samaritansfeet.org
Open in
urlscan Pro
192.252.144.30
Public Scan
Submitted URL: https://u35796417.ct.sendgrid.net/ls/click?upn=A6n-2FQX0vH88ljQD0SPzt3Yp3dBb0HiEihLlrjOlHGOykUdE9gvp3yTUJHaQ41-2BAyi-2BMnLckBxCXWh...
Effective URL: https://samaritansfeet.org/?blm_aid=1679964
Submission: On January 22 via manual from IN — Scanned from DE
Effective URL: https://samaritansfeet.org/?blm_aid=1679964
Submission: On January 22 via manual from IN — Scanned from DE
Form analysis
10 forms found in the DOMGET https://samaritansfeet.org/
<form class="nd_options_navigation_search_content_form" method="get" action="https://samaritansfeet.org/">
<input class="nd_options_first_font" type="search" placeholder="Keyword" value="" name="s">
<input class="" type="submit" value="Search">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="7"
class="fc-form fc-form-7 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field1" data-index="0" style="width: 50%" class=" form-element form-element-field1 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="First Name" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field6" data-index="1" style="width: 50%" class=" even form-element form-element-field6 options-false form-element-1 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Last Name" make-read-only="false" data-field-id="field6" name="field6[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="2" style="width: 100%" class=" form-element form-element-field2 options-false form-element-2 default-false form-element-type-email is-required-true odd -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field4" data-index="3" style="width: 100%" class=" even form-element form-element-field4 options-false form-element-3 default-false form-element-type-oneLineText is-required-false -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Phone Number</span></span><span class="sub-label"><span>your full name</span></span></span>
<div><span class="error"></span><input type="text" placeholder="Phone Number" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="numbers" data-regexp=""
data-is-required="false" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="4" style="width: 100%" class=" form-element form-element-field3 options-false form-element-4 default-false form-element-type-textarea is-required-true odd -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Comments</span></span><span class="sub-label"><span>more details</span></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="Comments" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="true" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 92.5469px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="5" style="width: 100%" class=" even form-element form-element-field5 options-false form-element-5 default-false form-element-type-submit is-required-false -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="11752">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="5"
class="fc-form fc-form-5 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-block field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field1" data-index="0" style="width: 100%" class=" form-element form-element-field1 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Name of Family/Individual, Business, School, Church, Etc.</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="1" style="width: 100%" class=" even form-element form-element-field2 options-false form-element-1 default-false form-element-type-email is-required-true -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field12" data-index="2" style="width: 100%" class=" form-element form-element-field12 form-element-2 default-false form-element-type-customText is-required-false odd -handle options-false">
<div class="form-element-html">
<div>
<div class="absolute-false customText-cover field-cover" style="left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:">
<div class="full" style="text-align: left">
<p></p>
<p><span xml:lang="EN-US" lang="EN-US" style="padding: 0px"><span style="padding: 0px">We offer warehouse volunteer shifts on:</span></span></p>
<p><span xml:lang="EN-US" lang="EN-US" style="padding: 0px"><span style="padding: 0px">Tuesday-Saturday: 9:00am-12:00pm</span></span></p>
<ul></ul>
<p></p>
</div><input type="hidden" name="field12" data-field-id="field12">
</div>
</div>
</div>
</div>
<div data-identifier="field4" data-index="3" style="width: 100%" class=" even form-element form-element-field4 form-element-3 default-false form-element-type-oneLineText is-required-true -handle options-false">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Preferred Volunteer Date(s) MM/DD</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field10" data-index="4" style="width: 100%" class=" form-element form-element-field10 options-false form-element-4 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Number of People in Your Group</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field10" name="field10[]" data-min-char="" data-max-char="" data-val-type="numbers" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field14" data-index="5" style="width: 100%" class=" even form-element form-element-field14 options-false form-element-5 default-false form-element-type-checkbox is-required-true -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-true"><span class="main-label"><span>Age Policy Agreement</span></span><span class="sub-label"><span>In order to volunteer at Samaritan's Feet, individuals must be a
minimum of eight years of age and must be chaperoned by an adult at all times. Please note that we require all minors to be chaperoned in a ratio of one adult to every five minors. By selecting yes, you agree to supply the
required number of chaperones and to not bring minors in attendance under the age of eight.</span></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span><label style="width:"><img alt=""><input data-field-id="field14" type="radio"
data-is-required="true" name="field14[]" value="Yes" class="validation-lenient"><span><span>Yes</span></span></label><label style="width:"><img alt=""><input data-field-id="field14" type="radio" data-is-required="true"
name="field14[]" value="No" class="validation-lenient"><span><span>No</span></span></label></div>
</div>
</div>
</div>
</div>
<div data-identifier="field15" data-index="6" style="width: 100%" class=" form-element form-element-field15 options-false form-element-6 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>How many minors (age 8 - 18) will be in your group?</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field15" name="field15[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="7" style="width: 100%" class=" even form-element form-element-field3 options-false form-element-7 default-false form-element-type-textarea is-required-true -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Comments</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="true" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 91.7969px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="8" style="width: 100%" class=" form-element form-element-field5 options-false form-element-8 default-false form-element-type-submit is-required-false odd -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="5624">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="7"
class="fc-form fc-form-7 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field1" data-index="0" style="width: 50%" class=" form-element form-element-field1 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="First Name" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field6" data-index="1" style="width: 50%" class=" even form-element form-element-field6 options-false form-element-1 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Last Name" make-read-only="false" data-field-id="field6" name="field6[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="2" style="width: 100%" class=" form-element form-element-field2 options-false form-element-2 default-false form-element-type-email is-required-true odd -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field4" data-index="3" style="width: 100%" class=" even form-element form-element-field4 options-false form-element-3 default-false form-element-type-oneLineText is-required-false -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Phone Number</span></span><span class="sub-label"><span>your full name</span></span></span>
<div><span class="error"></span><input type="text" placeholder="Phone Number" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="numbers" data-regexp=""
data-is-required="false" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="4" style="width: 100%" class=" form-element form-element-field3 options-false form-element-4 default-false form-element-type-textarea is-required-true odd -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Comments</span></span><span class="sub-label"><span>more details</span></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="Comments" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="true" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 92.5469px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="5" style="width: 100%" class=" even form-element form-element-field5 options-false form-element-5 default-false form-element-type-submit is-required-false -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="10733">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="67"
class="fc-form fc-form-67 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field1" data-index="0" style="width: 50%" class=" form-element form-element-field1 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="First Name" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field6" data-index="1" style="width: 50%" class=" even form-element form-element-field6 options-false form-element-1 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Last Name" make-read-only="false" data-field-id="field6" name="field6[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="2" style="width: 100%" class=" form-element form-element-field2 options-false form-element-2 default-false form-element-type-email is-required-true odd -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field4" data-index="3" style="width: 100%" class=" even form-element form-element-field4 options-false form-element-3 default-false form-element-type-oneLineText is-required-false -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Phone Number</span></span><span class="sub-label"><span>your full name</span></span></span>
<div><span class="error"></span><input type="text" placeholder="Phone Number" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="numbers" data-regexp=""
data-is-required="false" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="4" style="width: 100%" class=" form-element form-element-field3 options-false form-element-4 default-false form-element-type-textarea is-required-true odd -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Comments</span></span><span class="sub-label"><span>more details</span></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="Comments" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="true" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 92.5469px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="5" style="width: 100%" class=" even form-element form-element-field5 options-false form-element-5 default-false form-element-type-submit is-required-false -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="7614">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="60"
class="fc-form fc-form-60 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field1" data-index="0" style="width: 50%" class=" form-element form-element-field1 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="First Name" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field6" data-index="1" style="width: 50%" class=" even form-element form-element-field6 options-false form-element-1 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Last Name" make-read-only="false" data-field-id="field6" name="field6[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="2" style="width: 100%" class=" form-element form-element-field2 options-false form-element-2 default-false form-element-type-email is-required-true odd -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field4" data-index="3" style="width: 100%" class=" even form-element form-element-field4 options-false form-element-3 default-false form-element-type-oneLineText is-required-false -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Phone Number</span></span><span class="sub-label"><span>your full name</span></span></span>
<div><span class="error"></span><input type="text" placeholder="Phone Number" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="numbers" data-regexp=""
data-is-required="false" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="4" style="width: 100%" class=" form-element form-element-field3 options-false form-element-4 default-false form-element-type-textarea is-required-true odd -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Comments</span></span><span class="sub-label"><span>more details</span></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="Comments" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="true" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 92.5469px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="5" style="width: 100%" class=" even form-element form-element-field5 options-false form-element-5 default-false form-element-type-submit is-required-false -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="6607">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="42"
class="fc-form fc-form-42 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field1" data-index="0" style="width: 100%" class=" form-element form-element-field1 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>First & Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="First & Last Name" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp=""
data-is-required="true" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="1" style="width: 100%" class=" even form-element form-element-field2 options-false form-element-1 default-false form-element-type-email is-required-true -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field4" data-index="2" style="width: 100%" class=" form-element form-element-field4 options-false form-element-2 default-false form-element-type-oneLineText is-required-false odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Phone Number</span></span><span class="sub-label"><span>your full name</span></span></span>
<div><span class="error"></span><input type="text" placeholder="Phone Number" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="numbers" data-regexp=""
data-is-required="false" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="3" style="width: 100%" class=" even form-element form-element-field3 options-false form-element-3 default-false form-element-type-textarea is-required-true -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Comments</span></span><span class="sub-label"><span>more details</span></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="Comments" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="true" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 91.7969px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="4" style="width: 100%" class=" form-element form-element-field5 options-false form-element-4 default-false form-element-type-submit is-required-false odd -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="5844">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="38"
class="fc-form fc-form-38 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-block field-border-visible frame-hidden field-alignment-left align-center"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field24" data-index="0" style="width: 50%" class=" form-element form-element-field24 options-false form-element-0 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field24" name="field24[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field25" data-index="1" style="width: 50%" class=" even form-element form-element-field25 options-false form-element-1 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field25" name="field25[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field1" data-index="2" style="width: 100%" class=" form-element form-element-field1 options-false form-element-2 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Name of Family/Individual, Business, School, Church, Etc.</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="3" style="width: 100%" class=" even form-element form-element-field2 options-false form-element-3 default-false form-element-type-email is-required-true -handle">
<div class="form-element-html">
<div><label class="email-cover field-cover"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="" data-field-id="field2" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field2" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field12" data-index="4" style="width: 100%" class=" form-element form-element-field12 options-false form-element-4 default-false form-element-type-customText is-required-false odd -handle">
<div class="form-element-html">
<div>
<div class="absolute-false customText-cover field-cover" style="left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:">
<div class="full" style="text-align: left">
<p></p>
<p><span xml:lang="EN-US" lang="EN-US" style="padding: 0px"><span style="padding: 0px">We offer pick-up and drop-off during the following times:</span></span></p>
<p><span xml:lang="EN-US" lang="EN-US" style="padding: 0px"><span style="padding: 0px">Monday-Friday: 9:00am-12:00pm or 1:00pm-3:00pm</span></span></p>
<ul></ul>
<p></p>
</div><input type="hidden" name="field12" data-field-id="field12">
</div>
</div>
</div>
</div>
<div data-identifier="field26" data-index="5" style="width: 100%" class=" even form-element form-element-field26 options-true form-element-5 default-false form-element-type-datepicker is-required-true -handle">
<div class="form-element-html">
<div><label class="datepicker-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Preferred Date(s) for Pick-Up (MM/DD)</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input autocomplete="off" data-field-id="field26" placeholder="" type="text" class="validation-lenient ng-empty hasDatepicker" data-is-required="true" datepicker="" data-date-min-range=""
data-date-format="mm/dd/yy" data-date-days="{"0":false,"1":true,"2":true,"3":true,"4":true,"5":true,"6":false}" data-date-min="" data-date-min-alt=""
data-date-max-alt="" data-date-max="" data-date-lang="en" name="field26" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""
id="dp1705936332662"><i class="formcraft-icon">date_range</i></div>
</label></div>
</div>
</div>
<div data-identifier="field28" data-index="6" style="width: 100%" class=" form-element form-element-field28 options-false form-element-6 default-false form-element-type-dropdown is-required-true odd -handle">
<div class="form-element-html">
<div><label class="dropdown-cover field-cover autocomplete-type- has-input"><span class="sub-label-false"><span class="main-label"><span>Preferred Time for Pick-Up</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><select data-is-required="true" class="validation-lenient" data-field-id="field28" name="field28" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true"
data-original-title="">
<option value="" class=" ">Select An Option</option>
<option value="9:00am - 9:30am" class=" ">9:00am - 9:30am</option>
<option value="9:30am - 10:00am" class=" ">9:30am - 10:00am</option>
<option value="10:00am - 10:30am" class=" ">10:00am - 10:30am</option>
<option value="10:30am - 11:00am" class=" ">10:30am - 11:00am</option>
<option value="11:00am - 11:30am" class=" ">11:00am - 11:30am</option>
<option value="11:30am - 12:00pm" class=" ">11:30am - 12:00pm</option>
<option value="1:00pm - 1:30pm" class=" ">1:00pm - 1:30pm</option>
<option value="1:30pm - 2:00pm" class=" ">1:30pm - 2:00pm</option>
<option value="2:00pm - 2:30pm" class=" ">2:00pm - 2:30pm</option>
</select><input type="text"></div>
</label></div>
</div>
</div>
<div data-identifier="field27" data-index="7" style="width: 100%" class=" even form-element form-element-field27 options-false form-element-7 default-false form-element-type-datepicker is-required-true -handle">
<div class="form-element-html">
<div><label class="datepicker-cover field-cover"><span class="sub-label-true"><span class="main-label"><span>Preferred Date(s) for Drop-Off</span></span><span class="sub-label"><span>Not to exceed two weeks past pick-up
date.</span></span></span>
<div><span class="error"></span><input autocomplete="off" data-field-id="field27" placeholder="" type="text" class="validation-lenient ng-empty hasDatepicker" data-is-required="true" datepicker="" data-date-min-range=""
data-date-format="mm/dd/yy" data-date-days="{"0":false,"1":true,"2":true,"3":true,"4":true,"5":true,"6":false}" data-date-min="" data-date-min-alt=""
data-date-max-alt="" data-date-max="" data-date-lang="en" name="field27" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""
id="dp1705936332663"><i class="formcraft-icon">date_range</i></div>
</label></div>
</div>
</div>
<div data-identifier="field29" data-index="8" style="width: 100%" class=" form-element form-element-field29 options-false form-element-8 default-false form-element-type-dropdown is-required-true odd -handle">
<div class="form-element-html">
<div><label class="dropdown-cover field-cover autocomplete-type- has-input"><span class="sub-label-false"><span class="main-label"><span>Preferred Time for Drop-Off</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><select data-is-required="true" class="validation-lenient" data-field-id="field29" name="field29" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true"
data-original-title="">
<option value="" class=" ">Select An Option</option>
<option value="9:00am - 9:30am" class=" ">9:00am - 9:30am</option>
<option value="9:30am - 10:00am" class=" ">9:30am - 10:00am</option>
<option value="10:00am - 10:30am" class=" ">10:00am - 10:30am</option>
<option value="10:30am - 11:00am" class=" ">10:30am - 11:00am</option>
<option value="11:00am - 11:30am" class=" ">11:00am - 11:30am</option>
<option value="11:30am - 12:00pm" class=" ">11:30am - 12:00pm</option>
<option value="1:00pm - 1:30pm" class=" ">1:00pm - 1:30pm</option>
<option value="1:30pm - 2:00pm" class=" ">1:30pm - 2:00pm</option>
<option value="2:00pm - 2:30pm" class=" ">2:00pm - 2:30pm</option>
</select><input type="text"></div>
</label></div>
</div>
</div>
<div data-identifier="field18" data-index="9" style="width: 100%" class=" even form-element form-element-field18 options-false form-element-9 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Make and Model of Car</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field18" name="field18[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field21" data-index="10" style="width: 100%" class=" form-element form-element-field21 options-false form-element-10 default-false form-element-type-checkbox is-required-true odd -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Will the trunk of the car be available?</span></span><span class="sub-label"></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span><label style="width:"><img alt=""><input data-field-id="field21" type="radio"
data-is-required="true" name="field21[]" value="Yes" class="validation-lenient"><span><span>Yes</span></span></label><label style="width:"><img alt=""><input data-field-id="field21" type="radio" data-is-required="true"
name="field21[]" value="No" class="validation-lenient"><span><span>No</span></span></label></div>
</div>
</div>
</div>
</div>
<div data-identifier="field22" data-index="11" style="width: 100%" class=" even form-element form-element-field22 options-false form-element-11 default-false form-element-type-checkbox is-required-true -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Will the back seat of the car be available?</span></span><span class="sub-label"></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span><label style="width:"><img alt=""><input data-field-id="field22" type="radio"
data-is-required="true" name="field22[]" value="Yes" class="validation-lenient"><span><span>Yes</span></span></label><label style="width:"><img alt=""><input data-field-id="field22" type="radio" data-is-required="true"
name="field22[]" value="No" class="validation-lenient"><span><span>No</span></span></label></div>
</div>
</div>
</div>
</div>
<div data-identifier="field10" data-index="12" style="width: 100%" class=" form-element form-element-field10 options-false form-element-12 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover"><span class="sub-label-true"><span class="main-label"><span>How many hours are you looking to volunteer?</span></span><span class="sub-label"><span>If exceeding six hours, please consider
signing up for volunteer shifts in our warehouse.</span></span></span>
<div><span class="error"></span><input type="text" placeholder="" make-read-only="false" data-field-id="field10" name="field10[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field23" data-index="13" style="width: 100%" class=" even form-element form-element-field23 options-false form-element-13 default-false form-element-type-dropdown is-required-true -handle">
<div class="form-element-html">
<div><label class="dropdown-cover field-cover autocomplete-type- has-input"><span class="sub-label-true"><span class="main-label"><span>Is there a particular project you're interested in working on?</span></span><span
class="sub-label"><span>Please note that we cannot guarantee your request will be granted as selection is based off need.</span></span></span>
<div><span class="error"></span><select data-is-required="true" class="validation-lenient" data-field-id="field23" name="field23" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true"
data-original-title="">
<option value="" class=" ">Select An Option</option>
<option value="Whatever is Needed" class=" ">Whatever is Needed</option>
<option value="Socks" class=" ">Socks</option>
<option value="Hope Notes" class=" ">Hope Notes</option>
<option value="Hope Totes" class=" ">Hope Totes</option>
<option value="Sticker Rolls" class=" ">Sticker Rolls</option>
<option value="Stuff Envelopes" class=" ">Stuff Envelopes</option>
</select><input type="text"></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="14" style="width: 100%" class=" form-element form-element-field3 options-false form-element-14 default-false form-element-type-textarea is-required-false odd -handle">
<div class="form-element-html">
<div><label class="textarea-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Comments</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="" class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char="" data-is-required="false" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 92.5469px; overflow: hidden visible; overflow-wrap: break-word;"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="15" style="width: 100%" class=" even form-element form-element-field5 options-false form-element-15 default-false form-element-type-submit is-required-false -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="5632">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="33"
class="fc-form fc-form-33 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left align-center"
style="width: 480px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field27" data-index="0" style="width: 100%" class=" form-element form-element-field27 options-false form-element-0 default-false form-element-type-heading is-required-false odd -handle">
<div class="form-element-html">
<div>
<div style="background-color:" class="heading-cover field-cover ">
<div style="text-align: left; font-size: 1.5em; padding-top: ; padding-bottom: ; color:" class="bold-"><span>Shoe Locker Pledge Form</span></div><input type="hidden" data-field-id="field27" name="field27[]"
value="Shoe Locker Pledge Form">
</div>
</div>
</div>
</div>
<div data-identifier="field16" data-index="1" style="width: 100%" class=" even form-element form-element-field16 options-false form-element-1 default-false form-element-type-checkbox is-required-true -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Are you sponsoring as an individual or on behalf of a company?</span></span><span class="sub-label"></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span><label style="width:"><img alt=""><input data-field-id="field16" type="radio"
data-is-required="true" name="field16[]" value="Individual" class="validation-lenient"><span><span>Individual</span></span></label><label style="width:"><img alt=""><input data-field-id="field16" type="radio"
data-is-required="true" name="field16[]" value="Company" class="validation-lenient"><span><span>Company</span></span></label></div>
</div>
</div>
</div>
</div>
<div data-identifier="field1" data-index="2" style="width: 50%; display: none;" class="form-element form-element-field1 options-false form-element-2 default-true form-element-type-oneLineText is-required-true odd -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="First Name" make-read-only="false" data-field-id="field1" name="field1[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field2" data-index="3" style="width: 50%; display: none;" class="even form-element form-element-field2 options-false form-element-3 default-true form-element-type-oneLineText is-required-true -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Last Name" make-read-only="false" data-field-id="field2" name="field2[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="4" style="width: 100%; display: none;" class="form-element form-element-field3 options-false form-element-4 default-true form-element-type-email is-required-true odd -handle state-hidden">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field3" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field3" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field4" data-index="5" style="width: 100%; display: none;" class="even form-element form-element-field4 options-false form-element-5 default-true form-element-type-oneLineText is-required-true -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Phone Number</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Phone Number" make-read-only="false" data-field-id="field4" name="field4[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field18" data-index="6" style="width: 100%; display: none;" class="form-element form-element-field18 options-false form-element-6 default-true form-element-type-oneLineText is-required-true odd -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Company Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Company Name" make-read-only="false" data-field-id="field18" name="field18[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field19" data-index="7" style="width: 50%; display: none;" class="even form-element form-element-field19 options-false form-element-7 default-true form-element-type-oneLineText is-required-true -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Company Contact First Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Company Contact First Name" make-read-only="false" data-field-id="field19" name="field19[]" data-min-char="" data-max-char="" data-val-type="" data-regexp=""
data-is-required="true" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field20" data-index="8" style="width: 50%; display: none;" class="form-element form-element-field20 options-false form-element-8 default-true form-element-type-oneLineText is-required-true odd -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Company Contact Last Name</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Company Contact Last Name" make-read-only="false" data-field-id="field20" name="field20[]" data-min-char="" data-max-char="" data-val-type="" data-regexp=""
data-is-required="true" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field21" data-index="9" style="width: 100%; display: none;" class="even form-element form-element-field21 options-false form-element-9 default-true form-element-type-email is-required-true -handle state-hidden">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Company Contact Email</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input placeholder="Company Contact Email" data-field-id="field21" type="text" data-val-type="email" make-read-only="" data-is-required="true" name="field21" class="validation-lenient"
data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field23" data-index="10" style="width: 100%; display: none;" class="form-element form-element-field23 options-false form-element-10 default-true form-element-type-oneLineText is-required-true odd -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Company Contact Phone Number</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Company Contact Phone Number" make-read-only="false" data-field-id="field23" name="field23[]" data-min-char="" data-max-char="" data-val-type="" data-regexp=""
data-is-required="true" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field7" data-index="11" style="width: 100%" class=" even form-element form-element-field7 options-false form-element-11 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Mailing Address</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Mailing Address" make-read-only="false" data-field-id="field7" name="field7[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field8" data-index="12" style="width: 100%" class=" form-element form-element-field8 options-false form-element-12 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>City</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="City" make-read-only="false" data-field-id="field8" name="field8[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field10" data-index="13" style="width: 50%" class=" even form-element form-element-field10 options-false form-element-13 default-false form-element-type-dropdown is-required-true -handle">
<div class="form-element-html">
<div><label class="dropdown-cover field-cover autocomplete-type- has-input"><span class="sub-label-false"><span class="main-label"><span>State</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><select data-is-required="true" class="validation-lenient" data-field-id="field10" name="field10" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true"
data-original-title="">
<option value="" class=" ">Select State</option>
<option value="AL" class=" ">Alabama</option>
<option value="AK" class=" ">Alaska</option>
<option value="AZ" class=" ">Arizona</option>
<option value="AR" class=" ">Arkansas</option>
<option value="CA" class=" ">California</option>
<option value="CO" class=" ">Colorado</option>
<option value="CT" class=" ">Connecticut</option>
<option value="DE" class=" ">Delaware</option>
<option value="FL" class=" ">Florida</option>
<option value="GA" class=" ">Georgia</option>
<option value="HI" class=" ">Hawaii</option>
<option value="ID" class=" ">Idaho</option>
<option value="IL" class=" ">Illinois</option>
<option value="IN" class=" ">Indiana</option>
<option value="IA" class=" ">Iowa</option>
<option value="KS" class=" ">Kansas</option>
<option value="KY" class=" ">Kentucky</option>
<option value="LA" class=" ">Louisiana</option>
<option value="ME" class=" ">Maine</option>
<option value="MD" class=" ">Maryland</option>
<option value="MA" class=" ">Massachusetts</option>
<option value="MI" class=" ">Michigan</option>
<option value="MN" class=" ">Minnesota</option>
<option value="MS" class=" ">Mississippi</option>
<option value="MO" class=" ">Missouri</option>
<option value="MT" class=" ">Montana</option>
<option value="NE" class=" ">Nebraska</option>
<option value="NV" class=" ">Nevada</option>
<option value="NH" class=" ">New Hampshire</option>
<option value="NJ" class=" ">New Jersey</option>
<option value="NM" class=" ">New Mexico</option>
<option value="NY" class=" ">New York</option>
<option value="NC" class=" ">North Carolina</option>
<option value="ND" class=" ">North Dakota</option>
<option value="OH" class=" ">Ohio</option>
<option value="OK" class=" ">Oklahoma</option>
<option value="OR" class=" ">Oregon</option>
<option value="PA" class=" ">Pennsylvania</option>
<option value="RI" class=" ">Rhode Island</option>
<option value="SC" class=" ">South Carolina</option>
<option value="SD" class=" ">South Dakota</option>
<option value="TN" class=" ">Tennessee</option>
<option value="TX" class=" ">Texas</option>
<option value="UT" class=" ">Utah</option>
<option value="VT" class=" ">Vermont</option>
<option value="VA" class=" ">Virginia</option>
<option value="WA" class=" ">Washington</option>
<option value="WV" class=" ">West Virginia</option>
<option value="WI" class=" ">Wisconsin</option>
<option value="WY" class=" ">Wyoming</option>
</select><input type="text"></div>
</label></div>
</div>
</div>
<div data-identifier="field9" data-index="14" style="width: 50%" class=" form-element form-element-field9 options-false form-element-14 default-false form-element-type-oneLineText is-required-true odd -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Zip</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Zip" make-read-only="false" data-field-id="field9" name="field9[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="false" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field6" data-index="15" style="width: 100%" class=" even form-element form-element-field6 options-false form-element-15 default-false form-element-type-oneLineText is-required-true -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Desired City, State or School You Want to Adopt</span></span><span class="sub-label"><span>Samaritan's Feet cannot
guarantee your desired school will be chosen.</span></span></span>
<div><span class="error"></span><input type="text" placeholder="Desired City, State or School You Want to Adopt" make-read-only="false" data-field-id="field6" name="field6[]" data-min-char="" data-max-char="" data-val-type=""
data-regexp="" data-is-required="true" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder=""
data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field11" data-index="16" style="width: 100%" class=" form-element form-element-field11 options-false form-element-16 default-false form-element-type-checkbox is-required-true odd -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Pledge</span></span><span class="sub-label"></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span><label style="width: 60%"><img alt=""><input data-field-id="field11" type="radio"
data-is-required="true" name="field11[]" value="$5,000: 250 shoe commitment" class="validation-lenient"><span><span>$5,000: 250 shoe commitment</span></span></label><label style="width: 60%"><img alt=""><input
data-field-id="field11" type="radio" data-is-required="true" name="field11[]" value="$10,000: 500 shoe commitment" class="validation-lenient"><span><span>$10,000: 500 shoe commitment</span></span></label><label
style="width: 60%"><img alt=""><input data-field-id="field11" type="radio" data-is-required="true" name="field11[]" value="Other" class="validation-lenient"><span><span>Other</span></span></label></div>
</div>
</div>
</div>
</div>
<div data-identifier="field13" data-index="17" style="width: 100%; display: none;" class="even form-element form-element-field13 options-false form-element-17 default-true form-element-type-oneLineText is-required-true -handle state-hidden">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>Other</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="Other" make-read-only="false" data-field-id="field13" name="field13[]" data-min-char="" data-max-char="" data-val-type="" data-regexp="" data-is-required="true"
data-allow-spaces="false" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask="" data-mask-placeholder="$" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field14" data-index="18" style="width: 100%" class=" form-element form-element-field14 options-false form-element-18 default-false form-element-type-checkbox is-required-true odd -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-false"><span class="main-label"><span>Payment Method</span></span><span class="sub-label"></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span><label style="width:"><img alt=""><input data-field-id="field14" type="radio"
data-is-required="true" name="field14[]" value="Credit Card" class="validation-lenient"><span><span>Credit Card</span></span></label><label style="width:"><img alt=""><input data-field-id="field14" type="radio"
data-is-required="true" name="field14[]" value="Check" class="validation-lenient"><span><span>Check</span></span></label><label style="width:"><img alt=""><input data-field-id="field14" type="radio" data-is-required="true"
name="field14[]" value="Invoice" class="validation-lenient"><span><span>Invoice</span></span></label></div>
</div>
</div>
</div>
</div>
<div data-identifier="field24" data-index="19" style="width: 100%" class=" even form-element form-element-field24 options-false form-element-19 default-false form-element-type-oneLineText is-required-false -handle">
<div class="form-element-html">
<div><label class="oneLineText-cover field-cover has-input"><span class="sub-label-false"><span class="main-label"><span>How did you hear about the Samaritan's Feet Shoe Lockers?</span></span><span class="sub-label"></span></span>
<div><span class="error"></span><input type="text" placeholder="How did you hear about the Samaritan's Feet Shoe Lockers?" make-read-only="false" data-field-id="field24" name="field24[]" data-min-char="" data-max-char=""
data-val-type="" data-regexp="" data-is-required="false" data-allow-spaces="" class="validation-lenient" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-input-mask=""
data-mask-placeholder="" data-original-title=""></div>
</label></div>
</div>
</div>
<div data-identifier="field26" data-index="20" style="width: 100%" class=" form-element form-element-field26 options-false form-element-20 default-false form-element-type-customText is-required-false odd -handle">
<div class="form-element-html">
<div>
<div class="absolute-false customText-cover field-cover" style="left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:">
<div class="full" style="text-align: left">
<p>I agree to the above by signing below.</p>
</div><input type="hidden" name="field26" data-field-id="field26">
</div>
</div>
</div>
</div>
<div data-identifier="field15" data-index="21" style="width: 100%" class=" even form-element form-element-field15 options-false form-element-21 default-false form-element-type-signature is-required-true -handle">
<div class="form-element-html">
<div>
<div class="signature-cover field-cover "><span><span class="main-label"><span>Signature</span></span><span class="sub-label"><span>I agree to the above.</span></span></span>
<div class="signature-pad-placeholder" style="width: 300px; height: 150px"><span class="error"></span><span class="pad-placeholder"><span>(Sign Here)</span></span><canvas class="signature-canvas"
style="width: 300px; height: 150px; touch-action: none;" width="300px" height="150px"></canvas></div><span class="clear-signature"><span>Clear Signature</span></span>
</div><input type="hidden" data-is-required="true" class="signature-hidden no-save validation-lenient " name="field15[]">
</div>
</div>
</div>
<div data-identifier="field5" data-index="22" style="width: 100%" class=" form-element form-element-field5 options-false form-element-22 default-false form-element-type-submit is-required-false odd -handle">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SUBMIT</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot" style="display: none;"></label>
</div>
</div>
</div>
<div data-identifier="field12" data-index="23" style="width: 100%" class=" even form-element form-element-field12 options-false form-element-23 default-false form-element-type- is-required-false -handle">
<div class="form-element-html">
<div>
<div class="images- checkbox-cover field-cover"><span class="sub-label-true"><span class="main-label"></span><span class="sub-label"></span></span>
<div data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title=""><span class="error"></span></div>
</div>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="4878">
</form>
<form data-auto-scroll="" data-no-message-redirect="" data-thousand="" data-decimal="." data-delay="" data-id="30"
class="fc-form fc-form-30 align- save-form- dont-submit-hidden- remove-asterisk- icons-hide- disable-enter- label-placeholder field-border-visible frame-hidden field-alignment-left"
style="width: 420px; color: #666666; font-size: 100%; background: none">
<!-- ngRepeat: page in Builder.FormElements track by $index -->
<div class="form-page form-page-0 active" data-index="0">
<div class="form-page-content ng-not-empty">
<div data-identifier="field7" data-index="0" style="width: 100%; position: relative; z-index: 101; left: 0px; top: 0px"
class=" form-element form-element-field7 options- default-false form-element-type-email is-required-false -handle odd form-element-0">
<div class="form-element-html">
<div><label class="email-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>Email</span></span><span class="sub-label"><span>a valid email</span></span></span>
<div><span class="error"></span><input placeholder="Email" data-field-id="field7" type="text" data-val-type="email" make-read-only="" data-is-required="false" name="field7" class="validation-lenient" data-placement="right"
data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title=""><i class="formcraft-icon">email</i></div>
</label></div>
</div>
</div>
<div data-identifier="field3" data-index="1" style="width: 100%" class=" form-element form-element-field3 options-false default-false form-element-type-textarea is-required-true -handle even form-element-1">
<div class="form-element-html">
<div><label class="textarea-cover field-cover has-input"><span class="sub-label-true"><span class="main-label"><span>I'm thankful for Samaritan's Feet because...</span></span><span class="sub-label"><span>more details</span></span></span>
<div><span class="error"></span><textarea data-field-id="field3" placeholder="I'm thankful for Samaritan's Feet because..." class="validation-lenient" name="field3" value="" rows="4" data-min-char="" data-max-char=""
data-is-required="true" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="focus" data-html="true" data-original-title="" style="min-height: 92.5859px"></textarea>
<div class="count-"><span class="current-count">0</span> / <span class="max-count "></span></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field6" data-index="2" style="width: 100%" class=" form-element form-element-field6 options-false default-false form-element-type-fileupload is-required-false -handle odd form-element-2">
<div class="form-element-html">
<div><label class="wide- fileupload-cover field-cover"><span class="sub-label-"><span class="main-label"><span>File</span></span><span class="sub-label"><span>upload</span></span></span>
<div><span class="error"></span>
<div class="button button-file fileupload-button" data-placement="right" data-toggle="tooltip" tooltip="" data-trigger="hover" data-html="true" data-original-title="">
<i class="icon-upload-cloud formcraft-icon">cloud_upload</i><span>Upload Photo, Video, Etc.</span><input type="file" data-name-list="field6" name="files" multiple="multiple" data-allow-extensions="" data-min-files=""
data-max-files="" data-max-size="" accept="."></div>
</div>
</label></div>
</div>
</div>
<div data-identifier="field5" data-index="3" style="width: 100%" class=" form-element form-element-field5 options-false default-false form-element-type-submit is-required-false -handle even form-element-3">
<div class="form-element-html">
<div>
<div class="align-center wide-false submit-cover field-cover"><button type="submit" class="button submit-button"><span class="text ">SEND MESSAGE</span><span
class="spin-cover"><i style="color:" class="loading-icon icon-cog animate-spin"></i></span></button></div>
<div class="submit-response "></div><label><input type="text" class="required_field" name="website" autocomplete="maple-syrup-pot"></label>
</div>
</div>
</div>
</div>
</div><!-- end ngRepeat: page in Builder.FormElements track by $index -->
<input type="hidden" name="pum_form_popup_id" value="4803">
</form>
Text Content
* OUR WORK * IMPACT * STORIES * WHY SHOES? * GET INVOLVED * ABOUT US * OUR STORY * STAFF * BOARD & ADVISORS * FINANCIALS * PRESS ROOM * CAREERS * ONE CITY * SEARCH * VOLUNTEER * DONATE * OUR WORK * IMPACT * STORIES * WHY SHOES? * GET INVOLVED * ABOUT US * OUR STORY * STAFF * BOARD & ADVISORS * FINANCIALS * PRESS ROOM * CAREERS * ONE CITY * SEARCH * VOLUNTEER * DONATE JOIN NOW LET'S DISTRIBUTE 1.1 MILLION PAIRS OF SHOES IN 2024 WATCH OUR DOCUMENTARY Impact Video OUR DOCUMENTARY: THE ROAD TO 10 MILLION WATCH NOW Our Inspiring Book THE JOURNEY ORDER TODAY Impact Story MEET THE 10 MILLIONTH SERVED READ STORY WE GIVE H.O.P.E. Promote good HEALTH and well-being by creating a strong foundation. With shoes and proper self-care instructions, individuals can be protected from foot-borne diseases, of which over 1.5 billion are infected worldwide. Feet are your foundation and can take you many places in life, so let's make sure they are strong. WE GIVE H.O.P.E. Create OPPORTUNITIES by encouraging and equipping those we serve. When an individual has proper footwear, they can focus comfortably at work, school, or on other needs. This can have positive long-term effects on the quality of life in those we serve around the world. WE GIVE H.O.P.E. Promote PEACE when communities humbly serve one another. Volunteers from diverse backgrounds come together with those in need to serve them. This platform can prompt conversations and relationships that symbolize and ignite unity. WE GIVE H.O.P.E. Boost EDUCATION as children are comfortable and confident in school. Shoes are often a requirement to attend school. When children have proper footwear, they have access to education; they have the chance to learn and pursue their dreams. GIVE HOPE TODAY, EVERYDAY YOUR GENEROSITY CAN CHANGE SOMEONE'S LIFE. SAMARITAN'S FEET IS PROUD TO HAVE 90% OF THEIR FINANCES GO TOWARDS PROGRAMMING, SO KNOW THAT WE VALUE THAT GENEROSITY, TOO. CHOOSE TO MAKE A ONE-TIME DONATION, OR MAKE IT MONTHLY AND YOU'LL BE INCLUDED IN OUR SPECIAL GROUP EXCLUSIVELY FOR RECURRING DONORS, SOLE SOCIETY, WHO ARE MAKING A DIFFERENCE EACH AND EVERY MONTH. DONATE OUR WORK GET INVOLVED ABOUT US Happening Now: JOIN US ON A MISSION TRIP Our 2024 mission trip calendar is live! We partner with incredible on-the-ground partners to make a lasting difference. So, check out where we're going, who we are serving, and consider joining us! LEARN MORE ` FINANCIALS CAREERS GET INVOLVED IMPACT OUR STORY DONATE Samaritan’s Feet is a 501 (c)(3) organization that serves & inspires hope in children by providing shoes as the foundation to a spiritual and healthy life. International Headquarters: 4808 Chesapeake Dr., Charlotte, NC 28216 Phone: 980-939-8150; Email: info@samaritansfeet.org Copyright © 2024 Samaritans Feet International. All rights reserved. Samaritan’s Feet is a trademark of Samaritan’s Feet International, which has no affiliation or association with Samaritan’s Purse. 1 Step 1 First Name Last Name Email email Phone Numberyour full name Commentsmore details 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X 1 Step 1 Name of Family/Individual, Business, School, Church, Etc. Email email We offer warehouse volunteer shifts on: Tuesday-Saturday: 9:00am-12:00pm Preferred Volunteer Date(s) MM/DD Number of People in Your Group Age Policy AgreementIn order to volunteer at Samaritan's Feet, individuals must be a minimum of eight years of age and must be chaperoned by an adult at all times. Please note that we require all minors to be chaperoned in a ratio of one adult to every five minors. By selecting yes, you agree to supply the required number of chaperones and to not bring minors in attendance under the age of eight. YesNo How many minors (age 8 - 18) will be in your group? Comments 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X 1 Step 1 First Name Last Name Email email Phone Numberyour full name Commentsmore details 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X X 1 Step 1 First Name Last Name Email email Phone Numberyour full name Commentsmore details 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X X AMAZON SMILE AmazonSmile is a simple and automatic way for you to support Samaritan’s Feet, at no cost to you. When you shop at smile.amazon.com, you’ll find the same shopping experience as Amazon.com, with the added bonus that Amazon will donate a portion of the purchase price to the charity of your choice. Follow these instructions to start giving to Samaritan’s Feet through your regular Amazon purchases: Sign in to smile.amazon.com on your desktop or mobile phone browser. From your desktop, go to Your Account and select the option to Change your Charity. Or, from your mobile browser, select Change your Charity from the options at the bottom of the page. Select Samaritan’s Feet. X MIXED GRILL MENU Supporting Samaritan’s Feet First Course The Smith House Salad Mixed Greens, Radish, Carrots, & Cherry Tomato with a Mustard Seed Vinaigrette Second Course 4 oz. Petit USDA Prime Filet Mignon Served Medium Rare with Standard Sauce & 4 oz. Norwegian Salmon Home-Style Mashed Potatoes & Steamed Asparagus Third Course Tennessee Cheesecake Jack Daniels Caramel Sauce & Southern Candied Pecans X 1 Step 1 First Name Last Name Email email Phone Numberyour full name Commentsmore details 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X X 1 Step 1 First & Last Name Email email Phone Numberyour full name Commentsmore details 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X X MATCHING GIFTS Many companies have programs through which they will “match” the charitable contributions made by their employees. Through corporate gift matching, your employer can multiply your donation to Samaritan’s Feet, making it go further. Check with your company’s Human Resources office to see if they offer gift matching. If your employer does offer this program, your Human Resources department should provide you with a matching gift form to send to us, along with your donation. Complete this form and mail it with your donation to: Samaritan’s Feet International P.O. Box 78992 Charlotte, NC 28271 X 1 Step 1 First Name Last Name Name of Family/Individual, Business, School, Church, Etc. Email email We offer pick-up and drop-off during the following times: Monday-Friday: 9:00am-12:00pm or 1:00pm-3:00pm Preferred Date(s) for Pick-Up (MM/DD) date_range Preferred Time for Pick-Up Select An Option9:00am - 9:30am9:30am - 10:00am10:00am - 10:30am10:30am - 11:00am11:00am - 11:30am11:30am - 12:00pm1:00pm - 1:30pm1:30pm - 2:00pm2:00pm - 2:30pm Preferred Date(s) for Drop-OffNot to exceed two weeks past pick-up date. date_range Preferred Time for Drop-Off Select An Option9:00am - 9:30am9:30am - 10:00am10:00am - 10:30am10:30am - 11:00am11:00am - 11:30am11:30am - 12:00pm1:00pm - 1:30pm1:30pm - 2:00pm2:00pm - 2:30pm Make and Model of Car Will the trunk of the car be available? YesNo Will the back seat of the car be available? YesNo How many hours are you looking to volunteer?If exceeding six hours, please consider signing up for volunteer shifts in our warehouse. Is there a particular project you're interested in working on?Please note that we cannot guarantee your request will be granted as selection is based off need. Select An OptionWhatever is NeededSocksHope NotesHope TotesSticker RollsStuff Envelopes Comments 0 / SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X X 1 Step 1 Shoe Locker Pledge Form Are you sponsoring as an individual or on behalf of a company? IndividualCompany First Name Last Name Email email Phone Number Company Name Company Contact First Name Company Contact Last Name Company Contact Email email Company Contact Phone Number Mailing Address City State Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Desired City, State or School You Want to AdoptSamaritan's Feet cannot guarantee your desired school will be chosen. Pledge $5,000: 250 shoe commitment$10,000: 500 shoe commitmentOther Other Payment Method Credit CardCheckInvoice How did you hear about the Samaritan's Feet Shoe Lockers? I agree to the above by signing below. SignatureI agree to the above. (Sign Here) Clear Signature SUBMIT keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X 1 Step 1 Emaila valid email email I'm thankful for Samaritan's Feet because...more details 0 / Fileupload cloud_uploadUpload Photo, Video, Etc. SEND MESSAGE keyboard_arrow_leftPrevious Nextkeyboard_arrow_right X This form does not exist X PLANNED OR LEGACY GIVING With thoughtful planning, you can make a lasting contribution to our mission. Your gift can take any of the following forms: Residual Bequest: after making provisions for your family and friends, the balance of your belongings (legally referred to as your “estate”) is donated to Samaritan’s Feet. Percentage of your Estate: where a specific percentage of your estate is left to Samaritan’s Feet. Pecuniary Bequest: where a specific sum of money is donated. Specific Gift Bequest: referring to any non-cash items such as stock, annuities, property, jewelry, artwork, or other valuables, which can be given to Samaritan’s Feet. Life Insurance Policy Want to know more about a planned gift to Samaritan’s Feet? You should make an appointment with your legal or financial adviser. They have all the tools to help you decide what type of request to make. We have partnered with the National Christian Foundation to make it easy for our supporters to donate cash and non-cash assets to us to take full advantage of all tax credits and benefits. X X X X X