option>
<option value="5" selected="selected">May</option>
<option value="6">Jun</option>
<option value="7">Jul</option>
<option value="8">Aug</option>
<option value="9">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
<select name="ecard_send_date_DAY" id="ecard_send_date_DAY" title="Day">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23" selected="selected">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select name="ecard_send_date_YEAR" id="ecard_send_date_YEAR" title="Year">
<option value="2034">2034</option>
<option value="2033">2033</option>
<option value="2032">2032</option>
<option value="2031">2031</option>
<option value="2030">2030</option>
<option value="2029">2029</option>
<option value="2028">2028</option>
<option value="2027">2027</option>
<option value="2026">2026</option>
<option value="2025">2025</option>
<option value="2024" selected="selected">2024</option>
</select>
</div>
<input type="hidden" name="ecard_send_datesubmit" id="ecard_send_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('ecard_send_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('ecard_send_date_row', _display);
disable_submit_flag('ecard_send_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('ecard_send_date_MONTH', _disabled);
disable_element('ecard_send_date_DAY', _disabled);
disable_element('ecard_send_date_YEAR', _disabled);
disable_element('ecard_send_date_HOUR12', _disabled);
disable_element('ecard_send_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('ecard_send_date_MINUTE', _disabled);
disable_element('ecard_send_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="ecard_recpients_row" class="form-row form-text form-row-23" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="ecard_recpientsname">Recipient email addresses (separated by commas):</label>
<textarea cols="60" rows="4" name="ecard_recpientsname" id="ecard_recpientsname"></textarea>
<input type="hidden" name="ecard_recpientssubmit" id="ecard_recpientssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('ecard_recpients', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('ecard_recpients_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="select_grid_row" class="form-row form-text form-row-24" style="display: none;">
<div class="form-content">
<label for="select_gridname">Layout:</label>
<input type="hidden" name="stationery_layout_chooser" id="stationery_layout_chooser" value="true">
<div class="layout-chooser-container clearfix">
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_1021">
<img src="../images/stationery/layout_thumbnail_1021.633038014.custom.jpg" alt="Basic eCard" border="0">
</label>
<input type="hidden" name="stationery_layout_id" id="stationery_layout_id_1021" value="1021">
</div>
</div>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('select_grid', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('select_grid_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
<input type="hidden" name="select_gridsubmit" id="select_gridsubmit" value="true">
</div>
</div>
<div id="tribute_ecard_subject_row" class="form-row form-text form-row-25" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_ecard_subjectname">Subject Line:</label>
<input type="text" name="tribute_ecard_subjectname" id="tribute_ecard_subjectname" value="" maxlength="50">
<input type="hidden" name="tribute_ecard_subjectsubmit" id="tribute_ecard_subjectsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_ecard_subject', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_ecard_subject_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="e_card_copy_sender_row" class="form-row form-checkbox form-row-26" style="display: none;">
<div class="form-content">
<input type="checkbox" name="e_card_copy_sendername" id="e_card_copy_sendername" onclick="fire_obs_comp_event('e_card_copy_sender', this);">
<label for="e_card_copy_sendername">Yes, please send me a copy of this email notification.</label>
<input type="hidden" name="e_card_copy_sendersubmit" id="e_card_copy_sendersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('e_card_copy_sender', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('e_card_copy_sender_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('e_card_copy_sendername')) {
document.getElementById('e_card_copy_sendername').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('e_card_copy_sendername')) {
return document.getElementById('e_card_copy_sendername').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<h2 class="section-header-container section-header-4" id="billing-info-header"> Billing Information </h2>
<div id="organization-name-visible_row" class="form-row form-checkbox form-row-27">
<div class="form-content">
<input type="checkbox" name="organization-name-visiblename" id="organization-name-visiblename" onclick="fire_obs_comp_event('organization-name-visible', this);">
<label for="organization-name-visiblename">Make this gift on behalf of an organization</label>
<input type="hidden" name="organization-name-visiblesubmit" id="organization-name-visiblesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('organization-name-visible', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('organization-name-visible_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('organization-name-visiblename')) {
document.getElementById('organization-name-visiblename').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('organization-name-visiblename')) {
return document.getElementById('organization-name-visiblename').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor-organization-name_row" class="form-row form-text form-row-28" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="donor-organization-namename">Organization Name:</label>
<input type="text" name="donor-organization-namename" id="donor-organization-namename" value="" maxlength="255" disabled="">
<input type="hidden" name="donor-organization-namesubmit_skip" id="donor-organization-namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor-organization-name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor-organization-name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('organization-name-visible.true', new ComponentEnabler('donor-organization-name'));
observe_component('organization-name-visible.true', new ComponentDisplayer('donor-organization-name'));
</script><noscript> </noscript>
</div>
</div>
<div id="billing_first_name_row" class="form-row form-text form-row-29">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name:</label>
<input type="text" name="billing_first_namename" id="billing_first_namename" value="" maxlength="50">
<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_last_name_row" class="form-row form-text form-row-30">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name:</label>
<input type="text" name="billing_last_namename" id="billing_last_namename" value="" maxlength="50">
<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street1_row" class="form-row form-text form-row-31">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street Address:</label>
<input type="text" name="billing_addr_street1name" id="billing_addr_street1name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street1_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street2_row" class="form-row form-text form-row-32">
<div class="form-content">
<label for="billing_addr_street2name">Apt/Box/Unit/Suite:</label>
<input type="text" name="billing_addr_street2name" id="billing_addr_street2name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street2submit" id="billing_addr_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street2_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_city_row" class="form-row form-text form-row-33">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City:</label>
<input type="text" name="billing_addr_cityname" id="billing_addr_cityname" value="" maxlength="50">
<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_city_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_state_row" class="form-row form-selectlist form-row-34">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_state">State/Province:</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" onchange="fire_obs_comp_event('billing_addr_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_state', src);
}
}
var el = document.getElementById('billing_addr_state');
if (el) {
Utils.addEvent(el, 'change', billing_addr_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_zip_row" class="form-row form-text form-row-35">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">ZIP/Postal Code:</label>
<input type="text" name="billing_addr_zipname" id="billing_addr_zipname" value="" maxlength="50">
<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_zip_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_country_row" class="form-row form-selectlist form-row-36">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_country">Country:</label>
<select name="billing_addr_country" id="billing_addr_country" size="1" onchange="fire_obs_comp_event('billing_addr_country', this)">
<option></option>
<option selected="selected" value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivarian Republic of Venezuela">Bolivarian Republic of Venezuela</option>
<option value="Bonaire, Sint Eustatios and Saba">Bonaire, Sint Eustatios and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Democratic People's Republic of Korea">Democratic People's Republic of Korea</option>
<option value="The Democratic Republic of the Congo">The Democratic Republic of the Congo</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="The Former Yugoslav Republic of Macedonia">The Former Yugoslav Republic of Macedonia</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Islamic Republic of Iran">Islamic Republic of Iran</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Plurinational State of Bolivia">Plurinational State of Bolivia</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Korea">Republic of Korea</option>
<option value="Republic of Moldova">Republic of Moldova</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French)">Saint Martin (French)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls.</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch)">Sint Maarten (Dutch)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United Republic of Tanzania">United Republic of Tanzania</option>
<option value="Uruguay">Uruguay</option>
<option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_countrysubmit" id="billing_addr_countrysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_country_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_country', src);
}
}
var el = document.getElementById('billing_addr_country');
if (el) {
Utils.addEvent(el, 'change', billing_addr_country_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_email_address_row" class="form-row form-text form-row-37">
<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">Email Address:</label>
<input type="text" name="donor_email_addressname" id="donor_email_addressname" value="" maxlength="255">
<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_address', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_address_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div class="form-row form-checkbox form-row-38" id="donor_email_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="checkbox" name="donor_email_opt_inname" id="donor_email_opt_inname" checked="checked" onclick="fire_obs_comp_event('donor_email_opt_in', this);">
<label for="donor_email_opt_inname"> Yes, I would like to opt in to receive email from Folds of Honor. </label>
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_opt_in', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_opt_in_Row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_email_opt_inname')) {
document.getElementById('donor_email_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_email_opt_inname')) return document.getElementById('donor_email_opt_inname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true">
</div>
</div>
<div class="form-row form-checkbox form-row-39" id="donor_postal_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="hidden" name="donor_postal_opt_inname" id="donor_postal_opt_inname" value="implicit">
<span class="auto-opt-in-warning-message">If you donate and have not already registered, you will receive periodic updates and communications from Folds of Honor Foundation.</span>
<script type="text/javascript">
var comp = new ObservableComponent('donor_postal_opt_in', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_postal_opt_in_Row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_postal_opt_inname')) {
document.getElementById('donor_postal_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_postal_opt_inname')) return document.getElementById('donor_postal_opt_inname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
<input type="hidden" name="donor_postal_opt_insubmit" id="donor_postal_opt_insubmit" value="true">
</div>
</div>
<h2 class="section-header-container section-header-5" id="payment-type-header"> Payment Type </h2>
<div class="payment-type-element-container">
<div class="payment-type-selection-container payment-field-container">
<h3>Payment Method:</h3>
<div id="responsive_payment_typepay_typeradio_row" class="form-row form-row-40">
<div class="form-content">
<div class="payment-type-selections" id="responsive_payment_typepay_typeradio_payment_types">
<span class="internal-payment"><span class="payment-type-option selected payment-option-1"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiocredit" value="credit"
checked="checked" onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiocredit"><a href="javascript:void(0);" class="payment-type-label">Credit Card</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span><span class="payment-type-option payment-option-2"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradioach" value="ach"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradioach"><a href="javascript:void(0);" class="payment-type-label">Bank Account</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span></span>
<span class="external-payment"></span>
</div>
<input type="hidden" name="responsive_payment_typepay_typeradiosubmit" id="responsive_payment_typepay_typeradiosubmit" value="true">
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observable for payment type options
jQuery('.payment-type-option').each(function() {
var syncAction = function(obj) {
if (obj.hasClass('selected')) {
var radioGroupName = obj.find('input').attr('name');
obj.find('input').prop('checked', true);
fire_obs_comp_event(radioGroupName, obj.find('input').get());
}
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('.payment-type-option').removeClass('selected');
jQuery(this).addClass('selected');
syncAction(jQuery(this));
var selectedValue = jQuery(this).find('input').val();
if (selectedValue == 'paypal' || selectedValue == 'amazon') {
// open up a boxinator dialog
jQuery(document).trigger('redirect-external');
jQuery('#btn_next').click();
}
});
});
});
});
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typepay_typeradio_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_cc_container" class="payment-field-container">
<h3>Credit Card Information:</h3>
<div id="responsive_payment_typecc_type_row" class="form-row form-radio-array form-row-41">
<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="responsive_payment_typecc_type_Discover" id="responsive_payment_typecc_type_Discover">
</li>
<li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="responsive_payment_typecc_type_American_Express" id="responsive_payment_typecc_type_American_Express">
</li>
<li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="responsive_payment_typecc_type_MasterCard" id="responsive_payment_typecc_type_MasterCard">
</li>
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="responsive_payment_typecc_type_Visa" id="responsive_payment_typecc_type_Visa">
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_typesubmit" id="responsive_payment_typecc_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typecc_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_number_row" class="form-row form-text form-row-42">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_numbername">Credit Card Number:</label>
<input type="text" name="responsive_payment_typecc_numbername" id="responsive_payment_typecc_numbername" value="" maxlength="22" autocomplete="off">
<div class="creditcardimg_div"></div>
<input type="hidden" name="responsive_payment_typecc_numbersubmit" id="responsive_payment_typecc_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_number_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typecc_number'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_exp_date_row" class="form-row form-date form-row-43">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_exp_date_MONTH">
<span class="label-text">Expiration Date:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="responsive_payment_typecc_exp_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<fieldset class="cardExpGroup">
<select name="responsive_payment_typecc_exp_date_MONTH" id="responsive_payment_typecc_exp_date_MONTH" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_MONTH', this)">
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5" selected="selected">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
<select name="responsive_payment_typecc_exp_date_YEAR" id="responsive_payment_typecc_exp_date_YEAR" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_YEAR', this)">
<option value="2024" selected="selected">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>
</select>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_exp_date_DAY" id="responsive_payment_typecc_exp_date_DAY" value="1">
<script type="text/javascript">
<!--
var comp1 = new ObservableComponent('responsive_payment_typecc_exp_date_MONTH', '');
comp1.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
var comp2 = new ObservableComponent('responsive_payment_typecc_exp_date_YEAR', '');
comp2.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
</div>
<input type="hidden" name="responsive_payment_typecc_exp_datesubmit" id="responsive_payment_typecc_exp_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_exp_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_row', _display);
disable_submit_flag('responsive_payment_typecc_exp_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('responsive_payment_typecc_exp_date_MONTH', _disabled);
disable_element('responsive_payment_typecc_exp_date_DAY', _disabled);
disable_element('responsive_payment_typecc_exp_date_YEAR', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR12', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('responsive_payment_typecc_exp_date_MINUTE', _disabled);
disable_element('responsive_payment_typecc_exp_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_cvv_row" class="form-row form-text cvv-input form-row-44">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_cvvname">
<span class="FormLabelText">CVV Number:</span>
</label>
<a href="http://help.convio.net/site/PageServer?s_site=fohf&pagename=user_donation_cvv" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typecc_cvvname" id="responsive_payment_typecc_cvvname" value="" maxlength="4" autocomplete="cc-csc">
<input type="hidden" name="responsive_payment_typecc_cvvsubmit" id="responsive_payment_typecc_cvvsubmit" value="true">
<script type="text/javascript">
//chrome is mapping cvv as card name
if (/CriOS/.test(navigator.userAgent) || (/Chrome/.test(navigator.userAgent) && /Google Inc/.test(navigator.vendor))) {
document.getElementById('responsive_payment_typecc_cvvname').autocomplete = 'cc-csc';
}
var comp = new ObservableComponent('responsive_payment_typecc_cvv', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_cvv_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_bank_container" class="payment-field-container" style="display: none;">
<h3>Bank Account Information: </h3>
<div id="responsive_payment_typerouting_number_row" class="form-row form-text form-row-45">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typerouting_numbername">Bank Routing Number:</label>
<a href="http://help.convio.net/site/PageServer?s_site=fohf&pagename=User_Donation_ACH" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typerouting_numbername" id="responsive_payment_typerouting_numbername" value="" size="20" maxlength="20" onchange="fire_obs_comp_event('responsive_payment_typerouting_number', this);"
autocomplete="off">
<input type="hidden" name="responsive_payment_typerouting_numbersubmit" id="responsive_payment_typerouting_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typerouting_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typerouting_number_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typebank_account_row" class="form-row form-text form-row-46">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typebank_accountname">Bank Account Number:</label>
<input type="text" name="responsive_payment_typebank_accountname" id="responsive_payment_typebank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typebank_accountsubmit" id="responsive_payment_typebank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typebank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typebank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typebank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeverify_bank_account_row" class="form-row form-text form-row-47">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typeverify_bank_accountname">Verify Bank Account Number:</label>
<input type="text" name="responsive_payment_typeverify_bank_accountname" id="responsive_payment_typeverify_bank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typeverify_bank_accountsubmit" id="responsive_payment_typeverify_bank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeverify_bank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeverify_bank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typeverify_bank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_type.account_type_row" class="form-row form-radio-array form-row-48">
<div class="form-content">
<fieldset>
<legend><span class="field-required"></span> Account Type:</legend>
<ul class="radio-array-list">
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking" value="CHECKING"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);" checked="checked">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking">Checking</label>
</span>
</li>
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings" value="SAVINGS"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings">Savings</label>
</span>
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_type.account_typesubmit" id="responsive_payment_type.account_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_type.account_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_type.account_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeach_confirm_row" class="form-row form-checkbox form-row-49">
<div class="form-content">
<span class="field-required"></span>
<input type="checkbox" name="responsive_payment_typeach_confirmname" id="responsive_payment_typeach_confirmname" onclick="fire_obs_comp_event('responsive_payment_typeach_confirm', this);">
<label for="responsive_payment_typeach_confirmname">I agree to use my bank account as a payment method and authorize the Folds of Honor Foundation to debit my bank account to fulfill my donation commitment. </label>
<input type="hidden" name="responsive_payment_typeach_confirmsubmit" id="responsive_payment_typeach_confirmsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeach_confirm', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeach_confirm_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
document.getElementById('responsive_payment_typeach_confirmname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
return document.getElementById('responsive_payment_typeach_confirmname').checked;
}
}
comp.clear = function() {
this.set(false);
}
observe_component('null', new ComponentEnabler('responsive_payment_typeach_confirm'));
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_check_container" class="payment-field-container" style="display: none;">
<h3>Check Information</h3>
</div>
<input type="hidden" name="responsive_payment_typesubmit" id="responsive_payment_typesubmit" value="true">
<script type="text/javascript">
function PaymentObserver() {
this.observe = function(_event) {
var sVal = _event.component.get();
switch (sVal) {
case 'check':
hide_element('payment_cc_container');
hide_element('payment_bank_container');
show_element('payment_check_container');
break;
case 'credit':
hide_element('payment_bank_container');
hide_element('payment_check_container');
show_element('payment_cc_container');
break;
case 'ach':
hide_element('payment_cc_container');
hide_element('payment_check_container');
show_element('payment_bank_container');
break;
case 'paypal':
case 'amazon':
case 'mobilepay':
default:
// hide all
hide_element('payment_bank_container');
hide_element('payment_cc_container');
hide_element('payment_check_container');
break;
}
}
}
// Set the observer to show/hide the relevant fields
observe_component('responsive_payment_typepay_typeradio', new PaymentObserver());
</script><noscript> </noscript>
</div>
<div id="donor_info_same_as_billing_row" class="form-row form-checkbox form-row-50">
<div class="form-content">
<input type="checkbox" name="donor_info_same_as_billingname" id="donor_info_same_as_billingname" onclick="fire_obs_comp_event('donor_info_same_as_billing', this);">
<label for="donor_info_same_as_billingname">My address is the same as the billing information above.</label>
<input type="hidden" name="donor_info_same_as_billingsubmit" id="donor_info_same_as_billingsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_info_same_as_billing', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_info_same_as_billing_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_info_same_as_billingname')) {
document.getElementById('donor_info_same_as_billingname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_info_same_as_billingname')) {
return document.getElementById('donor_info_same_as_billingname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<h2 class="section-header-container section-header-6" id="recognition-name-header"> Your Name and Address </h2>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
jQuery('#donor_info_same_as_billingname').click(function() {
if (jQuery(this).attr('checked')) {
copySrcNameElement('billing_addr_street1', '', 'donor_addr_street1');
copySrcNameElement('billing_addr_street2', '', 'donor_addr_street2');
copySrcNameElement('billing_addr_city', '', 'donor_addr_city');
copySrcElement('billing_addr_state', '', 'donor_addr_state');
copySrcNameElement('billing_addr_zip', '', 'donor_addr_zip');
copySrcElement('billing_addr_country', '', 'donor_addr_country');
copySrcElement('billing_title', '', 'donor_title');
copySrcNameElement('billing_first_name', '', 'donor_first_name');
copySrcNameElement('billing_middle_name', '', 'donor_middle_name');
copySrcNameElement('billing_last_name', '', 'donor_last_name');
copySrcElement('billing_suffix', '', 'donor_suffix');
copySrcElement('billing_prof_suffix', '', 'donor_prof_suffix');
copySrcNameElement('billing_email_address', '', 'donor_email_address');
copySrcNameElement('billing_phone', '', 'donor_phone');
copySrcNameElement('billing_addr_street3', '', 'donor_addr_street3');
copySrcNameElement('billing_addr_county', '', 'donor_addr_county');
copySrcNameElement('billing_addr_postcode', '', 'donor_addr_postcode');
} else {
clearDestinationNameElement('donor_addr_street1');
clearDestinationNameElement('donor_addr_street2');
clearDestinationNameElement('donor_addr_city');
clearDestinationElement('donor_addr_state');
clearDestinationNameElement('donor_addr_zip');
clearDestinationElement('donor_addr_country');
clearDestinationElement('donor_title');
clearDestinationNameElement('donor_first_name');
clearDestinationNameElement('donor_middle_name');
clearDestinationNameElement('donor_last_name');
clearDestinationElement('donor_suffix');
clearDestinationElement('donor_prof_suffix');
clearDestinationNameElement('donor_email_address');
clearDestinationNameElement('donor_phone');
clearDestinationNameElement('donor_addr_street3');
clearDestinationNameElement('donor_addr_county');
clearDestinationNameElement('donor_addr_postcode');
}
});
});
function copySrcNameElement(source, previousPageValue, destination) {
copySrcElement(source + "name", previousPageValue, destination + "name");
}
function copySrcElement(source, previousPageValue, destination) {
if (previousPageValue !== '') {
jQuery('#' + destination).val(previousPageValue);
} else if (jQuery('#' + source).val() != undefined) {
jQuery('#' + destination).val(jQuery('#' + source).val());
}
}
function clearDestinationNameElement(destination) {
clearDestinationElement(destination + "name");
}
function clearDestinationElement(destination) {
jQuery('#' + destination).val("");
}
});
</script><noscript> </noscript>
<div id="donor_first_name_row" class="form-row form-text form-row-51">
<div class="form-content">
<label for="donor_first_namename">Your First Name:</label>
<input type="text" name="donor_first_namename" id="donor_first_namename" value="" maxlength="50">
<input type="hidden" name="donor_first_namesubmit" id="donor_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_last_name_row" class="form-row form-text form-row-52">
<div class="form-content">
<label for="donor_last_namename">Your Last Name:</label>
<input type="text" name="donor_last_namename" id="donor_last_namename" value="" maxlength="50">
<input type="hidden" name="donor_last_namesubmit" id="donor_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_addr_street1_row" class="form-row form-text form-row-53">
<div class="form-content">
<label for="donor_addr_street1name">Street Address: </label>
<input type="text" name="donor_addr_street1name" id="donor_addr_street1name" value="" maxlength="50">
<input type="hidden" name="donor_addr_street1submit" id="donor_addr_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_addr_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_addr_street1_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_addr_street2_row" class="form-row form-text form-row-54">
<div class="form-content">
<label for="donor_addr_street2name">Apt/Box/Unit/Suite: </label>
<input type="text" name="donor_addr_street2name" id="donor_addr_street2name" value="" maxlength="50">
<input type="hidden" name="donor_addr_street2submit" id="donor_addr_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_addr_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_addr_street2_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_addr_city_row" class="form-row form-text form-row-55">
<div class="form-content">
<label for="donor_addr_cityname">City:</label>
<input type="text" name="donor_addr_cityname" id="donor_addr_cityname" value="" maxlength="50">
<input type="hidden" name="donor_addr_citysubmit" id="donor_addr_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_addr_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_addr_city_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_addr_state_row" class="form-row form-selectlist form-row-56">
<div class="form-content">
<label class="FormLabel" for="donor_addr_state">State/Province:</label>
<select name="donor_addr_state" id="donor_addr_state" size="1" onchange="fire_obs_comp_event('donor_addr_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('donor_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_addr_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="donor_addr_statesubmit" id="donor_addr_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_addr_state_row', _display);
this.disable_submit_flag(_hidden);
}
function donor_addr_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('donor_addr_state', src);
}
}
var el = document.getElementById('donor_addr_state');
if (el) {
Utils.addEvent(el, 'change', donor_addr_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_addr_zip_row" class="form-row form-text form-row-57">
<div class="form-content">
<label for="donor_addr_zipname">ZIP/Postal code:</label>
<input type="text" name="donor_addr_zipname" id="donor_addr_zipname" value="" maxlength="50">
<input type="hidden" name="donor_addr_zipsubmit" id="donor_addr_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_addr_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_addr_zip_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div class="custom-field-container form-row custom-field-3 form-row-58 custom-field-container-3" id="alternative-donor-recognition-row" style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<label for="alternative_donor_recognition_dropdown">Alternative Donor Recognition</label>
</div>
<fieldset>
<input type="checkbox" name="alternative_donor_recognition_radio" id="alternative_donor_recognition_radio" value="true">
<label class="custom-element-checkbox-label" for="alternative_donor_recognition_radio">I/We would like to present the recognition for this gift on behalf of a family, company or other name instead.</label>
</fieldset>
<input type="hidden" name="alternative_donor_recognitionsubmit" id="alternative_donor_recognitionsubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row custom-field-4 form-row-59 custom-field-container-4" id="alt-donor-recog-other-field-input-row" style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<label for="alt_donor_recog_other_field_input">How would you this gift to be recognized (Family, Company or Other Name):</label>
</div>
<input type="text" name="alt_donor_recog_other_field_input" id="alt_donor_recog_other_field_input" value="" maxlength="255">
<input type="hidden" name="alt_donor_recog_other_fieldsubmit" id="alt_donor_recog_other_fieldsubmit" value="true">
</div>
</div>
<div class="form-row form-row-60" id="squadron-addl-information-prompt-row">
<div class="html-caption-container html-caption-5 html-caption-container-5">
<h3 id="squadron-addl-information-prompt" style="font-size: 18px; color: #222;">Additional Information</h3>
<p>Folds of Honor would like to learn more about our donors and, at times, provide timely information about our mission and appreciation gifts from our partners. Please tell us about yourself:</p>
</div>
</div>
<div class="custom-field-container form-row custom-field-5 form-row-61 custom-field-container-5" id="how-did-you-hear-about-folds-row">
<div class="form-content">
<div class="form-input-label-block">
<label for="where_did_you_hear_about_folds_input">How did you hear about us?</label>
</div>
<fieldset>
<div class="radio-button-container">
<input type="radio" name="where_did_you_hear_about_folds_radio" id="where_did_you_hear_about_folds_radio_cv_list" value="_cv_list" style="display: none;">
<select name="where_did_you_hear_about_folds_dropdown" id="where_did_you_hear_about_folds_dropdown" size="1">
<option value=""></option>
<option value="RC">Current / Past Scholarship Recipient</option>
<option value="RF">Referral / Word of Mouth (Donor, Family Member, Friend, Colleague, etc.)</option>
<option value="TV">TV / News Outlet</option>
<option value="SM">Social Media / Internet Search / Podcast</option>
<option value="CP">Corporate Partner</option>
<option value="EV">Event (Golf, Gala, Concert, etc.)</option>
<option value="OT">Other</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('where_did_you_hear_about_folds_dropdown', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('where_did_you_hear_about_folds_dropdown_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<label class="aural-only" for="where_did_you_hear_about_folds_radio_cv_list">This radio option selects the field value from the following selection list.</label>
</div>
<div class="radio-button-container how-did-you-hear-about-folds-other-row" style="display: none;">
<input type="radio" name="where_did_you_hear_about_folds_radio" id="where_did_you_hear_about_folds_radio_cv_txt" value="_cv_txt" style="display: none;">
<label class="aural-only" for="where_did_you_hear_about_folds_radio_cv_txt">This radio option selects the field value from the following text input field.</label>
<input type="text" name="where_did_you_hear_about_folds_input" id="where_did_you_hear_about_folds_input" value="" maxlength="60" placeholder="Please specify: Max length is 60 characters." style="display: none;">
</div>
</fieldset>
<input type="hidden" name="where_did_you_hear_about_foldssubmit" id="where_did_you_hear_about_foldssubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row custom-field-6 form-row-62 custom-field-container-6" id="birth-date-row">
<div class="form-content">
<div class="form-input-label-block">
<label for="birth_date_date_MONTH">Birth Month/Year</label>
</div>
<fieldset>
<label for="birth_date_date_MONTH"><span style="display:none;">Month</span></label>
<label for="birth_date_date_DAY"><span style="display:none;">Day</span></label>
<label for="birth_date_date_YEAR"><span style="display:none;">Year</span></label>
<select name="birth_date_date_MONTH" id="birth_date_date_MONTH" title="Month" class="pre-selected-option">
<option value="1">Jan</option>
<option value="2">Feb</option>
<option value="3">Mar</option>
<option value="4">Apr</option>
<option value="5">May</option>
<option value="6">Jun</option>
<option value="7">Jul</option>
<option value="8">Aug</option>
<option value="9">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
<select name="birth_date_date_DAY" id="birth_date_date_DAY" title="Day" class="pre-selected-option hide" style="display: none;">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select name="birth_date_date_YEAR" id="birth_date_date_YEAR" title="Year" class="pre-selected-option">
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1900">1900</option>
</select>
</fieldset>
<input type="hidden" name="birth_datesubmit" id="birth_datesubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row custom-field-7 form-row-63 custom-field-container-7" id="shirt-size-dropdown-row">
<div class="form-content">
<div class="form-input-label-block">
<label for="shirt_size_dropdown">T-Shirt Size</label>
</div>
<select name="shirt_size_dropdown" id="shirt_size_dropdown" size="1">
<option value=""></option>
<option value="Small">Small</option>
<option value="Medium">Medium</option>
<option value="Large">Large</option>
<option value="X-Large">X-Large</option>
<option value="XX-Large">XX-Large</option>
<option value="XXX-Large">XXX-Large</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('shirt_size_dropdown', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('shirt_size_dropdown_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="shirt_sizesubmit" id="shirt_sizesubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row custom-field-8 form-row-64 custom-field-container-8" id="no-donor-appreciation-gifts-row">
<div class="form-content">
<div class="form-input-label-block hide" style="display: none;">
<label for="no_donor_appreciation_gifts_dropdown">No Donor Appreciation Gifts</label>
</div>
<fieldset>
<input type="checkbox" name="no_donor_appreciation_gifts_radio" id="no_donor_appreciation_gifts_radio" value="true">
<label class="custom-element-checkbox-label" for="no_donor_appreciation_gifts_radio">I choose not to receive appreciation gifts, please apply my entire donation to the mission.</label>
</fieldset>
<input type="hidden" name="no_donor_appreciation_giftssubmit" id="no_donor_appreciation_giftssubmit" value="true">
</div>
</div>
<input type="hidden" name="charity_namehidden" id="charity_namehidden" value="Folds of Honor - South Texas Chapter">
<input type="hidden" name="charity_addresshidden" id="charity_addresshidden" value="124 Lamar Canyon Lane , Friendswood, TX 77546">
<input type="hidden" name="charity_contacthidden" id="charity_contacthidden" value="dnemecek@foldsofhonor.org">
<div class="form-row form-row-65" id="employer-matching-row">
<div class="html-caption-container html-caption-6 html-caption-container-6">
<span style="display: block;">
<h2 style="text-align: center;" id="employer-matching-header">Employer Matching</h2>
<script src="//doublethedonation.com/api/js/ddplugin.js"></script>
<link href="//doublethedonation.com/api/css/ddplugin.css" rel="stylesheet">
<p style="text-align: left;">Does your employer have a matching gift program? Please use the field below to find out.</p>
<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"><input type="hidden" name="doubledonation_company_id"><input type="hidden" name="doublethedonation_company_id"><input type="hidden" name="doubledonation_company_name"><input type="hidden"
name="doublethedonation_company_name">
<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="combobox" aria-expanded="false"
name="doublethedonation_company_name_input" autocomplete="new-password" type="text" id="dd-input" class="dtd-search-input form-control BBFormTextbox" placeholder="Search for company..." aria-label="Search for company..."
style="width: 100%;">
</div>
</div>
</div>
<script type="text/javascript">
Y.use('jquery-noconflict', function() {
jQuery(document).ready(function() {
jQuery(document).on('doublethedonation_company_id', function() {
setTimeout(function() {
var dtd_company_id = jQuery('input[name="doublethedonation_company_id"]').val();
jQuery('#double_the_donation_company_idhidden').val(dtd_company_id);
}, 2000);
});
});
});
</script>
</span>
<hr>
<style type="text/css">
div.responsive .cover-fee input {
margin: 6px 1px 1px 1px;
}
.cover-fee {
width: 100%;
float: left;
clear: both;
}
#cover-fee-yes {
max-width: 12px;
float: left;
margin-right: .3em;
}
label[for="cover-fee-yes"] {
float: left;
max-width: 92%;
}
</style>
<div class="cover-fee"><input type="checkbox" name="fee-cover" id="cover-fee-yes" value="yes"> <label for="cover-fee-yes">Yes, I want 100% to go to Folds of Honor. Please increase my amount by 3% to cover all transaction fees<span
class="cover_fees_total"></span>.</label></div>
<script type="text/javascript">
Y.use('jquery-noconflict', function() {
jQuery(document).ready(function($) {
var rememberLevel = readCookie('levelId');
var otherAmt = readCookie('otherAmt');
var coverFees = readCookie('coverFees');
var coverFees = readCookie('coverFees');
// $('div.donation-level-label-input-container input[type="radio"]:checked').parent().parent().parent().parent().addClass('cca-donation-amount-selected');
var deleteCookie = function(name) {
document.cookie = name + '=;expires= Thu, 01 Jan 1970 00:00:01 GMT;';
};
var formatMoney = function(amount) {
amountInCents = Number(amount);
var i = parseInt(amount = Math.abs(+amount || 0).toFixed(2), 10) + '',
j = (j = i.length) > 3 ? j % 3 : 0,
formattedMoney = '$' + (j ? i.substr(0, j) + ',' : '') + i.substr(j).replace(/(\d{3})(?=\d)/g, "$1" + ',') + '.' + Math.abs(amount - i).toFixed(2).slice(2);
formattedMoney = formattedMoney.replace('.00', '');
return formattedMoney;
}
var populateBtn = function(activeAmt) {
if ($('#cover-fee-yes').is(':checked')) {
var btnText = 'Donate ' + activeAmt;
} else {
var btnText = 'Donate';
}
if ($('#pstep_next').length > 0) {
$('#pstep_next').text(btnText);
}
if ($('#pstep_finish').length > 0) {
$('#pstep_finish').text(btnText);
}
}
var getAmt = function() {
if ($('.other-amount input[type="radio"]').is(':checked')) {
selectAmt = Number(delimitNumbers($('.donation-level-user-entered input').val()));
document.cookie = "levelId=other";
document.cookie = "otherAmt=" + selectAmt;
} else {
if ($('#level_standard_row').length > 0) {
$("[id^=level_standardexpanded]").each(function() {
if ($(this).is(':checked')) {
var selectedLevelId = $(this).prop('id');
selectAmt = Number(delimitNumbers($(this).parent().next().children('.donation-level-amount-container, .donation-level-label-container').text()));
document.cookie = "levelId=" + selectedLevelId;
}
});
}
}
activeAmtAdd = Number(strRound(delimitNumbers(selectAmt) * .03), 2);
activeAmtAdd = activeAmtAdd + 0;
activeAmt = strRound(delimitNumbers(selectAmt + activeAmtAdd));
activeAmtFormat = formatMoney(activeAmt);
totalAmt = Number(selectAmt) + Number(activeAmt);
totalAmtFormat = formatMoney(totalAmt);
activeAmtAddFormat = formatMoney(activeAmtAdd);
paypalAmtAdd = Number(strRound(delimitNumbers(selectAmt) * .03), 2);
paypalAmtAdd = paypalAmtAdd + 0;
paypalAmt = strRound(delimitNumbers(paypalAmtAdd + selectAmt));
paypalAmtFormat = formatMoney(paypalAmt);
$('.cover_fees_total').html(', an extra <strong>' + activeAmtAddFormat + '</strong>, increasing your total donation to <strong>' + activeAmtFormat + '</strong>');
paymentType = $('.payment-type-selections input[name="responsive_payment_typepay_typeradio"]').val();
if ($('.external-payment .payment-type-option').hasClass('selected')) {
//console.log('use paypal');
donateAmt = paypalAmtFormat;
} else {
//console.log('use cc');
donateAmt = activeAmtFormat;
}
}
function delimitNumbers(str) {
return (str + '').replace(/[^\d.-]/g, '');
}
function removeNonNumbers(str) {
return (str + '').replace(/[^0-9\.]+/g, '');
}
function strRound(str) {
str = removeNonNumbers(str).split('.', 2);
if (str[1]) {
str[1] = str[1].substring(0, 2);
}
str = str.join('.');
return str;
}
function readCookie(name) {
var nameEQ = name + '=';
var ca = document.cookie.split(';');
for (var i = 0; i < ca.length; i++) {
var c = ca[i];
while (c.charAt(0) == ' ') c = c.substring(1, c.length);
if (c.indexOf(nameEQ) == 0) return c.substring(nameEQ.length, c.length);
}
return null;
}
$('#cc_fees_row').insertAfter('.donation-levels');
$('.donation-level-user-entered').parent().addClass('other-amount');
if (rememberLevel != undefined || rememberLevel != null) {
$('#' + rememberLevel).prop('checked', true);
$('.donation-level-user-entered input[type="text"]').val('');
if (rememberLevel == 'other') {
$('.other-amount input[type="radio"]').prop('checked', true);
$('.donation-level-user-entered input[type="text"]').val(otherAmt);
}
}
if (coverFees == 'true') {
$('#cover-fee-yes').prop('checked', true);
$('#cover_feeshidden').val('true');
if ($('div.donation-level-label-input-container input[type="radio"]:checked').length > 0) {
getAmt();
}
//populateBtn(donateAmt);
} else {
$('#cover_feeshidden').val('false');
}
$('#cover_fees, .donation-level-container, div.donation-level-label-input-container input[type="radio"]').change(function() {
/*
var oldHref = $('#org_donate_button').attr('href');
console.log(oldHref.indexOf('set.DonationLevel='));
var hrefIndex = Number(oldHref.indexOf('set.DonationLevel=')) + 18;
var newHref = $('#org_donate_button').attr('href').substring(0,hrefIndex) + $('.donation-level-container input[type="radio"]:checked').val();
console.log(newHref);
$('#org_donate_button').attr('href',newHref);
*/
if ($('#cover-fee-yes').is(':checked')) {
if ($('div.donation-level-label-input-container input[type="radio"]:checked').length > 0) {
getAmt();
}
} else {
if ($('div.donation-level-label-input-container input[type="radio"]:checked').length > 0) {
getAmt();
}
deleteCookie('coverFees');
deleteCookie('levelId');
deleteCookie('otherAmt');
}
//populateBtn(donateAmt);
});
$('.tabbutton a').click(function() {
deleteCookie('levelId');
deleteCookie('otherAmt');
if ($('#cover-fee-yes').is(':checked')) {
deleteCookie('coverFees');
document.cookie = 'coverFees=true';
} else {
deleteCookie('coverFees');
document.cookie = 'coverFees=false';
}
});
$('.internal-payment a').click(function() {
//populateBtn(activeAmtFormat);
});
$('.external-payment a').click(function() {
//populateBtn(paypalAmtFormat);
});
$('#ProcessForm').submit(function() {
if ($('#cover-fee-yes').is(':checked')) {
getAmt();
$('#s_cover_fees').val('checked');
$('#cover_feeshidden').val('true');
$('.other-amount input[type="radio"]').prop('checked', true);
$('.donation-level-user-entered input[type="text"]').val(donateAmt);
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<p style="display: inline-block;" align="center">If you have questions or to donate by phone, please call <a style="color: #222; text-decoration: none; cursor: pointer;" href="tel:+19182744700">(918) 274-4700</a>.</p>
<p align="center">Folds of Honor South Texas Chapter<br>124 Lamar Canyon Lane , Friendswood, TX 77546 | dnemecek@foldsofhonor.org</p>
<p style="font-size: 0.8em; font-style: italic;" align="center">Folds of Honor Foundation is a registered 501(c)(3) public charity number 83-1547041.</p>
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<p class="modal-title"><strong>Thank you for your support of Folds of Honor Foundation!</strong><br>Sometimes you want to do more. You can help more military families affected by war by switching your $<span
class="oneTimeAmt"></span> gift to a $<span class="suggestedAmt"></span> monthly gift now and become a Folds of Honor Wingman. A Folds of Honor Wingman dutifully supports the pursuit of education for our military families
affected by war.</p> <br>
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</form>Text Content
STAND WITH US. Your donation faithfully supports the pursuit of education for the families of America’s fallen and disabled heroes. = Required fields GIFT FREQUENCY One-time GiftJoin the Squadron Join the Squadron for $13 or more a month. Join the Squadron for $13 or more a month. Field Is Required Enter A Gift Amount: $13 $50 $100 $250 Enter amount Comments: TRIBUTE INFORMATION This gift is to honor or in memory of someone. Honor Gift Type: In Memory of In Honor of Required In Honor ofIn Memory of Tribute Title: Mr. Ms. Mrs. Miss Dr. Required Tribute First Name: Tribute Last Name: WOULD YOU LIKE TO NOTIFY SOMEONE ABOUT THIS GIFT? Please note that the notification address information below will only be used to send a notification and not used for any other purpose. By MailNo, Thank You RECIPIENT ADDRESS INFORMATION Notification Recipient Name: Notification Street Address: Notification Apt/Box/Unit/Suite: Notification City: Notification State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required Notification ZIP/Postal Code: Personal Message: How would you like your information to be shared in the notification letter? Name Only Name and Address Anonymous Required Please send an email notification on: Yes, please send an email notification. Send email notification on:Select month of credit card Select Expiration Year Month Day Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2034 2033 2032 2031 2030 2029 2028 2027 2026 2025 2024 Recipient email addresses (separated by commas): Layout: Subject Line: Yes, please send me a copy of this email notification. BILLING INFORMATION Make this gift on behalf of an organization Organization Name: First Name: Last Name: Street Address: Apt/Box/Unit/Suite: City: State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required ZIP/Postal Code: Country: United States Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivarian Republic of Venezuela Bonaire, Sint Eustatios and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic People's Republic of Korea The Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Federated States of Micronesia Fiji Finland The Former Yugoslav Republic of Macedonia France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Islamic Republic of Iran Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Plurinational State of Bolivia Poland Portugal Puerto Rico Qatar Republic of Korea Republic of Moldova Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles S. Georgia & S. Sandwich Isls. Sierra Leone Singapore Sint Maarten (Dutch) Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania Uruguay USA Minor Outlying Islands Uzbekistan Vanuatu Viet Nam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Required Email Address: Yes, I would like to opt in to receive email from Folds of Honor. If you donate and have not already registered, you will receive periodic updates and communications from Folds of Honor Foundation. PAYMENT TYPE PAYMENT METHOD: Credit Card Bank Account CREDIT CARD INFORMATION: Credit Card Type: * * * * Credit Card Number: Expiration Date:Select month of credit card Select Expiration Year 01 02 03 04 05 06 07 08 09 10 11 12 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 CVV Number: What is this? BANK ACCOUNT INFORMATION: Bank Routing Number: What is this? Bank Account Number: Verify Bank Account Number: Account Type: * Checking * Savings I agree to use my bank account as a payment method and authorize the Folds of Honor Foundation to debit my bank account to fulfill my donation commitment. CHECK INFORMATION My address is the same as the billing information above. YOUR NAME AND ADDRESS Your First Name: Your Last Name: Street Address: Apt/Box/Unit/Suite: City: State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required ZIP/Postal code: Alternative Donor Recognition I/We would like to present the recognition for this gift on behalf of a family, company or other name instead. How would you this gift to be recognized (Family, Company or Other Name): ADDITIONAL INFORMATION Folds of Honor would like to learn more about our donors and, at times, provide timely information about our mission and appreciation gifts from our partners. Please tell us about yourself: How did you hear about us? Current / Past Scholarship Recipient Referral / Word of Mouth (Donor, Family Member, Friend, Colleague, etc.) TV / News Outlet Social Media / Internet Search / Podcast Corporate Partner Event (Golf, Gala, Concert, etc.) Other Required This radio option selects the field value from the following selection list. This radio option selects the field value from the following text input field. Birth Month/Year Month Day Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1900 T-Shirt Size Small Medium Large X-Large XX-Large XXX-Large Required No Donor Appreciation Gifts I choose not to receive appreciation gifts, please apply my entire donation to the mission. EMPLOYER MATCHING Does your employer have a matching gift program? Please use the field below to find out. -------------------------------------------------------------------------------- Yes, I want 100% to go to Folds of Honor. Please increase my amount by 3% to cover all transaction fees. Submit If you have questions or to donate by phone, please call (918) 274-4700. Folds of Honor South Texas Chapter 124 Lamar Canyon Lane , Friendswood, TX 77546 | dnemecek@foldsofhonor.org Folds of Honor Foundation is a registered 501(c)(3) public charity number 83-1547041. https://southtexas.foldsofhonor.org Folds of Honor South Texas Chapter Thank you for your support of Folds of Honor Foundation! Sometimes you want to do more. You can help more military families affected by war by switching your $ gift to a $ monthly gift now and become a Folds of Honor Wingman. A Folds of Honor Wingman dutifully supports the pursuit of education for our military families affected by war. Keep my one-time $ gift. Make it a $ monthly gift instead.