donate.lovetotherescue.org
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Submitted URL: https://t.e2ma.net/click/t7zuqeb/hio3tydh/15fwnlu
Effective URL: https://donate.lovetotherescue.org/give/180622/
Submission: On May 09 via api from US — Scanned from DE
Effective URL: https://donate.lovetotherescue.org/give/180622/
Submission: On May 09 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: FORM —
<form name="FORM" novalidate="novalidate" data-ng-submit="submit()" class="donation-block_form ng-pristine ng-invalid ng-invalid-required ng-valid-email-address ng-valid-maxlength ng-valid-phone-number ng-valid-min ng-valid-max"
data-sc-broadcast-form-errors="">
<!-- Honeypot -->
<input type="hidden" data-ng-model="MODEL.z" autocomplete="off" class="ng-pristine ng-untouched ng-valid ng-empty ng-not-modified">
<!-- Components -->
<!-- ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-welcome ng-scope" data-ng-controller="frsDonationWelcomeCtrl">
<div data-sc-filler-text="{
fontBase: 16,
fontRatio: 14
}" data-title-container="'.donation-welcome_container'" data-parent-container="'.donation-welcome_container'" class="ng-isolate-scope">
<div class="donation-welcome_container">
<div class="sr-only">
<!-- ngIf: META.errorList.length -->
<!-- ngRepeat: error in META.errorList -->
</div>
<!-- ngIf: !editable && !isPreview() -->
<h1 class="donation-welcome_title ng-binding ng-scope" data-ng-if="!editable && !isPreview()" data-ng-bind-html="trustedBlockHeadlineHtml">
<p style="font-size: 40px;"><strong><span style="font-size: 44px; color: rgb(0, 0, 0);">The Mother’s Day Match!</span></strong></p>
</h1><!-- end ngIf: !editable && !isPreview() -->
<!-- ngIf: !editable && isPreview() -->
<!-- ngIf: editable && !getLock('headline') -->
<!-- ngIf: editable && getLock('headline') -->
<!-- Appeal -->
<!-- ngIf: !editable -->
<div class="donation-welcome_description ng-scope" data-ng-if="!editable" sc-allow-html="block.description | scImgAssetRef | userLinks" sc-responsive-video="">
<p><span style="font-size: 18px;"><img src="https://assets.classy.org/18900505/1fbeb3ac-07f1-11ef-82bc-0a58a9feac02.png" id="img_32577243574824" class="fr-fic fr-dii"><br></span></p>
<p><span style="font-size: 18px;">Make your generous gift before midnight on May 12, and it will DOUBLE in impact for a child to get <em>The Most Amazing Care Anywhere</em>™.<br></span></p>
<p><span style="font-size: 18px;">Your gift now can make twice the impact to support:</span></p>
<ul>
<li><span style="font-size: 18px;">Innovative pediatric specialty care — regardless of the families’ ability to pay or insurance status</span></li>
<li><span style="font-size: 18px;">Critical research to improve quality of lives and quality of care</span></li>
<li><span style="font-size: 18px;">Outstanding educational programs for medical professionals</span></li>
</ul>
</div><!-- end ngIf: !editable -->
<!-- ngIf: editable && !getLock('description') -->
<!-- ngIf: editable && getLock('description') -->
</div>
</div>
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-amount ng-scope" data-ng-controller="frsDonationAmountCtrl">
<!-- ngIf: preventRecurringFrequency -->
<!-- ngIf: show.levels() && !displayRecurringExperiment() && preventRecurringFrequency -->
<!-- ngIf: !displayRecurringExperiment() && preventRecurringFrequency -->
<!-- ngIf: showLegacyDonationGrid --><donation-amount-recurring-rf ng-if="showLegacyDonationGrid" donation-context="CONTEXT" frequency="MODEL.frequency" setting-page-frequency="MODEL.frequency"
frequency-levels="DonationBlock.current['recurring-level']" levels="state.levels" recurring-donation-levels="state.recurringDonationLevels" recur_until="MODEL.recur_until" amount="MODEL.items[0].raw_final_price"
previous-frequency-price="MODEL.items[0].previous_frequency_price" new-amount="MODEL.items[0].raw_final_price" preview="globalState.isPreview" currency="MODEL.payment.raw_currency_code" class="ng-scope ng-isolate-scope"><!-- **** DONT MAKE CHANGES TO THIS FILE ****
This file is LEGACY and is only being kept around for certain orgs
that have customized this section of the page.
They must have the `legacy-donation-grid` org tag
-->
<div class="donation-amount-recurring">
<!-- FREQUENCY TOGGLE-->
<!-- ngIf: !$ctrl.preventOldrfForDeque && !$ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 0 -->
<div data-ng-init="$ctrl.showFreqDropdown()" data-ng-if="!$ctrl.preventOldrfForDeque && !$ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 0"
class="donation-amount-recurring__switch rf ng-scope" role="radiogroup" aria-label="Select a donation frequency">
<div data-ng-click="$ctrl.selectFrequency('one-time'); $ctrl.showFreqDropdown('one-time'); $ctrl.isRecurringFrequency($event)" data-ng-keypress="$ctrl.selectFrequency('one-time',$event); $ctrl.isRecurringFrequency($event)"
data-ng-mouseover="$ctrl.hoverFrequencyStyle('one-time',true)" data-ng-mouseout="$ctrl.hoverFrequencyStyle('one-time',false)" class="donation-amount-recurring__btn once hover-state_one-time selected" _spec="one-time" tabindex="0"
data-ng-class="{'selected': $ctrl.frequency === 'one-time'}" data-ng-style="$ctrl.oneTimeBtnStyle('one-time')" style="background-color: rgb(130, 10, 30); color: rgb(255, 255, 255); border: 2px solid rgb(130, 10, 30);">
<label for="donation-amount-recurring__radio-input" class="donation-amount-recurring__btn__frequency-label">
<input type="radio" id="donation-amount-recurring__radio-input" role="radio" tabindex="-1" name="donation-frequency" class="donation-amount-recurring__btn__frequency-input" aria-checked="true">One time </label>
</div>
<div data-ng-click="$ctrl.selectFrequency($ctrl.frequency); $ctrl.showFreqDropdown($ctrl.recurringBtnText()); $ctrl.isRecurringFrequency($event)"
data-ng-keypress="$ctrl.selectFrequency($ctrl.recurringBtnText(),$event); $ctrl.isRecurringFrequency($event)" data-ng-mouseover="$ctrl.hoverFrequencyStyle('recurring',true)"
data-ng-mouseout="$ctrl.hoverFrequencyStyle('recurring',false)" class="donation-amount-recurring__btn monthly hover-state_recurring" _spec="recurring" tabindex="0"
data-ng-class="{'selected': $ctrl.recurringBtnSelected($ctrl.frequency)}" data-ng-style="$ctrl.recurringBtnStyle($ctrl.frequency)"
style="background-color: rgb(255, 255, 255); color: rgb(130, 10, 30); border: 2px solid rgb(130, 10, 30);">
<label for="donation-amount-monthly__radio-input" class="donation-amount-recurring__btn__frequency-label ng-binding">
<input type="radio" role="radio" id="donation-amount-monthly__radio-input" name="donation-frequency" tabindex="-1" class="donation-amount-recurring__btn__frequency-input" aria-checked="false"> monthly </label>
</div>
</div><!-- end ngIf: !$ctrl.preventOldrfForDeque && !$ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 0 -->
<!-- FREQUENCY DROPDOWN PHASE 1-->
<!-- ngIf: $ctrl.preventOldrfForDeque && $ctrl.noOfFrequencyLevel($ctrl.frequencyLevels) !== 1 -->
<!-- FREQUENCY DROPDOWN PHASE 2 -->
<!-- ngIf: !$ctrl.preventOldrfForDeque && ($ctrl.isFreqDropdown || ($ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 1)) -->
<!-- END DATE -->
<!-- ngIf: !$ctrl.preventOldrfForDeque && $ctrl.showRecurringEndDate && $ctrl.frequency !== 'one-time' -->
<!-- ngIf: !$ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.levels) !== 1 || $ctrl.showCustomAmtField($ctrl.levels))) -->
<p data-ng-if="!$ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.levels) !== 1 || $ctrl.showCustomAmtField($ctrl.levels)))" id="amount-options-label" class="ng-scope"> Choose a
<b class="ng-binding">one-time</b> amount</p><!-- end ngIf: !$ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.levels) !== 1 || $ctrl.showCustomAmtField($ctrl.levels))) -->
<!-- ngIf: $ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.recurringDonationLevels) !== 1 || $ctrl.showCustomAmtField($ctrl.recurringDonationLevels))) -->
<!-- IF MULTIPLE AMOUNT DISPLAYED -->
<!-- ngIf: !$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) > 1 || $ctrl.showCustomAmtField($ctrl.levels)) -->
<ul data-ng-if="!$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) > 1 || $ctrl.showCustomAmtField($ctrl.levels))" class="donation-amount-recurring__levels rf ng-scope bb"
aria-labelledby="amount-options-label" role="radiogroup" data-ng-class="{'bb': $ctrl.hasBigButtons, 'multiple-amount-hidden' : $ctrl.noOfDonationAmount($ctrl.levels) === 1 && !$ctrl.showCustomAmtField($ctrl.levels)}">
<!-- ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" id="D-A500"
data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})" data-ng-click="$ctrl.selectAmount(level.displayAmount)"
data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.hoverStyle($index,true)" data-ng-mouseout="$ctrl.hoverStyle($index,false)" class="donation-amount-recurring__level-item rf hover-state_0 bb"
role="radio" tabindex="0" aria-checked="false" data-ng-class="{'bb': $ctrl.hasBigButtons, 'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount)" style="color: rgba(0, 0, 0, 0.87); background-color: rgba(130, 10, 30, 0.12); border: none; max-width: 50%;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A500" class="donation-amount-recurring__level-item__amount-label rf ng-binding ng-scope bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">
<input data-ng-model="$ctrl.amount" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donation-amount"
class="donation-amount-recurring__level-item__amount-input rf ng-pristine ng-untouched ng-valid ng-not-empty ng-not-modified bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">€470 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" id="D-A100"
data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})" data-ng-click="$ctrl.selectAmount(level.displayAmount)"
data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.hoverStyle($index,true)" data-ng-mouseout="$ctrl.hoverStyle($index,false)"
class="donation-amount-recurring__level-item rf hover-state_1 bb selected" role="radio" tabindex="0" aria-checked="true"
data-ng-class="{'bb': $ctrl.hasBigButtons, 'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}" data-ng-style="$ctrl.donationLevelStyle(level.displayAmount)"
style="color: rgb(255, 255, 255); background-color: rgb(130, 10, 30); border: none; max-width: 50%;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A100" class="donation-amount-recurring__level-item__amount-label rf ng-binding ng-scope bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">
<input data-ng-model="$ctrl.amount" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donation-amount"
class="donation-amount-recurring__level-item__amount-input rf ng-pristine ng-untouched ng-valid ng-not-empty ng-not-modified bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">€100 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" id="D-A50"
data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})" data-ng-click="$ctrl.selectAmount(level.displayAmount)"
data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.hoverStyle($index,true)" data-ng-mouseout="$ctrl.hoverStyle($index,false)" class="donation-amount-recurring__level-item rf hover-state_2 bb"
role="radio" tabindex="0" aria-checked="false" data-ng-class="{'bb': $ctrl.hasBigButtons, 'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount)" style="color: rgba(0, 0, 0, 0.87); background-color: rgba(130, 10, 30, 0.12); border: none; max-width: 50%;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A50" class="donation-amount-recurring__level-item__amount-label rf ng-binding ng-scope bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">
<input data-ng-model="$ctrl.amount" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donation-amount"
class="donation-amount-recurring__level-item__amount-input rf ng-pristine ng-untouched ng-valid ng-not-empty ng-not-modified bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">€47 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" id="D-A25"
data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})" data-ng-click="$ctrl.selectAmount(level.displayAmount)"
data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.hoverStyle($index,true)" data-ng-mouseout="$ctrl.hoverStyle($index,false)" class="donation-amount-recurring__level-item rf hover-state_3 bb"
role="radio" tabindex="0" aria-checked="false" data-ng-class="{'bb': $ctrl.hasBigButtons, 'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount)" style="color: rgba(0, 0, 0, 0.87); background-color: rgba(130, 10, 30, 0.12); border: none; max-width: 50%;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A25" class="donation-amount-recurring__level-item__amount-label rf ng-binding ng-scope bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">
<input data-ng-model="$ctrl.amount" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donation-amount"
class="donation-amount-recurring__level-item__amount-input rf ng-pristine ng-untouched ng-valid ng-not-empty ng-not-modified bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">€24 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) -->
<!-- REMOVE WHEN BIG BUTTONS GO TO ALL ORGS -->
<!-- ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: !$ctrl.hasBigButtons && level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: !$ctrl.hasBigButtons && level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: !$ctrl.hasBigButtons && level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: !$ctrl.hasBigButtons && level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: !$ctrl.hasBigButtons && level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} -->
</ul><!-- end ngIf: !$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) > 1 || $ctrl.showCustomAmtField($ctrl.levels)) -->
<!-- IF MULTIPLE RECURRING DONATION AMOUNT DISPLAYED -->
<!-- ngIf: $ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.recurringDonationLevels) > 1 || $ctrl.showCustomAmtField($ctrl.recurringDonationLevels)) -->
<!-- ngRepeat: level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true} --><!-- ngIf: $ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time')) --><!-- end ngRepeat: level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true} --><!-- ngIf: $ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time')) --><!-- end ngRepeat: level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true} --><!-- ngIf: $ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time')) --><!-- end ngRepeat: level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true} --><!-- ngIf: $ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time')) --><!-- end ngRepeat: level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true} --><!-- ngIf: $ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time')) -->
<div
data-ng-if="$ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time'))"
data-ng-repeat="level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true}" data-ng-click="$ctrl.selectAmount('Custom')"
class="donation-amount-recurring__level-item other-rf hover-state_other ng-scope bb" role="radio" data-ng-class="{'bb': $ctrl.hasBigButtons, 'selected': $ctrl.showCustomAmtSelected}">
<label for="D-AOther" class="donation-amount-recurring__level-item__amount-label other-rf bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">
<div id="custom-amount" class="donation-amount-recurring__amount rf currency-picker" data-ng-class="{'has-focus': $ctrl.show.inputFocus === true}" data-sc-form-error="highlight if amount fails" aria-invalid="false">
<div sc-currency-picker="" currency-model="$ctrl.currency" currency-entity="'donation'" selected="$ctrl.showCustomAmtSelected" class="currency-picker__wrapper-rf ng-isolate-scope bb" data-ng-class="{'bb': $ctrl.hasBigButtons}">
<div class="currency-picker__wrapper ng-isolate-scope" ng-style="selected ? changeWrapperStyle() : defaultStyle()" ng-class="{'no-pick':!showDropdown, 'disabled': disabled}" aria-hidden="false" sc-lock-field="disabled"
tooltip-text="tooltipText">
<div class="currency-picker__select-wrapper">
<select class="currency-picker__select ng-pristine ng-untouched ng-valid ng-not-empty ng-not-modified" ng-change="optionSwap()" ng-model="currency" id="dropdown" ng-show="showDropdown" data-testid="currency-picker-dropdown"
ng-options="currency as currency.longText for currency in currencyOptions track by currency.currency" aria-label="Select a currency" ng-disabled="disabled">
<option label="AED | United Arab Emirates Dirham" value="AED">AED | United Arab Emirates Dirham</option>
<option label="AFN | Afghan Afghani" value="AFN">AFN | Afghan Afghani</option>
<option label="ALL | Albanian Lek" value="ALL">ALL | Albanian Lek</option>
<option label="AMD | Armenian Dram" value="AMD">AMD | Armenian Dram</option>
<option label="ANG | Netherlands Antillean Guilder" value="ANG">ANG | Netherlands Antillean Guilder</option>
<option label="AOA | Angolan Kwanza" value="AOA">AOA | Angolan Kwanza</option>
<option label="ARS | Argentine Peso" value="ARS">ARS | Argentine Peso</option>
<option label="AUD | Australian Dollar" value="AUD">AUD | Australian Dollar</option>
<option label="AWG | Aruban Florin" value="AWG">AWG | Aruban Florin</option>
<option label="AZN | Azerbaijani Manat" value="AZN">AZN | Azerbaijani Manat</option>
<option label="BAM | Bosnia And Herzegovina Convertible Mark" value="BAM">BAM | Bosnia And Herzegovina Convertible Mark</option>
<option label="BBD | Barbados Dollar" value="BBD">BBD | Barbados Dollar</option>
<option label="BDT | Bangladeshi Taka" value="BDT">BDT | Bangladeshi Taka</option>
<option label="BGN | Bulgarian Lev" value="BGN">BGN | Bulgarian Lev</option>
<option label="BHD | Bahraini Dinar" value="BHD">BHD | Bahraini Dinar</option>
<option label="BIF | Burundian Franc" value="BIF">BIF | Burundian Franc</option>
<option label="BMD | Bermudian Dollar (customarily Known As Bermuda Dollar)" value="BMD">BMD | Bermudian Dollar (customarily Known As Bermuda Dollar)</option>
<option label="BND | Brunei Dollar" value="BND">BND | Brunei Dollar</option>
<option label="BOB | Boliviano" value="BOB">BOB | Boliviano</option>
<option label="BRL | Brazilian Real" value="BRL">BRL | Brazilian Real</option>
<option label="BSD | Bahamian Dollar" value="BSD">BSD | Bahamian Dollar</option>
<option label="BTN | Bhutanese Ngultrum" value="BTN">BTN | Bhutanese Ngultrum</option>
<option label="BWP | Botswana Pula" value="BWP">BWP | Botswana Pula</option>
<option label="BZD | Belize Dollar" value="BZD">BZD | Belize Dollar</option>
<option label="CAD | Canadian Dollar" value="CAD">CAD | Canadian Dollar</option>
<option label="CDF | Congolese Franc" value="CDF">CDF | Congolese Franc</option>
<option label="CHF | Swiss Franc" value="CHF">CHF | Swiss Franc</option>
<option label="CLF | Unidad De Fomento (funds Code)" value="CLF">CLF | Unidad De Fomento (funds Code)</option>
<option label="CLP | Chilean Peso" value="CLP">CLP | Chilean Peso</option>
<option label="CNY | Chinese Yuan" value="CNY">CNY | Chinese Yuan</option>
<option label="COP | Colombian Peso" value="COP">COP | Colombian Peso</option>
<option label="CRC | Costa Rican Colon" value="CRC">CRC | Costa Rican Colon</option>
<option label="CUC | Cuban Convertible Peso" value="CUC">CUC | Cuban Convertible Peso</option>
<option label="CUP | Cuban Peso" value="CUP">CUP | Cuban Peso</option>
<option label="CVE | Cape Verde Escudo" value="CVE">CVE | Cape Verde Escudo</option>
<option label="CZK | Czech Koruna" value="CZK">CZK | Czech Koruna</option>
<option label="DJF | Djiboutian Franc" value="DJF">DJF | Djiboutian Franc</option>
<option label="DKK | Danish Krone" value="DKK">DKK | Danish Krone</option>
<option label="DOP | Dominican Peso" value="DOP">DOP | Dominican Peso</option>
<option label="DZD | Algerian Dinar" value="DZD">DZD | Algerian Dinar</option>
<option label="EGP | Egyptian Pound" value="EGP">EGP | Egyptian Pound</option>
<option label="ERN | Eritrean Nakfa" value="ERN">ERN | Eritrean Nakfa</option>
<option label="ETB | Ethiopian Birr" value="ETB">ETB | Ethiopian Birr</option>
<option label="EUR | Euro" value="EUR" selected="selected">EUR | Euro</option>
<option label="FJD | Fiji Dollar" value="FJD">FJD | Fiji Dollar</option>
<option label="FKP | Falkland Islands Pound" value="FKP">FKP | Falkland Islands Pound</option>
<option label="GBP | Pound Sterling" value="GBP">GBP | Pound Sterling</option>
<option label="GEL | Georgian Lari" value="GEL">GEL | Georgian Lari</option>
<option label="GHS | Ghanaian Cedi" value="GHS">GHS | Ghanaian Cedi</option>
<option label="GIP | Gibraltar Pound" value="GIP">GIP | Gibraltar Pound</option>
<option label="GMD | Gambian Dalasi" value="GMD">GMD | Gambian Dalasi</option>
<option label="GNF | Guinean Franc" value="GNF">GNF | Guinean Franc</option>
<option label="GTQ | Guatemalan Quetzal" value="GTQ">GTQ | Guatemalan Quetzal</option>
<option label="GYD | Guyanese Dollar" value="GYD">GYD | Guyanese Dollar</option>
<option label="HKD | Hong Kong Dollar" value="HKD">HKD | Hong Kong Dollar</option>
<option label="HNL | Honduran Lempira" value="HNL">HNL | Honduran Lempira</option>
<option label="HRK | Croatian Kuna" value="HRK">HRK | Croatian Kuna</option>
<option label="HTG | Haitian Gourde" value="HTG">HTG | Haitian Gourde</option>
<option label="HUF | Hungarian Forint" value="HUF">HUF | Hungarian Forint</option>
<option label="IDR | Indonesian Rupiah" value="IDR">IDR | Indonesian Rupiah</option>
<option label="ILS | Israeli New Shekel" value="ILS">ILS | Israeli New Shekel</option>
<option label="INR | Indian Rupee" value="INR">INR | Indian Rupee</option>
<option label="IQD | Iraqi Dinar" value="IQD">IQD | Iraqi Dinar</option>
<option label="IRR | Iranian Rial" value="IRR">IRR | Iranian Rial</option>
<option label="ISK | Icelandic Króna" value="ISK">ISK | Icelandic Króna</option>
<option label="JMD | Jamaican Dollar" value="JMD">JMD | Jamaican Dollar</option>
<option label="JOD | Jordanian Dinar" value="JOD">JOD | Jordanian Dinar</option>
<option label="JPY | Japanese Yen" value="JPY">JPY | Japanese Yen</option>
<option label="KES | Kenyan Shilling" value="KES">KES | Kenyan Shilling</option>
<option label="KGS | Kyrgyzstani Som" value="KGS">KGS | Kyrgyzstani Som</option>
<option label="KHR | Cambodian Riel" value="KHR">KHR | Cambodian Riel</option>
<option label="KMF | Comoro Franc" value="KMF">KMF | Comoro Franc</option>
<option label="KPW | North Korean Won" value="KPW">KPW | North Korean Won</option>
<option label="KRW | South Korean Won" value="KRW">KRW | South Korean Won</option>
<option label="KWD | Kuwaiti Dinar" value="KWD">KWD | Kuwaiti Dinar</option>
<option label="KYD | Cayman Islands Dollar" value="KYD">KYD | Cayman Islands Dollar</option>
<option label="KZT | Kazakhstani Tenge" value="KZT">KZT | Kazakhstani Tenge</option>
<option label="LAK | Lao Kip" value="LAK">LAK | Lao Kip</option>
<option label="LBP | Lebanese Pound" value="LBP">LBP | Lebanese Pound</option>
<option label="LKR | Sri Lankan Rupee" value="LKR">LKR | Sri Lankan Rupee</option>
<option label="LRD | Liberian Dollar" value="LRD">LRD | Liberian Dollar</option>
<option label="LSL | Lesotho Loti" value="LSL">LSL | Lesotho Loti</option>
<option label="LYD | Libyan Dinar" value="LYD">LYD | Libyan Dinar</option>
<option label="MAD | Moroccan Dirham" value="MAD">MAD | Moroccan Dirham</option>
<option label="MDL | Moldovan Leu" value="MDL">MDL | Moldovan Leu</option>
<option label="MGA | Malagasy Ariary" value="MGA">MGA | Malagasy Ariary</option>
<option label="MKD | Macedonian Denar" value="MKD">MKD | Macedonian Denar</option>
<option label="MMK | Myanma Kyat" value="MMK">MMK | Myanma Kyat</option>
<option label="MNT | Mongolian Tugrik" value="MNT">MNT | Mongolian Tugrik</option>
<option label="MOP | Macanese Pataca" value="MOP">MOP | Macanese Pataca</option>
<option label="MUR | Mauritian Rupee" value="MUR">MUR | Mauritian Rupee</option>
<option label="MVR | Maldivian Rufiyaa" value="MVR">MVR | Maldivian Rufiyaa</option>
<option label="MWK | Malawian Kwacha" value="MWK">MWK | Malawian Kwacha</option>
<option label="MXN | Mexican Peso" value="MXN">MXN | Mexican Peso</option>
<option label="MYR | Malaysian Ringgit" value="MYR">MYR | Malaysian Ringgit</option>
<option label="MZN | Mozambican Metical" value="MZN">MZN | Mozambican Metical</option>
<option label="NAD | Namibian Dollar" value="NAD">NAD | Namibian Dollar</option>
<option label="NGN | Nigerian Naira" value="NGN">NGN | Nigerian Naira</option>
<option label="NIO | Nicaraguan Córdoba" value="NIO">NIO | Nicaraguan Córdoba</option>
<option label="NOK | Norwegian Krone" value="NOK">NOK | Norwegian Krone</option>
<option label="NPR | Nepalese Rupee" value="NPR">NPR | Nepalese Rupee</option>
<option label="NZD | New Zealand Dollar" value="NZD">NZD | New Zealand Dollar</option>
<option label="OMR | Omani Rial" value="OMR">OMR | Omani Rial</option>
<option label="PAB | Panamanian Balboa" value="PAB">PAB | Panamanian Balboa</option>
<option label="PEN | Peruvian Nuevo Sol" value="PEN">PEN | Peruvian Nuevo Sol</option>
<option label="PGK | Papua New Guinean Kina" value="PGK">PGK | Papua New Guinean Kina</option>
<option label="PHP | Philippine Peso" value="PHP">PHP | Philippine Peso</option>
<option label="PKR | Pakistani Rupee" value="PKR">PKR | Pakistani Rupee</option>
<option label="PLN | Polish Złoty" value="PLN">PLN | Polish Złoty</option>
<option label="PYG | Paraguayan Guaraní" value="PYG">PYG | Paraguayan Guaraní</option>
<option label="QAR | Qatari Riyal" value="QAR">QAR | Qatari Riyal</option>
<option label="RON | Romanian New Leu" value="RON">RON | Romanian New Leu</option>
<option label="RSD | Serbian Dinar" value="RSD">RSD | Serbian Dinar</option>
<option label="RWF | Rwandan Franc" value="RWF">RWF | Rwandan Franc</option>
<option label="SAR | Saudi Riyal" value="SAR">SAR | Saudi Riyal</option>
<option label="SBD | Solomon Islands Dollar" value="SBD">SBD | Solomon Islands Dollar</option>
<option label="SCR | Seychelles Rupee" value="SCR">SCR | Seychelles Rupee</option>
<option label="SDG | Sudanese Pound" value="SDG">SDG | Sudanese Pound</option>
<option label="SEK | Swedish Krona/kronor" value="SEK">SEK | Swedish Krona/kronor</option>
<option label="SGD | Singapore Dollar" value="SGD">SGD | Singapore Dollar</option>
<option label="SHP | Saint Helena Pound" value="SHP">SHP | Saint Helena Pound</option>
<option label="SLL | Sierra Leonean Leone" value="SLL">SLL | Sierra Leonean Leone</option>
<option label="SOS | Somali Shilling" value="SOS">SOS | Somali Shilling</option>
<option label="SRD | Surinamese Dollar" value="SRD">SRD | Surinamese Dollar</option>
<option label="SSP | South Sudanese Pound" value="SSP">SSP | South Sudanese Pound</option>
<option label="STD | São Tomé And Príncipe Dobra" value="STD">STD | São Tomé And Príncipe Dobra</option>
<option label="SYP | Syrian Pound" value="SYP">SYP | Syrian Pound</option>
<option label="SZL | Swazi Lilangeni" value="SZL">SZL | Swazi Lilangeni</option>
<option label="THB | Thai Baht" value="THB">THB | Thai Baht</option>
<option label="TJS | Tajikistani Somoni" value="TJS">TJS | Tajikistani Somoni</option>
<option label="TMT | Turkmenistani Manat" value="TMT">TMT | Turkmenistani Manat</option>
<option label="TND | Tunisian Dinar" value="TND">TND | Tunisian Dinar</option>
<option label="TOP | Tongan Paʻanga" value="TOP">TOP | Tongan Paʻanga</option>
<option label="TRY | Turkish Lira" value="TRY">TRY | Turkish Lira</option>
<option label="TTD | Trinidad And Tobago Dollar" value="TTD">TTD | Trinidad And Tobago Dollar</option>
<option label="TWD | New Taiwan Dollar" value="TWD">TWD | New Taiwan Dollar</option>
<option label="TZS | Tanzanian Shilling" value="TZS">TZS | Tanzanian Shilling</option>
<option label="UAH | Ukrainian Hryvnia" value="UAH">UAH | Ukrainian Hryvnia</option>
<option label="UGX | Ugandan Shilling" value="UGX">UGX | Ugandan Shilling</option>
<option label="USD | United States Dollar" value="USD">USD | United States Dollar</option>
<option label="UYU | Uruguayan Peso" value="UYU">UYU | Uruguayan Peso</option>
<option label="UZS | Uzbekistan Som" value="UZS">UZS | Uzbekistan Som</option>
<option label="VND | Vietnamese Dong" value="VND">VND | Vietnamese Dong</option>
<option label="VUV | Vanuatu Vatu" value="VUV">VUV | Vanuatu Vatu</option>
<option label="WST | Samoan Tala" value="WST">WST | Samoan Tala</option>
<option label="XAF | CFA Franc BEAC" value="XAF">XAF | CFA Franc BEAC</option>
<option label="XCD | East Caribbean Dollar" value="XCD">XCD | East Caribbean Dollar</option>
<option label="XDR | Special Drawing Rights" value="XDR">XDR | Special Drawing Rights</option>
<option label="XOF | CFA Franc BCEAO" value="XOF">XOF | CFA Franc BCEAO</option>
<option label="XPF | CFP Franc" value="XPF">XPF | CFP Franc</option>
<option label="YER | Yemeni Rial" value="YER">YER | Yemeni Rial</option>
<option label="ZAR | South African Rand" value="ZAR">ZAR | South African Rand</option>
</select>
<span class="currency-picker__short ng-binding" data-testid="currency-picker-currencySymbol" ng-style="selected ? changeSpanStyle() : defaultStyle(true)">EUR</span>
</div>
<!-- ngIf: currency.currency !== currency.fullSymbol --><span class="currency-picker__full-symbol ng-binding ng-scope" data-testid="currency-picker-fullcurrencySymbol" ng-if="currency.currency !== currency.fullSymbol"
aria-hidden="true">€</span><!-- end ngIf: currency.currency !== currency.fullSymbol -->
</div>
</div>
<currency-field-rf model="$ctrl.otherAmount" modal-bind-value="$ctrl.amount" selected="$ctrl.showCustomAmtSelected" class="currency-field rf ng-isolate-scope bb" data-ng-class="{'bb': $ctrl.hasBigButtons}" label="''"
round-currency="false" name="'amount'" placeholder="!$ctrl.preventOldrfForDeque ? 'Other': 'Custom amount'" currency-aria-label="Enter an other amount to donate">
<!-- ngIf: $ctrl.label -->
<input class="form__text-input--dark ng-pristine ng-untouched ng-isolate-scope ng-empty sc-valid ng-valid-required ng-not-modified ng-valid-min ng-valid ng-valid-max" ng-model="$ctrl.model"
ng-model-options="{ getterSetter: $ctrl.getterSetter }" ng-required="$ctrl.required" sc-currency="" sc-validity-reporter="" sc-validity-classes="" symbol="" round-currency="$ctrl.roundCurrency" ng-disabled="$ctrl.disableFlag"
max="$ctrl.max" min="$ctrl.min" type="string" inputmode="numeric" autocomplete="off" name="amount" placeholder="Other" ng-change="$ctrl.onChange()" ng-blur="$ctrl.onFocus = false"
ng-style="$ctrl.selected ? $ctrl.changeInputStyle() : $ctrl.defaultStyle()" qa-id="text-input" aria-label="Enter an other amount to donate" _spec="input">
<div style="position: absolute;
width: 100%;
left: 0;
text-align: left;" aria-live="polite">
<form-error name="$ctrl.name" messages="$ctrl.errorMessages" _spec="errors" class="ng-isolate-scope">
<p class="form__error" aria-live="polite" role="alert" sc-validity-message="::$ctrl.name" messages="::$ctrl.messages" style="display: none;"></p>
</form-error>
</div>
</currency-field-rf>
</div>
</label>
</div>
<!-- end ngIf: $ctrl.hasBigButtons && level.amount === 'Custom' && (($ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time') || ($ctrl.showCustomAmtField($ctrl.recurringDonationLevels) && $ctrl.frequency !== 'one-time')) --><!-- end ngRepeat: level in ($ctrl.frequency === 'one-time' ? $ctrl.levels : $ctrl.recurringDonationLevels) | filter: { display_on_page: true} -->
<!-- IF ONLY SINGLE AMOUNT DISPLAYED-->
<!-- ngIf: !$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) === 1 && !$ctrl.showCustomAmtField($ctrl.levels)) -->
<!-- IF ONLY SINGLE RECURRING AMOUNT DISPLAYED-->
<!-- ngIf: $ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.recurringDonationLevels) === 1 && !$ctrl.showCustomAmtField($ctrl.recurringDonationLevels)) -->
</div>
</donation-amount-recurring-rf><!-- end ngIf: showLegacyDonationGrid -->
<!-- ngIf: !showLegacyDonationGrid -->
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-dedication ng-scope" data-ng-controller="frsDonationDedicationCtrl">
<button type="button" class="sc-checkbox " data-ng-click="toggle()" role="checkbox" aria-checked="false" data-sc-checkbox="" data-ng-model="state.dedicationFormEnabled" name="dedicate"
aria-label="Dedicate my donation in honor or in memory of someone"><span class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true"> Dedicate my donation <strong class="ng-scope">in honor or in
memory</strong> of someone </span></button>
<div data-ng-show="show.dedicationForm()" data-ng-form="dedicationForm" id="donation-page_checkout_dedication-form" class="ng-pristine ng-hide ng-valid-email-address ng-invalid ng-invalid-required">
<!-- ngInclude: ::template('type') -->
<div data-heap-ignore="true" data-ng-include="::template('type')" class="mp-sensitive ng-scope">
<div class="donation-table ng-scope">
<div class="donation-table-label-type">
<label class="donation-label">Type</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<radio-group role="radiogroup" aria-label="select dedication type" class="ng-isolate-scope"><ng-transclude>
<radio-control ng-model="dedicationModel.type" name="'type'" value="'honor'" ng-required="true" aria-label="select to donate in honor of someone"
class="ng-pristine ng-untouched ng-valid ng-scope ng-isolate-scope ng-not-empty ng-valid-required ng-not-modified" required="required">
<button class="form__radio-control checked" aria-checked="true" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)" ng-disabled="$ctrl.disabled"
type="button" aria-label="select to donate in honor of someone" _spec="button">
<span class="form__radio-control_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control_label" qa-id="radio-field" ng-transclude="" _spec="label"> In honor of … </span>
</button>
</radio-control>
<radio-control ng-model="dedicationModel.type" name="'type'" value="'memory'" ng-required="true" aria-label="select to donate in memory of someone"
class="ng-pristine ng-untouched ng-valid ng-scope ng-isolate-scope ng-not-empty ng-valid-required ng-not-modified" required="required">
<button class="form__radio-control" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)" ng-disabled="$ctrl.disabled"
type="button" aria-label="select to donate in memory of someone" _spec="button">
<span class="form__radio-control_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control_label" qa-id="radio-field" ng-transclude="" _spec="label"> In memory of … </span>
</button>
</radio-control>
</ng-transclude></radio-group>
</div>
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('honoree') -->
<div data-heap-ignore="true" data-ng-include="::template('honoree')" class="mp-sensitive ng-scope">
<div class="donation-table donation-dedication__honoree ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half">
<span class="donation-label required" data-sc-form-error="highlight if dedicationForm.honoree_first_name fails">Honoree’s First Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="dedicationModel.honoree_first_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.honoree_first_name fails" type="text" name="honoree_first_name" aria-label="honoree's first name" required="" aria-invalid="false">
</div>
<div class="donation-table_column half">
<span class="donation-label required" data-sc-form-error="highlight if dedicationForm.honoree_last_name fails">Honoree’s Last Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="dedicationModel.honoree_last_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.honoree_last_name fails" type="text" name="honoree_last_name" aria-label="honoree's last name" required="" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if [dedicationForm.honoree_first_name, dedicationForm.honoree_last_name] fails required" style="display: none;"> Don't forget to give us a name for the dedication.
</span>
</div>
</div>
</div>
</div>
<!-- ngIf: show.emailForm() || state.postcardEnabled --><!-- ngInclude: ::template('recipient-email') -->
<div data-heap-ignore="true" data-ng-include="::template('recipient-email')" data-ng-if="show.emailForm() || state.postcardEnabled" class="mp-sensitive ng-scope">
<div class="donation-table donation-dedication_recipient-info ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<label class="donation-label" data-ng-class="{required: show.requiredDedicationInfo()}" data-sc-form-error="highlight if [dedicationForm.name, dedicationForm.email_address] fails">Recipient's email</label>
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-email-address ng-valid-required ng-not-modified" data-ng-model="dedicationModel.email_address" data-sc-validate-email-address=""
data-sc-retain-focus-validity="" data-sc-form-error="highlight if dedicationForm.email_address fails" data-ng-required="show.requiredDedicationInfo()" type="text" name="email_address" placeholder="Email Address"
aria-label="recipient's email address, not required, use to optionally send a notification email" aria-invalid="false">
</div>
</div>
<div>
<span aria-live="polite" role="alert" class="donation-error ng-binding" data-sc-form-error="show if dedicationForm.email_address fails emailAddress" style="display: none;"> Please enter dedication recipient email in the format:
name@domain.com. </span>
</div>
<small class="donation-table_row-helper ng-binding"> Optionally send a notification email </small>
</div>
</div>
<div class="donation-table donation-dedication_recipient-info ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half">
<span class="donation-label" data-sc-form-error="highlight if billing_first_name fails" data-ng-class="{required: show.requiredDedicationInfo() || state.postcardEnabled}">Recipient’s First Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-required ng-not-modified" data-ng-model="dedicationModel.first_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.first_name fails" type="text" name="first_name" ng-required="show.requiredDedicationInfo() || state.postcardEnabled" aria-label="recipient's first name" aria-invalid="false">
</div>
<div class="donation-table_column half">
<span class="donation-label" data-sc-form-error="highlight if billing_first_name fails" data-ng-class="{required: show.requiredDedicationInfo() || state.postcardEnabled}">Recipient’s Last Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-required ng-not-modified" data-ng-model="dedicationModel.last_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.last_name fails" type="text" name="last_name" ng-required="show.requiredDedicationInfo() || state.postcardEnabled" aria-label="recipient's last name" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if [dedicationForm.name,dedicationForm.email_address] fails required" style="display: none;"> Don't forget to include the of your recipient. </span>
</div>
</div>
</div>
</div><!-- end ngIf: show.emailForm() || state.postcardEnabled -->
<!-- ngIf: show.postcardToggle() -->
<!-- ngIf: show.postcardForm() -->
<!-- ngIf: show.emailForm() || state.postcardEnabled --><!-- ngInclude: ::template('recipient-message') -->
<div data-heap-ignore="true" data-ng-include="::template('recipient-message')" data-ng-if="show.emailForm() || state.postcardEnabled" class="mp-sensitive ng-scope">
<div class="donation-dedication_message ng-scope" data-sc-form-error="highlight if dedicationForm.ecard_message fails" aria-invalid="false">
<!-- Message Text -->
<div class="donation-dedication_message-text half" data-ng-class="{ half: show.ecardsForm() }">
<div class="donation-dedication_message-label">
<label class="donation-label" for="dedicationMessage" data-sc-form-error="highlight if dedicationForm.ecard_message fails">Your Message to the Recipient</label>
<!-- ngIf: dedicationModel.ecard_id -->
</div>
<textarea class="donation-dedication_message-input ng-pristine ng-untouched ng-valid ng-empty ng-not-modified" data-sc-form-error="highlight if dedicationForm.ecard_message fails" data-ng-model="dedicationModel.ecard_message"
data-sc-retain-focus-validity="" name="ecard_message" aria-label="Your Message to the Recipient." aria-invalid="false"></textarea>
<small class="donation-dedication_message-helper"> Please spell check, include how you would like your name(s) signed, mention the amount if desired, and format your message as you would like it delivered. </small>
</div>
<!-- Image (ecard) -->
<!-- ngIf: show.ecardsForm() -->
<div class="donation-dedication_message-ecard ng-scope" data-ng-if="show.ecardsForm()">
<label class="donation-dedication_message-label">Include an e-Card?</label>
<radio-group role="radiogroup" aria-label="select eCard to send" class="ng-isolate-scope"><ng-transclude>
<div class="donation-dedication_message-ecard-none ng-scope">
<radio-control ng-model="dedicationModel.ecard_id" name="'ecard_id'" value="null" aria-label="don't include an e-card design with the e-mail"
class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control checked" aria-checked="true" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)" ng-disabled="$ctrl.disabled"
type="button" aria-label="don't include an e-card design with the e-mail" _spec="button">
<span class="form__radio-control_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control_label" qa-id="radio-field" ng-transclude="" _spec="label"> No e-Card </span>
</button>
</radio-control>
</div>
<div class="donation-dedication_message-ecard-grid ng-scope">
<!-- ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(130, 10, 30);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 1" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 1" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/3477095/14e51ba2-4979-11e8-a213-0aaaf8d58f8e.jpg" alt="dedication message ecard 1"
src="https://assets.classy.org/3477095/14e51ba2-4979-11e8-a213-0aaaf8d58f8e.jpg">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(130, 10, 30);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 2" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 2" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/3477095/19405c3e-4979-11e8-a366-0a40284d5f8e.jpg" alt="dedication message ecard 2"
src="https://assets.classy.org/3477095/19405c3e-4979-11e8-a366-0a40284d5f8e.jpg">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(130, 10, 30);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 3" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 3" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/3477095/1d95d7f0-4979-11e8-b11c-0e536837d064.jpg" alt="dedication message ecard 3"
src="https://assets.classy.org/3477095/1d95d7f0-4979-11e8-b11c-0e536837d064.jpg">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(130, 10, 30);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 4" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 4" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(130, 10, 30);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/3477095/2ab917bc-4979-11e8-8ad1-0ee7c2ade0b8.jpg" alt="dedication message ecard 4"
src="https://assets.classy.org/3477095/2ab917bc-4979-11e8-8ad1-0ee7c2ade0b8.jpg">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<!-- ngIf: dedicationModel.ecard_id -->
</div>
</ng-transclude></radio-group>
</div><!-- end ngIf: show.ecardsForm() -->
</div>
</div><!-- end ngIf: show.emailForm() || state.postcardEnabled -->
</div>
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-matching ng-scope" data-ng-controller="frsDoubleTheDonationCtrl" data-ng-show="isEmployerMatchOnDonationPage">
<button type="button" class="sc-checkbox " data-ng-click="toggle()" role="checkbox" aria-checked="false" data-sc-checkbox="" data-ng-model="state.doubleTheDonationFormEnabled" aria-label="Have your employer match your donation"><span
class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true"> See if your employer will match your donation </span></button>
<div data-ng-show="show.doubleTheDonationForm()" data-ng-form="doubleTheDonationForm" class="ng-pristine ng-valid ng-hide">
<div class="double-the-donation-label"> Check to see if your employer will match your donation. You may receive an email on how to submit your match request to maximize your impact. </div>
<!-- ngInclude: ::template('company') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('company')">
<div class="donation-table donation-table_margin_top_12 ng-scope">
<div class="donation-table_label">
<label class="donation-label">Company</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column">
<div id="dd-company-name-input"></div>
<script>
var DDCONF = {
API_KEY: SC.organization.doubleTheDonationChannel.publicKey
};
</script>
</div>
</div>
</div>
</div>
</div>
</div>
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-credit ng-scope no-fundraising" ng-class="{'no-fundraising': !campaign.HAS_FUNDRAISING}" data-ng-controller="frsDonationCreditCtrl">
<!-- ngIf: !campaign.current.disable_donation_attribution && campaign.HAS_FUNDRAISING -->
<!-- ngIf: show.designation() -->
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<div class="donation-donor ng-scope" data-ng-controller="frsDonationDonorCtrl" aria-labelledby="donationPage_your-information-heading" id="donation-page_checkout_donor-information-form">
<h2 class="donation-subtitle" id="donationPage_your-information-heading">Your Information</h2>
<!-- ngIf: show.prefix() -->
<!-- ngInclude: ::template('name') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('name')">
<div class="donation-table ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half" data-ng-class="show.middleName() ? 'third' : 'half'">
<span class="donation-label required" data-sc-form-error="highlight if member_first_name fails">First Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="META.member_first_name" data-sc-form-error="highlight if member_first_name fails"
data-sc-retain-focus-validity="" type="text" name="member_first_name" aria-label="Please enter your first name" required="" aria-invalid="false">
</div>
<!-- ngIf: show.middleName() -->
<div class="donation-table_column half" data-ng-class="show.middleName() ? 'third' : 'half'">
<span class="donation-label required" data-sc-form-error="highlight if member_last_name fails">Last Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="META.member_last_name" data-sc-form-error="highlight if member_last_name fails"
data-sc-retain-focus-validity="" type="text" name="member_last_name" aria-label="Please enter your last name" required="" aria-invalid="false">
</div>
</div>
<div aria-live="assertive">
<span class="donation-error ng-binding" data-sc-form-error="show if [member_first_name,optional_middle_name,member_last_name] fails" ng-bind="build.nameError()" style="display: none;">Be sure to provide your name.</span>
</div>
<!-- ngIf: show.anonymous() || show.anonymousDonationAmounts() -->
<div class="donation-table_columns donation-table_columns_without_margin ng-scope" data-ng-if="show.anonymous() || show.anonymousDonationAmounts()">
<!-- ngIf: show.anonymous() -->
<div class="donation-table_column ng-scope" data-ng-if="show.anonymous()">
<button type="button" class="inline sc-checkbox " data-ng-click="toggle()" role="checkbox" aria-checked="false" data-sc-checkbox="" aria-label="Make donation anonymous" data-ng-model="MODEL.is_anonymous" name="is_anonymous"><span
class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true"> Hide my name from the public. </span></button>
<i tabindex="0" class="fa fa-question-circle donation-tooltip inline ng-binding ng-isolate-scope" data-sc-tooltip="" data-sc-tooltip-class="donation-tooltip_message" data-ng-style="{ color: theme.current.styles.primaryColor }" data-hasqtip="0" style="color: rgb(130, 10, 30);"></i>
</div><!-- end ngIf: show.anonymous() -->
<!-- ngIf: show.anonymousDonationAmounts() -->
</div><!-- end ngIf: show.anonymous() || show.anonymousDonationAmounts() -->
</div>
</div>
</div>
<!-- ngIf: show.suffix() -->
<!-- ngInclude: ::template('email') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('email')">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if member_email_address fails">Email</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column">
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-valid-email-address ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.member_email_address"
data-sc-form-error="highlight if member_email_address fails" data-sc-validate-email-address="" data-sc-retain-focus-validity="" type="text" name="member_email_address" aria-label="Email address. Your receipt will be emailed here."
required="" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if member_email_address fails required" style="display: none;"> Don't forget your email address. </span>
<span class="donation-error ng-binding" data-sc-form-error="show if member_email_address fails emailAddress" style="display: none;"> Please enter in the format: name@domain.com. </span>
</div>
<small class="donation-table_row-helper"> Your receipt will be emailed here. </small>
<sc-consent data-show="!campaign.current.hide_contact_opt_in" data-opt-in="MODEL.opt_in" data-language="MODEL.opt_in_wording" name="opt_in" class="ng-isolate-scope">
<!-- ngIf: $ctrl.show -->
<div data-ng-if="$ctrl.show" data-ng-hide="$ctrl.hide" class="sc-consent ng-scope">
<button type="button" class="sc-checkbox_top sc-checkbox checked" data-ng-click="toggle()" role="checkbox" aria-checked="true" data-sc-checkbox="" data-ng-model="$ctrl.optIn"
aria-label="I want to stay connected. Send me Inspiring patient stories, medical advancements and important updates." name="opt_in"><span class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude=""
aria-hidden="true"> I want to stay connected. Send me Inspiring patient stories, medical advancements and important updates. </span></button>
</div><!-- end ngIf: $ctrl.show -->
</sc-consent>
</div>
</div>
</div>
<div>
<!-- ngInclude: ::template('billing-address1') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-address1')">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if billing_address1 fails">Address</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<div data-class="donation-text_input" data-name="billing_address1" ng-model="MODEL.billing_address1" data-sc-retain-focus-validity="" data-sc-address-lookup="" data-parser="parseBillingAddressAutocomplete(response)"
data-aria-label="billing address 1" data-placeholder="Enter your billing address" data-required="true" class="ng-pristine ng-untouched ng-isolate-scope ng-empty ng-invalid ng-invalid-required ng-not-modified"><input type="text"
class="donation-text_input" name="billing_address1" placeholder="Enter your billing address" required="" data-sc-form-error="highlight if billing_address1 fails" aria-invalid="false"></div>
</div>
</div>
<div style="display: flex; justify-content: space-between">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_address1 fails required" style="display: none;"> Don't forget to provide a billing address. </span>
</div>
<!-- ngIf: !showAddressLine2 -->
<div style="display: flex; align-items: center" data-ng-if="!showAddressLine2" data-ng-click="handleAddLine2Click()" class="ng-scope">
<img width="22px" height="22x" sc-cdn-src="/static/global/images/add-circle.svg" class="ng-isolate-scope" src="https://prod-frs.content.classy.org/prod/3f67ddbf598a1096a57eb6a65a40c24e13d4278b/static/global/images/add-circle.svg">
<span> Add apt., suite, floor </span>
</div><!-- end ngIf: !showAddressLine2 -->
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('billing-address2') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-address2')"><!-- ngIf: showAddressLine2 -->
</div>
<!-- ngInclude: ::template('billing-zip-city') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-zip-city')">
<div class="donation-table ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half">
<span class="donation-label required ng-binding" name="billing_postal_code_label" data-sc-form-error="highlight if billing_postal_code fails">ZIP</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.billing_postal_code" data-sc-form-error="highlight if billing_postal_code fails"
data-sc-retain-focus-validity="" type="text" name="billing_postal_code" aria-label="ZIP" required="" aria-invalid="false">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" name="billing_postal_code_error">
</span>
</div>
</div>
<div class="donation-table_column half">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if billing_city fails">City</label>
</div>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.billing_city" data-sc-form-error="highlight if billing_city fails"
data-sc-retain-focus-validity="" type="text" name="billing_city" aria-label="billing city" required="" aria-invalid="false">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_city fails required" style="display: none;"> Don't forget to provide a billing city. </span>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('billing-state-country') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-state-country')">
<div class="donation-table ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half" data-ng-show="show.states()">
<span class="donation-label required" data-sc-form-error="highlight if billing_state fails">State</span>
<select ng-options="state.value as state.label for state in states" qa-id="select-field" aria-label="billing state" class="donation-select ng-empty ng-invalid ng-invalid-required ng-not-modified"
data-ng-model="MODEL.billing_state" data-sc-form-error="highlight if billing_state fails" data-sc-select-states="" data-only-states="true" name="billing_state" required="required" aria-invalid="false">
<option value="" class="">Please Select</option>
<option label="Alabama" value="string:AL">Alabama</option>
<option label="Alaska" value="string:AK">Alaska</option>
<option label="Arizona" value="string:AZ">Arizona</option>
<option label="Arkansas" value="string:AR">Arkansas</option>
<option label="California" value="string:CA">California</option>
<option label="Colorado" value="string:CO">Colorado</option>
<option label="Connecticut" value="string:CT">Connecticut</option>
<option label="Delaware" value="string:DE">Delaware</option>
<option label="District of Columbia" value="string:DC">District of Columbia</option>
<option label="Florida" value="string:FL">Florida</option>
<option label="Georgia" value="string:GA">Georgia</option>
<option label="Hawaii" value="string:HI">Hawaii</option>
<option label="Idaho" value="string:ID">Idaho</option>
<option label="Illinois" value="string:IL">Illinois</option>
<option label="Indiana" value="string:IN">Indiana</option>
<option label="Iowa" value="string:IA">Iowa</option>
<option label="Kansas" value="string:KS">Kansas</option>
<option label="Kentucky" value="string:KY">Kentucky</option>
<option label="Louisiana" value="string:LA">Louisiana</option>
<option label="Maine" value="string:ME">Maine</option>
<option label="Maryland" value="string:MD">Maryland</option>
<option label="Massachusetts" value="string:MA">Massachusetts</option>
<option label="Michigan" value="string:MI">Michigan</option>
<option label="Minnesota" value="string:MN">Minnesota</option>
<option label="Mississippi" value="string:MS">Mississippi</option>
<option label="Missouri" value="string:MO">Missouri</option>
<option label="Montana" value="string:MT">Montana</option>
<option label="Nebraska" value="string:NE">Nebraska</option>
<option label="Nevada" value="string:NV">Nevada</option>
<option label="New Hampshire" value="string:NH">New Hampshire</option>
<option label="New Jersey" value="string:NJ">New Jersey</option>
<option label="New Mexico" value="string:NM">New Mexico</option>
<option label="New York" value="string:NY">New York</option>
<option label="North Carolina" value="string:NC">North Carolina</option>
<option label="North Dakota" value="string:ND">North Dakota</option>
<option label="Ohio" value="string:OH">Ohio</option>
<option label="Oklahoma" value="string:OK">Oklahoma</option>
<option label="Oregon" value="string:OR">Oregon</option>
<option label="Pennsylvania" value="string:PA">Pennsylvania</option>
<option label="Rhode Island" value="string:RI">Rhode Island</option>
<option label="South Carolina" value="string:SC">South Carolina</option>
<option label="South Dakota" value="string:SD">South Dakota</option>
<option label="Tennessee" value="string:TN">Tennessee</option>
<option label="Texas" value="string:TX">Texas</option>
<option label="Utah" value="string:UT">Utah</option>
<option label="Vermont" value="string:VT">Vermont</option>
<option label="Virginia" value="string:VA">Virginia</option>
<option label="Washington" value="string:WA">Washington</option>
<option label="West Virginia" value="string:WV">West Virginia</option>
<option label="Wisconsin" value="string:WI">Wisconsin</option>
<option label="Wyoming" value="string:WY">Wyoming</option>
<option label="Armed Forces (the) Americas" value="string:AA">Armed Forces (the) Americas</option>
<option label="Armed Forces Europe" value="string:AE">Armed Forces Europe</option>
<option label="Armed Forces Pacific" value="string:AP">Armed Forces Pacific</option>
<option label="American Samoa" value="string:AS">American Samoa</option>
<option label="Guam" value="string:GU">Guam</option>
<option label="Northern Mariana Islands" value="string:MP">Northern Mariana Islands</option>
<option label="Puerto Rico" value="string:PR">Puerto Rico</option>
<option label="Virgin Islands" value="string:VI">Virgin Islands</option>
</select>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_state fails required" style="display: none;"> Don't forget to provide a state. </span>
</div>
</div>
<div class="donation-table_column half ng-hide" data-ng-show="show.provinces()">
<span class="donation-label required" data-sc-form-error="highlight if billing_state fails">Province</span>
<select ng-options="province.value as province.label for province in provinces" class="donation-select ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.billing_state"
data-sc-form-error="highlight if billing_state fails" data-sc-select-provinces="" name="billing_state" aria-label="billing province" required="required" aria-invalid="false">
<option value="?" selected="selected"></option>
<option value="" class="">Please Select</option>
<option label="Alberta (AB)" value="string:AB">Alberta (AB)</option>
<option label="British Columbia (BC)" value="string:BC">British Columbia (BC)</option>
<option label="Manitoba (MB)" value="string:MB">Manitoba (MB)</option>
<option label="New Brunswick (NB)" value="string:NB">New Brunswick (NB)</option>
<option label="Newfoundland and Labrador (NL)" value="string:NL">Newfoundland and Labrador (NL)</option>
<option label="Northwest Territories (NT)" value="string:NT">Northwest Territories (NT)</option>
<option label="Nova Scotia (NS)" value="string:NS">Nova Scotia (NS)</option>
<option label="Nunavut (NU)" value="string:NU">Nunavut (NU)</option>
<option label="Prince Edward Island (PE)" value="string:PE">Prince Edward Island (PE)</option>
<option label="Saskatchewan (SK)" value="string:SK">Saskatchewan (SK)</option>
<option label="Ontario (ON)" value="string:ON">Ontario (ON)</option>
<option label="Quebec (QC)" value="string:QC">Quebec (QC)</option>
<option label="Yukon (YT)" value="string:YT">Yukon (YT)</option>
</select>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_state fails required" style="display: none;"> Don't forget to provide a province. </span>
</div>
</div>
<div class="donation-table_column half ng-hide" data-ng-show="show.genericLevel1()">
<span class="donation-label required" data-sc-form-error="highlight if billing_state fails">Region</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-maxlength ng-not-modified" data-ng-model="MODEL.billing_state" data-sc-form-error="highlight if billing_state fails"
data-sc-retain-focus-validity="" type="text" name="billing_state" aria-label="billing region" ng-maxlength="32" maxlength="32" required="" aria-invalid="false">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_state fails required" style="display: none;"> Don't forget to provide a region. </span>
</div>
</div>
<div class="donation-table_column half">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if billing_country fails">Country</label>
</div>
<!-- TODO: Exclude SG? -->
<select ng-options="country.value as country.label disable when country.disable for country in countries" qa-id="select-field" class="donation-select ng-not-empty ng-valid ng-valid-required ng-not-modified"
data-ng-model="MODEL.billing_country" data-sc-form-error="highlight if billing_country fails" data-sc-select-countries="" name="billing_country" aria-label="billing country" required="required" aria-invalid="false">
<option value="" class="">Please Select</option>
<option label="Afghanistan" value="string:AF">Afghanistan</option>
<option label="Aland Islands" value="string:AX">Aland Islands</option>
<option label="Albania" value="string:AL">Albania</option>
<option label="Algeria" value="string:DZ">Algeria</option>
<option label="American Samoa" value="string:AS">American Samoa</option>
<option label="Andorra" value="string:AD">Andorra</option>
<option label="Angola" value="string:AO">Angola</option>
<option label="Anguilla" value="string:AI">Anguilla</option>
<option label="Antarctica" value="string:AQ">Antarctica</option>
<option label="Antigua and Barbuda" value="string:AG">Antigua and Barbuda</option>
<option label="Argentina" value="string:AR">Argentina</option>
<option label="Armenia" value="string:AM">Armenia</option>
<option label="Aruba" value="string:AW">Aruba</option>
<option label="Australia" value="string:AU">Australia</option>
<option label="Austria" value="string:AT">Austria</option>
<option label="Azerbaijan" value="string:AZ">Azerbaijan</option>
<option label="Bahamas" value="string:BS">Bahamas</option>
<option label="Bahrain" value="string:BH">Bahrain</option>
<option label="Bangladesh" value="string:BD">Bangladesh</option>
<option label="Barbados" value="string:BB">Barbados</option>
<option label="Belgium" value="string:BE">Belgium</option>
<option label="Belize" value="string:BZ">Belize</option>
<option label="Benin" value="string:BJ">Benin</option>
<option label="Bermuda" value="string:BM">Bermuda</option>
<option label="Bhutan" value="string:BT">Bhutan</option>
<option label="Bolivia" value="string:BO">Bolivia</option>
<option label="Bonaire, Saint Eustatius and Saba " value="string:BQ">Bonaire, Saint Eustatius and Saba </option>
<option label="Bosnia and Herzegovina" value="string:BA">Bosnia and Herzegovina</option>
<option label="Botswana" value="string:BW">Botswana</option>
<option label="Bouvet Island" value="string:BV">Bouvet Island</option>
<option label="Brazil" value="string:BR">Brazil</option>
<option label="British Indian Ocean Territory" value="string:IO">British Indian Ocean Territory</option>
<option label="British Virgin Islands" value="string:VG">British Virgin Islands</option>
<option label="Brunei" value="string:BN">Brunei</option>
<option label="Bulgaria" value="string:BG">Bulgaria</option>
<option label="Burkina Faso" value="string:BF">Burkina Faso</option>
<option label="Burundi" value="string:BI">Burundi</option>
<option label="Cambodia" value="string:KH">Cambodia</option>
<option label="Cameroon" value="string:CM">Cameroon</option>
<option label="Canada" value="string:CA">Canada</option>
<option label="Cape Verde" value="string:CV">Cape Verde</option>
<option label="Cayman Islands" value="string:KY">Cayman Islands</option>
<option label="Central African Republic" value="string:CF">Central African Republic</option>
<option label="Chad" value="string:TD">Chad</option>
<option label="Chile" value="string:CL">Chile</option>
<option label="China" value="string:CN">China</option>
<option label="Christmas Island" value="string:CX">Christmas Island</option>
<option label="Cocos Islands" value="string:CC">Cocos Islands</option>
<option label="Colombia" value="string:CO">Colombia</option>
<option label="Comoros" value="string:KM">Comoros</option>
<option label="Cook Islands" value="string:CK">Cook Islands</option>
<option label="Costa Rica" value="string:CR">Costa Rica</option>
<option label="Croatia" value="string:HR">Croatia</option>
<option label="Cuba" value="string:CU">Cuba</option>
<option label="Curacao" value="string:CW">Curacao</option>
<option label="Cyprus" value="string:CY">Cyprus</option>
<option label="Czech Republic" value="string:CZ">Czech Republic</option>
<option label="Denmark" value="string:DK">Denmark</option>
<option label="Djibouti" value="string:DJ">Djibouti</option>
<option label="Dominica" value="string:DM">Dominica</option>
<option label="Dominican Republic" value="string:DO">Dominican Republic</option>
<option label="East Timor" value="string:TL">East Timor</option>
<option label="Ecuador" value="string:EC">Ecuador</option>
<option label="Egypt" value="string:EG">Egypt</option>
<option label="El Salvador" value="string:SV">El Salvador</option>
<option label="Equatorial Guinea" value="string:GQ">Equatorial Guinea</option>
<option label="Eritrea" value="string:ER">Eritrea</option>
<option label="Estonia" value="string:EE">Estonia</option>
<option label="Ethiopia" value="string:ET">Ethiopia</option>
<option label="Falkland Islands" value="string:FK">Falkland Islands</option>
<option label="Faroe Islands" value="string:FO">Faroe Islands</option>
<option label="Fiji" value="string:FJ">Fiji</option>
<option label="Finland" value="string:FI">Finland</option>
<option label="France" value="string:FR">France</option>
<option label="French Guiana" value="string:GF">French Guiana</option>
<option label="French Polynesia" value="string:PF">French Polynesia</option>
<option label="French Southern Territories" value="string:TF">French Southern Territories</option>
<option label="Gabon" value="string:GA">Gabon</option>
<option label="Gambia" value="string:GM">Gambia</option>
<option label="Georgia" value="string:GE">Georgia</option>
<option label="Germany" value="string:DE">Germany</option>
<option label="Ghana" value="string:GH">Ghana</option>
<option label="Gibraltar" value="string:GI">Gibraltar</option>
<option label="Greece" value="string:GR">Greece</option>
<option label="Greenland" value="string:GL">Greenland</option>
<option label="Grenada" value="string:GD">Grenada</option>
<option label="Guadeloupe" value="string:GP">Guadeloupe</option>
<option label="Guam" value="string:GU">Guam</option>
<option label="Guatemala" value="string:GT">Guatemala</option>
<option label="Guernsey" value="string:GG">Guernsey</option>
<option label="Guinea" value="string:GN">Guinea</option>
<option label="Guinea-Bissau" value="string:GW">Guinea-Bissau</option>
<option label="Guyana" value="string:GY">Guyana</option>
<option label="Haiti" value="string:HT">Haiti</option>
<option label="Heard Island and McDonald Islands" value="string:HM">Heard Island and McDonald Islands</option>
<option label="Honduras" value="string:HN">Honduras</option>
<option label="Hong Kong" value="string:HK">Hong Kong</option>
<option label="Hungary" value="string:HU">Hungary</option>
<option label="Iceland" value="string:IS">Iceland</option>
<option label="India" value="string:IN">India</option>
<option label="Indonesia" value="string:ID">Indonesia</option>
<option label="Ireland" value="string:IE">Ireland</option>
<option label="Isle of Man" value="string:IM">Isle of Man</option>
<option label="Israel" value="string:IL">Israel</option>
<option label="Italy" value="string:IT">Italy</option>
<option label="Ivory Coast" value="string:CI">Ivory Coast</option>
<option label="Jamaica" value="string:JM">Jamaica</option>
<option label="Japan" value="string:JP">Japan</option>
<option label="Jersey" value="string:JE">Jersey</option>
<option label="Jordan" value="string:JO">Jordan</option>
<option label="Kazakhstan" value="string:KZ">Kazakhstan</option>
<option label="Kenya" value="string:KE">Kenya</option>
<option label="Kiribati" value="string:KI">Kiribati</option>
<option label="Kosovo" value="string:XK">Kosovo</option>
<option label="Kuwait" value="string:KW">Kuwait</option>
<option label="Kyrgyzstan" value="string:KG">Kyrgyzstan</option>
<option label="Laos" value="string:LA">Laos</option>
<option label="Latvia" value="string:LV">Latvia</option>
<option label="Lebanon" value="string:LB">Lebanon</option>
<option label="Lesotho" value="string:LS">Lesotho</option>
<option label="Libya" value="string:LY">Libya</option>
<option label="Liechtenstein" value="string:LI">Liechtenstein</option>
<option label="Lithuania" value="string:LT">Lithuania</option>
<option label="Luxembourg" value="string:LU">Luxembourg</option>
<option label="Macao" value="string:MO">Macao</option>
<option label="Macedonia" value="string:MK">Macedonia</option>
<option label="Madagascar" value="string:MG">Madagascar</option>
<option label="Malawi" value="string:MW">Malawi</option>
<option label="Malaysia" value="string:MY">Malaysia</option>
<option label="Maldives" value="string:MV">Maldives</option>
<option label="Mali" value="string:ML">Mali</option>
<option label="Malta" value="string:MT">Malta</option>
<option label="Marshall Islands" value="string:MH">Marshall Islands</option>
<option label="Martinique" value="string:MQ">Martinique</option>
<option label="Mauritania" value="string:MR">Mauritania</option>
<option label="Mauritius" value="string:MU">Mauritius</option>
<option label="Mayotte" value="string:YT">Mayotte</option>
<option label="Mexico" value="string:MX">Mexico</option>
<option label="Micronesia" value="string:FM">Micronesia</option>
<option label="Moldova" value="string:MD">Moldova</option>
<option label="Monaco" value="string:MC">Monaco</option>
<option label="Mongolia" value="string:MN">Mongolia</option>
<option label="Montenegro" value="string:ME">Montenegro</option>
<option label="Montserrat" value="string:MS">Montserrat</option>
<option label="Morocco" value="string:MA">Morocco</option>
<option label="Mozambique" value="string:MZ">Mozambique</option>
<option label="Myanmar" value="string:MM">Myanmar</option>
<option label="Namibia" value="string:NA">Namibia</option>
<option label="Nauru" value="string:NR">Nauru</option>
<option label="Nepal" value="string:NP">Nepal</option>
<option label="Netherlands" value="string:NL">Netherlands</option>
<option label="New Caledonia" value="string:NC">New Caledonia</option>
<option label="New Zealand" value="string:NZ">New Zealand</option>
<option label="Nicaragua" value="string:NI">Nicaragua</option>
<option label="Niger" value="string:NE">Niger</option>
<option label="Nigeria" value="string:NG">Nigeria</option>
<option label="Niue" value="string:NU">Niue</option>
<option label="Norfolk Island" value="string:NF">Norfolk Island</option>
<option label="Northern Mariana Islands" value="string:MP">Northern Mariana Islands</option>
<option label="Norway" value="string:NO">Norway</option>
<option label="Oman" value="string:OM">Oman</option>
<option label="Pakistan" value="string:PK">Pakistan</option>
<option label="Palau" value="string:PW">Palau</option>
<option label="Palestinian Territory" value="string:PS">Palestinian Territory</option>
<option label="Panama" value="string:PA">Panama</option>
<option label="Papua New Guinea" value="string:PG">Papua New Guinea</option>
<option label="Paraguay" value="string:PY">Paraguay</option>
<option label="Peru" value="string:PE">Peru</option>
<option label="Philippines" value="string:PH">Philippines</option>
<option label="Pitcairn" value="string:PN">Pitcairn</option>
<option label="Poland" value="string:PL">Poland</option>
<option label="Portugal" value="string:PT">Portugal</option>
<option label="Puerto Rico" value="string:PR">Puerto Rico</option>
<option label="Qatar" value="string:QA">Qatar</option>
<option label="Republic of the Congo" value="string:CG">Republic of the Congo</option>
<option label="Reunion" value="string:RE">Reunion</option>
<option label="Romania" value="string:RO">Romania</option>
<option label="Russia" value="string:RU">Russia</option>
<option label="Rwanda" value="string:RW">Rwanda</option>
<option label="Saint Barthelemy" value="string:BL">Saint Barthelemy</option>
<option label="Saint Helena" value="string:SH">Saint Helena</option>
<option label="Saint Kitts and Nevis" value="string:KN">Saint Kitts and Nevis</option>
<option label="Saint Lucia" value="string:LC">Saint Lucia</option>
<option label="Saint Martin" value="string:MF">Saint Martin</option>
<option label="Saint Pierre and Miquelon" value="string:PM">Saint Pierre and Miquelon</option>
<option label="Saint Vincent and the Grenadines" value="string:VC">Saint Vincent and the Grenadines</option>
<option label="Samoa" value="string:WS">Samoa</option>
<option label="San Marino" value="string:SM">San Marino</option>
<option label="Sao Tome and Principe" value="string:ST">Sao Tome and Principe</option>
<option label="Saudi Arabia" value="string:SA">Saudi Arabia</option>
<option label="Senegal" value="string:SN">Senegal</option>
<option label="Serbia" value="string:RS">Serbia</option>
<option label="Seychelles" value="string:SC">Seychelles</option>
<option label="Singapore" value="string:SG">Singapore</option>
<option label="Sint Maarten" value="string:SX">Sint Maarten</option>
<option label="Slovakia" value="string:SK">Slovakia</option>
<option label="Slovenia" value="string:SI">Slovenia</option>
<option label="Solomon Islands" value="string:SB">Solomon Islands</option>
<option label="South Africa" value="string:ZA">South Africa</option>
<option label="South Georgia and the South Sandwich Islands" value="string:GS">South Georgia and the South Sandwich Islands</option>
<option label="South Korea" value="string:KR">South Korea</option>
<option label="South Sudan" value="string:SS">South Sudan</option>
<option label="Spain" value="string:ES">Spain</option>
<option label="Sri Lanka" value="string:LK">Sri Lanka</option>
<option label="Suriname" value="string:SR">Suriname</option>
<option label="Svalbard and Jan Mayen" value="string:SJ">Svalbard and Jan Mayen</option>
<option label="Swaziland" value="string:SZ">Swaziland</option>
<option label="Sweden" value="string:SE">Sweden</option>
<option label="Switzerland" value="string:CH">Switzerland</option>
<option label="Taiwan" value="string:TW">Taiwan</option>
<option label="Tajikistan" value="string:TJ">Tajikistan</option>
<option label="Tanzania" value="string:TZ">Tanzania</option>
<option label="Thailand" value="string:TH">Thailand</option>
<option label="Togo" value="string:TG">Togo</option>
<option label="Tokelau" value="string:TK">Tokelau</option>
<option label="Tonga" value="string:TO">Tonga</option>
<option label="Trinidad and Tobago" value="string:TT">Trinidad and Tobago</option>
<option label="Tunisia" value="string:TN">Tunisia</option>
<option label="Turkey" value="string:TR">Turkey</option>
<option label="Turkmenistan" value="string:TM">Turkmenistan</option>
<option label="Turks and Caicos Islands" value="string:TC">Turks and Caicos Islands</option>
<option label="Tuvalu" value="string:TV">Tuvalu</option>
<option label="U.S. Virgin Islands" value="string:VI">U.S. Virgin Islands</option>
<option label="Uganda" value="string:UG">Uganda</option>
<option label="Ukraine" value="string:UA">Ukraine</option>
<option label="United Arab Emirates" value="string:AE">United Arab Emirates</option>
<option label="United Kingdom" value="string:GB">United Kingdom</option>
<option label="United States" value="string:US" selected="selected">United States</option>
<option label="United States Minor Outlying Islands" value="string:UM">United States Minor Outlying Islands</option>
<option label="Uruguay" value="string:UY">Uruguay</option>
<option label="Uzbekistan" value="string:UZ">Uzbekistan</option>
<option label="Vanuatu" value="string:VU">Vanuatu</option>
<option label="Vatican" value="string:VA">Vatican</option>
<option label="Venezuela" value="string:VE">Venezuela</option>
<option label="Vietnam" value="string:VN">Vietnam</option>
<option label="Wallis and Futuna" value="string:WF">Wallis and Futuna</option>
<option label="Western Sahara" value="string:EH">Western Sahara</option>
<option label="Yemen" value="string:YE">Yemen</option>
<option label="Zambia" value="string:ZM">Zambia</option>
</select>
<!-- ngIf: countryResitrictedText -->
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_country fails required" style="display: none;"> Please select your country. </span>
</div>
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('phone') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('phone')">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label" data-ng-class="{ required: get.homephone('is_required') }" data-sc-form-error="highlight if member_phone fails">Phone Number</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column half">
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-phone-number ng-valid-required ng-not-modified" data-ng-model="MODEL.member_phone" data-sc-form-error="highlight if member_phone fails"
data-sc-validate-phone="" data-sc-retain-focus-validity="" data-ng-required="get.homephone('is_required')" inputmode="numeric" type="tel" aria-label="phone number, numbers only" name="member_phone" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if member_phone fails phoneNumber" style="display: none;"> Please enter a valid phone number. </span>
<span class="donation-error ng-binding" data-sc-form-error="show if member_phone fails required" style="display: none;"> Don't forget your phone number. </span>
</div>
</div>
</div>
</div>
<!-- ngIf: show.cellPhone() -->
<!-- ngIf: show.comment() -->
<!-- ngIf: show.company() -->
<!-- ngIf: show.blog() -->
<!-- ngIf: show.website() -->
<!-- ngIf: show.gender() -->
<!-- ngIf: show.pronoun() -->
<!-- ngIf: show.birthdate() -->
<!-- ngIf: show.customQuestions() --><!-- ngInclude: ::template('custom-questions') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('custom-questions')" data-ng-if="show.customQuestions()"><!-- ngRepeat: question in list.customQuestions -->
<div class="donation-table ng-scope" data-ng-repeat="question in list.customQuestions">
<!-- ngInclude: ::template('questions/' + question.type) -->
<div data-ng-include="::template('questions/' + question.type)" class="ng-scope">
<div class="donation-table_label ng-scope">
<label class="donation-label ng-binding required" data-sc-form-error="highlight if cq_189917 fails" data-ng-class="{ required: question.is_required }">Direct my gift to a location OR program:</label>
</div>
<div class="donation-table_row ng-scope">
<div class="donation-table_columns">
<div class="donation-table_column half">
<select class="donation-select ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="META.answers[question.id]" data-ng-model-options="{ getterSetter: true }"
data-sc-form-error="highlight if cq_189917 fails" data-ng-required="question.is_required" data-ng-options="option.label as option.label for option in question.enum_options" name="cq_189917" required="required"
aria-invalid="false">
<option value="" class="" selected="selected">Please select</option>
<option label="Shriners Hospitals for Children (Most Needed)" value="string:Shriners Hospitals for Children (Most Needed)">Shriners Hospitals for Children (Most Needed)</option>
<option label="Boston" value="string:Boston">Boston</option>
<option label="Canada" value="string:Canada">Canada</option>
<option label="Chicago" value="string:Chicago">Chicago</option>
<option label="Erie" value="string:Erie">Erie</option>
<option label="Florida Program" value="string:Florida Program">Florida Program</option>
<option label="Greenville" value="string:Greenville">Greenville</option>
<option label="Honolulu" value="string:Honolulu">Honolulu</option>
<option label="International Patients Program" value="string:International Patients Program">International Patients Program</option>
<option label="Lexington" value="string:Lexington">Lexington</option>
<option label="Mexico City" value="string:Mexico City">Mexico City</option>
<option label="Northern California" value="string:Northern California">Northern California</option>
<option label="Ohio" value="string:Ohio">Ohio</option>
<option label="Orthotic and Prosthetic Services Program" value="string:Orthotic and Prosthetic Services Program">Orthotic and Prosthetic Services Program</option>
<option label="Pasadena" value="string:Pasadena">Pasadena</option>
<option label="Philadelphia" value="string:Philadelphia">Philadelphia</option>
<option label="Portland" value="string:Portland">Portland</option>
<option label="Research Program" value="string:Research Program">Research Program</option>
<option label="Salt Lake City" value="string:Salt Lake City">Salt Lake City</option>
<option label="Shreveport" value="string:Shreveport">Shreveport</option>
<option label="Spokane" value="string:Spokane">Spokane</option>
<option label="Springfield" value="string:Springfield">Springfield</option>
<option label="St. Louis" value="string:St. Louis">St. Louis</option>
<option label="Texas" value="string:Texas">Texas</option>
<option label="Twin Cities" value="string:Twin Cities">Twin Cities</option>
</select>
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if cq_189917 fails required" style="display: none;"> This field is required. </span>
</div>
</div>
</div>
</div><!-- end ngRepeat: question in list.customQuestions -->
</div><!-- end ngIf: show.customQuestions() -->
</div>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<div data-ng-controller="frsDonationPaymentCtrl" id="df_checkout_donation-payment" class="donation-payment ng-scope" aria-label="Payment Details">
<div>
<cp-payment-widget id="classy-payment-widget" api="API" payment="MODEL.payment" submit-digital-wallets="submitDigitalWallets" fee-processing="globalState.feeProcessing" meta="META" parent-model="MODEL" hide-postal="true"
currency="MODEL.payment.raw_currency_code" class="ng-isolate-scope">
<div class="donation-payment-method-select row" ng-hide="$ctrl.hideButtons">
<div class="eg-payment-button-mask ng-hide" data-ng-show="!$ctrl.arePaymentButtonEnabled"></div>
<div class="column-md-7">
<summary-amount amount="$ctrl.meta.summaryAmount" recur_until="$ctrl.parentModel.recur_until" feeprocessing="$ctrl.feeProcessing" frequency="$ctrl.parentModel.frequency" taxcompliance="$ctrl.meta.unsupportedTaxCompliance"
currency="$ctrl.parentModel.payment.raw_currency_code" estimatedcharge="$ctrl.meta.estimatedCharge" class="ng-isolate-scope">
<p class="donation-summary-amount">
<span class="sr-only">your currently selected donation amount is </span>
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-label ng-binding ng-scope" aria-hidden="true" ng-if="!$ctrl.preventRecurringFrequency">One-time
donation</span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-amount ng-binding" data-ng-class="{ processing: $ctrl.feeprocessing }"> €104.00<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-currency ng-binding">EUR</span>
<span class="donation-summary-amount-processing">
<span class="donation-summary-amount-processing-spinner"></span>
</span>
</span>
<!-- ngIf: !$ctrl.preventRecurringFrequency && $ctrl.recurUntil -->
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-date ng-binding ng-scope" ng-if="!$ctrl.preventRecurringFrequency"></span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.taxCompliance -->
</p>
</summary-amount>
<fee-on-top fot="$ctrl.parentModel.fee_on_top" class="ng-isolate-scope"><!-- ngIf: $ctrl.showFOT() -->
<div class="donation-table ng-scope" ng-if="$ctrl.showFOT()" style="margin-top:0">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<button type="button" class="fot-checkbox sc-checkbox checked" data-ng-click="toggle()" role="checkbox" aria-checked="true" data-sc-checkbox="" data-ng-model="$ctrl.fot" name="donation_fot"
aria-label="I'd like to cover all transaction fees so 100% of my donation goes to Shriners Children’s."><span class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true">
<span data-sc-ctx-bind-html="$ctrl.classyModeAppeal() | scTrustedHtml" class="ng-scope">
<p>I'd like to cover all transaction fees so 100% of my donation goes to Shriners Children’s.</p>
</span>
</span></button>
</div>
</div>
</div>
</div><!-- end ngIf: $ctrl.showFOT() -->
</fee-on-top>
</div>
<div class="column-md-5">
<small ng-hide="$ctrl.showDW" class="donation-payment-method-select_description"> Donate with your preferred payment method: </small>
<!-- ngIf: $ctrl.showDW -->
<!-- ngIf: !$ctrl.isTrial --><cp-digital-wallets data-ng-if="!$ctrl.isTrial" frequency="$ctrl.parentModel.frequency" amount="$ctrl.getAmount()" currency="$ctrl.parentModel.payment.raw_currency_code" submit="$ctrl.submitDigitalWallets"
pay-type="$ctrl.meta.digitalWalletType" fot="$ctrl.parentModel.fee_on_top" classymode="$ctrl.isClassyMode"
class="ng-scope ng-isolate-scope"><!-- ngIf: $ctrl.showDigitalWallets --></cp-digital-wallets><!-- end ngIf: !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.paypal() && !$ctrl.isTrial --><cp-paypal-widget data-ng-if="$ctrl.show.paypal() && !$ctrl.isTrial" model="$ctrl.payment.paypal" sc-validity-reporter="" ng-model="$ctrl.payment.paypal.status"
on-ready="$ctrl.onPaypalReady()" on-success="$ctrl.onPaypalSuccess(params)" on-cancel="$ctrl.onPaypalCancel()" currency="$ctrl.currency"
class="ng-pristine ng-untouched ng-valid ng-scope ng-isolate-scope ng-not-empty ng-not-modified">
<div class="cp-paypal-widget">
<button data-tracked-element="donation-page_checkout_paypal-btn" type="button" ng-click="$ctrl.openModal()" ng-class="{'logged-in': $ctrl.model.status === $ctrl.constants.STATUS.SUCCESS}" class="payment-method-select-btn__paypal"
id="btPaypal" ng-show="$ctrl.model.status !== $ctrl.constants.STATUS.INACTIVE"><img ng-src="/static/global/images/payments/logo-paypal.svg" alt="PayPal" <="" button="" src="/static/global/images/payments/logo-paypal.svg">
</button>
</div>
</cp-paypal-widget><!-- end ngIf: $ctrl.show.paypal() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.paypalCommerce() || $ctrl.show.venmo() -->
<button data-tracked-element="donation-page_checkout_credit-card-btn" class="payment-method-select-btn__cc" type="button" style="background:rgb(130, 10, 30)" ng-click="$ctrl.showCardInputs()" aria-expanded="false"
aria-controls="donation-page_checkout_payment-form donation-page_checkout_payment-details">Credit Card</button>
<!-- ngIf: $ctrl.show.achButton() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.accountRoutingButton() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.crypto() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.crypto() && !$ctrl.isTrial -->
</div>
</div>
<!-- ngIf: $ctrl.meta.showPaymentDetails -->
<!-- ngIf: $ctrl.meta.showPaymentDetails -->
</cp-payment-widget>
</div>
<!-- ngIf: META.showPaymentDetails -->
</div>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section id="df_checkout_donation-footer" class="donation-footer ng-scope ng-hide" data-ng-controller="frsDonationFooterCtrl" data-ng-show="META.showPaymentDetails">
<div class="donation-footer_container">
<!-- ngIf: show.achTerms() -->
<small class="donation-footer_terms"> By clicking <span class="ng-binding">GIVE NOW!</span>, I agree to the <a href="https://www.classy.org/terms" target="_blank" aria-label="View Terms of Service page">Terms of Service</a> and
<a href="https://www.classy.org/terms/privacy" target="_blank" aria-label="View Classy Privacy Policy page">Classy Privacy Policy</a>
</small>
<!-- ngIf: show.feeOnTop() -->
<div class="donation-footer_controls">
<!-- ngIf: !editable --><button id="donate-cta-main" class="donation-footer_submit ng-binding ng-scope" ng-if="!editable" data-ng-style="{'background-color': theme.current.styles.primaryColor}"
data-ng-disabled="globalState.processing || globalState.submitDisabled" data-ng-bind="block['submit-button-text'] || 'Donate' " aria-label="click give now to donate €104.00" type="submit" style="background-color: rgb(130, 10, 30);">GIVE
NOW!</button><!-- end ngIf: !editable -->
<!-- ngIf: editable -->
</div>
<div class="donation-footer_summary">
<!-- ngIf: show.creditee() -->
<summary-amount amount="META.summaryAmount" recur_until="MODEL.recur_until" feeprocessing="globalState.feeProcessing" frequency="MODEL.frequency" taxcompliance="META.unsupportedTaxCompliance" currency="MODEL.payment.raw_currency_code"
estimatedcharge="META.estimatedCharge" class="ng-isolate-scope">
<p class="donation-summary-amount">
<span class="sr-only">your currently selected donation amount is </span>
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-label ng-binding ng-scope" aria-hidden="true" ng-if="!$ctrl.preventRecurringFrequency">One-time
donation</span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-amount ng-binding" data-ng-class="{ processing: $ctrl.feeprocessing }"> €104.00<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-currency ng-binding">EUR</span>
<span class="donation-summary-amount-processing">
<span class="donation-summary-amount-processing-spinner"></span>
</span>
</span>
<!-- ngIf: !$ctrl.preventRecurringFrequency && $ctrl.recurUntil -->
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-date ng-binding ng-scope" ng-if="!$ctrl.preventRecurringFrequency"></span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.taxCompliance -->
</p>
</summary-amount>
</div>
<!-- ngIf: META.unsupportedTaxCompliance -->
<div class="donation-footer__compliance--unsupported ng-scope" ng-if="META.unsupportedTaxCompliance">
<div class="donation-footer__compliance-img">
<i class="ci ci-world-hands"></i>
</div>
<div class="donation-footer__compliance-text">
<span class="donation-footer__compliance-title">International Gift</span>
<p class="ng-binding"> You are giving to an organization located in United States. This donation will be processed and receipted in USD and deposited to a US bank account. Contributions are tax deductible to the extent allowed by the
laws of your country. Consult your local tax professional. </p>
</div>
</div><!-- end ngIf: META.unsupportedTaxCompliance -->
</div>
</section>
<div class="donation-border-top donation-footer__compliance ng-scope ng-hide" ng-show="META.showTaxComplianceLanguage">
<p ng-bind-html="META.taxComplianceLanguage" class="ng-binding">Please print or save this message for your personal records. This transaction will appear on your statement as ShrinersHospitals. We are a 501(c)(3) tax-exempt organization (EIN
36-2193608) and your donation is tax-deductible within the guidelines of U.S. law. To claim a donation as a deduction on your U.S. taxes, please keep your donation receipt as your official record. In accordance with IRS regulations Shriners
Hospitals for Children® confirms no goods or services were received in exchange for this contribution.</p>
</div>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
</form>Text Content
Close THE MOTHER’S DAY MATCH! Make your generous gift before midnight on May 12, and it will DOUBLE in impact for a child to get The Most Amazing Care Anywhere™. Your gift now can make twice the impact to support: * Innovative pediatric specialty care — regardless of the families’ ability to pay or insurance status * Critical research to improve quality of lives and quality of care * Outstanding educational programs for medical professionals One time monthly Choose a one-time amount * €470 * €100 * €47 * €24 AED | United Arab Emirates DirhamAFN | Afghan AfghaniALL | Albanian LekAMD | Armenian DramANG | Netherlands Antillean GuilderAOA | Angolan KwanzaARS | Argentine PesoAUD | Australian DollarAWG | Aruban FlorinAZN | Azerbaijani ManatBAM | Bosnia And Herzegovina Convertible MarkBBD | Barbados DollarBDT | Bangladeshi TakaBGN | Bulgarian LevBHD | Bahraini DinarBIF | Burundian FrancBMD | Bermudian Dollar (customarily Known As Bermuda Dollar)BND | Brunei DollarBOB | BolivianoBRL | Brazilian RealBSD | Bahamian DollarBTN | Bhutanese NgultrumBWP | Botswana PulaBZD | Belize DollarCAD | Canadian DollarCDF | Congolese FrancCHF | Swiss FrancCLF | Unidad De Fomento (funds Code)CLP | Chilean PesoCNY | Chinese YuanCOP | Colombian PesoCRC | Costa Rican ColonCUC | Cuban Convertible PesoCUP | Cuban PesoCVE | Cape Verde EscudoCZK | Czech KorunaDJF | Djiboutian FrancDKK | Danish KroneDOP | Dominican PesoDZD | Algerian DinarEGP | Egyptian PoundERN | Eritrean NakfaETB | Ethiopian BirrEUR | EuroFJD | Fiji DollarFKP | Falkland Islands PoundGBP | Pound SterlingGEL | Georgian LariGHS | Ghanaian CediGIP | Gibraltar PoundGMD | Gambian DalasiGNF | Guinean FrancGTQ | Guatemalan QuetzalGYD | Guyanese DollarHKD | Hong Kong DollarHNL | Honduran LempiraHRK | Croatian KunaHTG | Haitian GourdeHUF | Hungarian ForintIDR | Indonesian RupiahILS | Israeli New ShekelINR | Indian RupeeIQD | Iraqi DinarIRR | Iranian RialISK | Icelandic KrónaJMD | Jamaican DollarJOD | Jordanian DinarJPY | Japanese YenKES | Kenyan ShillingKGS | Kyrgyzstani SomKHR | Cambodian RielKMF | Comoro FrancKPW | North Korean WonKRW | South Korean WonKWD | Kuwaiti DinarKYD | Cayman Islands DollarKZT | Kazakhstani TengeLAK | Lao KipLBP | Lebanese PoundLKR | Sri Lankan RupeeLRD | Liberian DollarLSL | Lesotho LotiLYD | Libyan DinarMAD | Moroccan DirhamMDL | Moldovan LeuMGA | Malagasy AriaryMKD | Macedonian DenarMMK | Myanma KyatMNT | Mongolian TugrikMOP | Macanese PatacaMUR | Mauritian RupeeMVR | Maldivian RufiyaaMWK | Malawian KwachaMXN | Mexican PesoMYR | Malaysian RinggitMZN | Mozambican MeticalNAD | Namibian DollarNGN | Nigerian NairaNIO | Nicaraguan CórdobaNOK | Norwegian KroneNPR | Nepalese RupeeNZD | New Zealand DollarOMR | Omani RialPAB | Panamanian BalboaPEN | Peruvian Nuevo SolPGK | Papua New Guinean KinaPHP | Philippine PesoPKR | Pakistani RupeePLN | Polish ZłotyPYG | Paraguayan GuaraníQAR | Qatari RiyalRON | Romanian New LeuRSD | Serbian DinarRWF | Rwandan FrancSAR | Saudi RiyalSBD | Solomon Islands DollarSCR | Seychelles RupeeSDG | Sudanese PoundSEK | Swedish Krona/kronorSGD | Singapore DollarSHP | Saint Helena PoundSLL | Sierra Leonean LeoneSOS | Somali ShillingSRD | Surinamese DollarSSP | South Sudanese PoundSTD | São Tomé And Príncipe DobraSYP | Syrian PoundSZL | Swazi LilangeniTHB | Thai BahtTJS | Tajikistani SomoniTMT | Turkmenistani ManatTND | Tunisian DinarTOP | Tongan PaʻangaTRY | Turkish LiraTTD | Trinidad And Tobago DollarTWD | New Taiwan DollarTZS | Tanzanian ShillingUAH | Ukrainian HryvniaUGX | Ugandan ShillingUSD | United States DollarUYU | Uruguayan PesoUZS | Uzbekistan SomVND | Vietnamese DongVUV | Vanuatu VatuWST | Samoan TalaXAF | CFA Franc BEACXCD | East Caribbean DollarXDR | Special Drawing RightsXOF | CFA Franc BCEAOXPF | CFP FrancYER | Yemeni RialZAR | South African Rand EUR € Dedicate my donation in honor or in memory of someone Type In honor of … In memory of … Honoree’s First Name Honoree’s Last Name Don't forget to give us a name for the dedication. Recipient's email Please enter dedication recipient email in the format: name@domain.com. Optionally send a notification email Recipient’s First Name Recipient’s Last Name Don't forget to include the of your recipient. Your Message to the Recipient Please spell check, include how you would like your name(s) signed, mention the amount if desired, and format your message as you would like it delivered. Include an e-Card? No e-Card See if your employer will match your donation Check to see if your employer will match your donation. You may receive an email on how to submit your match request to maximize your impact. Company YOUR INFORMATION First Name Last Name Be sure to provide your name. Hide my name from the public. Email Don't forget your email address. Please enter in the format: name@domain.com. Your receipt will be emailed here. I want to stay connected. Send me Inspiring patient stories, medical advancements and important updates. Address Don't forget to provide a billing address. Add apt., suite, floor ZIP City Don't forget to provide a billing city. State Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (the) AmericasArmed Forces EuropeArmed Forces PacificAmerican SamoaGuamNorthern Mariana IslandsPuerto RicoVirgin Islands Don't forget to provide a state. Province Please SelectAlberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Prince Edward Island (PE)Saskatchewan (SK)Ontario (ON)Quebec (QC)Yukon (YT) Don't forget to provide a province. Region Don't forget to provide a region. Country Please SelectAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and Saba Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the CongoReunionRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambia Please select your country. Phone Number Please enter a valid phone number. Don't forget your phone number. Direct my gift to a location OR program: Please selectShriners Hospitals for Children (Most Needed)BostonCanadaChicagoErieFlorida ProgramGreenvilleHonoluluInternational Patients ProgramLexingtonMexico CityNorthern CaliforniaOhioOrthotic and Prosthetic Services ProgramPasadenaPhiladelphiaPortlandResearch ProgramSalt Lake CityShreveportSpokaneSpringfieldSt. LouisTexasTwin Cities This field is required. your currently selected donation amount is One-time donation €104.00 EUR I'd like to cover all transaction fees so 100% of my donation goes to Shriners Children’s. Donate with your preferred payment method: Credit Card By clicking GIVE NOW!, I agree to the Terms of Service and Classy Privacy Policy GIVE NOW! your currently selected donation amount is One-time donation €104.00 EUR International Gift You are giving to an organization located in United States. This donation will be processed and receipted in USD and deposited to a US bank account. Contributions are tax deductible to the extent allowed by the laws of your country. Consult your local tax professional. Please print or save this message for your personal records. This transaction will appear on your statement as ShrinersHospitals. We are a 501(c)(3) tax-exempt organization (EIN 36-2193608) and your donation is tax-deductible within the guidelines of U.S. law. To claim a donation as a deduction on your U.S. taxes, please keep your donation receipt as your official record. In accordance with IRS regulations Shriners Hospitals for Children® confirms no goods or services were received in exchange for this contribution. QUESTIONS Is my donation secure? Absolutely. The security and confidentiality of your information is our highest priority. We use industry-standard SSL (secure socket layer) technology to protect your information and provide a safe and secure environment for online donations. We will not sell, trade or share your personal information with anyone else, nor send donor mailings on behalf of other organizations, and we will only share personal information if you have given us specific permission to do so. Do I get a receipt? A donation receipt will be sent to you at the email address you provide on this form. Please be sure to keep a copy of your receipt for tax purposes. If you select a recurring donation, you will be sent an individual receipt each month when your donation is processed. Is this donation tax deductible? Yes. Shriners Hospitals for Children® is a fully qualified 501(c)(3) organization. Contributions to Shriners Children's™ are tax-deductible to the extent allowed by law (EIN 36-2193608). To claim a donation as a deduction on U.S. taxes, please keep your email donation receipt as your official record. Receipts are issued via email upon successful completion of a donation. Shriners Children’s™ is a registered name under which Shriners Hospitals for Children conducts activities. Can I donate Real Estate? Making a gift of real estate directly contributes to Shriners Children’s mission of providing specialized, comprehensive care to all children, regardless of a families’ ability to pay. Click here to learn more. Can I donate Stock? Yes! Absolutely! If you’re a donor, please click here to donate Stock. If you’re a financial advisor, please click here for our Advisor page. How does Shriners Children's use funds? At Shriners Children's™ stewardship is one of our core values. Approximately 85 percent of all funds spent by Shriners Children's each year is dedicated to patient care, research and education. We work hard to make sure your gifts are used in the most efficient and effective manner. Shriners Children’s™ is a registered name under which Shriners Hospitals for Children conducts activities. Have an account? Sign in SHRINERS HOSPITALS FOR CHILDREN 2900 Rocky Point Drive Tampa, FL 33607 US 855-401-4897 Back to top Donor Support donorrelations@shrinenet.org 855-401-4897 Copyright ©2024 • All rights reserved • Classy Privacy Policy • Terms of Use • Cookie Statement • DMCA Policy Do Not Sell My Personal Information Have an account? Sign in • Powered by Classy, a GoFundMe company Hey there! * Sign in * Share this page