independencecenter.org Open in urlscan Pro
151.101.194.159  Public Scan

Submitted URL: https://u13778085.ct.sendgrid.net/ls/click?upn=6mFy9oubiMXZ3aDVSVZ1p5RVenj93mdxQArx6ZY-2FaXt0Ao9pNd4SgHEjdeBDMR8ogF5J0A-2B-2FIdeEj...
Effective URL: https://independencecenter.org/donation-form/?blm_aid=5260819
Submission: On December 18 via manual from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST

<form id="donation-form" class="donation-form" method="post" onsubmit="event.preventDefault(); collectPayment();">
  <div class="errors hidden"></div>
  <div class="section donation">
    <h3>Donation</h3>
    <div class="field radio 394240 required"><label for="394240"><input id="394240" name="donation-level" class="required" type="radio" value="1000" maxlength="255"><span class="label">$1,000.00 - Gift Amount</span></label></div>
    <div class="field radio 394241 required"><label for="394241"><input id="394241" name="donation-level" class="required" type="radio" value="500" maxlength="255"><span class="label">$500.00 - Gift Amount</span></label></div>
    <div class="field radio 394242 required"><label for="394242"><input id="394242" name="donation-level" class="required" type="radio" value="250" maxlength="255"><span class="label">$250.00 - Gift Amount</span></label></div>
    <div class="field radio 394243 required"><label for="394243"><input id="394243" name="donation-level" class="required" type="radio" value="100" maxlength="255"><span class="label">$100.00 - Gift Amount</span></label></div>
    <div class="field radio 394244 required"><label for="394244"><input id="394244" name="donation-level" class="required" type="radio" value="50" maxlength="255"><span class="label">$50.00 - Gift Amount</span></label></div>
    <div class="field radio other-option required"><label for="other-option"><input id="other-option" name="donation-level" class="required" type="radio" maxlength="255"><span class="label">Other</span></label></div>
    <div class="field text other-amount"><input id="other-amount" name="other-amount" class="otherAmount" type="text" placeholder="$0.00"></div>
  </div>
  <div class="section recurring">
    <div class="field checkbox recurring"><label for="recurring"><input id="recurring" name="recurring" type="checkbox" maxlength="255"><span class="label">Show my support by making this a recurring donation</span></label></div>
    <div class="field  frequency required" style="display: none"><label for="frequency">Frequency<span class="required-star">*</span></label><select id="frequency" name="frequency" class="required">
        <option value=""></option>
        <option value="Weekly">Weekly</option>
        <option value="Monthly" selected="">Monthly</option>
        <option value="Quarterly">Quarterly</option>
        <option value="Yearly">Yearly</option>
      </select></div>
    <div class="field date start-date required" style="display: none"><label for="start-date"><span class="label">Start Date</span><span class="required-star">*</span></label><input id="start-date" name="start-date" class="validDate required"
        type="date" placeholder="mm/dd/yyyy"></div>
  </div>
  <div class="section contact">
    <h3>Contact Information</h3>
    <div class="field text first-name required"><label for="first-name"><span class="label">First Name</span><span class="required-star">*</span></label><input id="first-name" name="first-name" class="required" type="text"></div>
    <div class="field text last-name required"><label for="last-name"><span class="label">Last Name</span><span class="required-star">*</span></label><input id="last-name" name="last-name" class="required" type="text"></div>
    <div class="field email email-address required"><label for="email-address"><span class="label">Email</span><span class="required-star">*</span></label><input id="email-address" name="email-address" class="email required" type="email"
        placeholder="someone@website.com"></div>
    <div class="field tel phone-number"><label for="phone-number"><span class="label">Phone</span></label><input id="phone-number" name="phone-number" class="phoneUS" type="tel"></div>
  </div>
  <div class="section billing-address">
    <h3>Billing Address</h3>
    <div class="field  country required"><label for="country">Country<span class="required-star">*</span></label><select id="country" name="country" class="required">
        <option value=""></option>
        <option value="AF">Afghanistan</option>
        <option value="AX">Aland Islands</option>
        <option value="AL">Albania</option>
        <option value="DZ">Algeria</option>
        <option value="AS">American Samoa</option>
        <option value="AD">Andorra</option>
        <option value="AO">Angola</option>
        <option value="AI">Anguilla</option>
        <option value="AQ">Antarctica</option>
        <option value="AG">Antigua and Barbuda</option>
        <option value="AR">Argentina</option>
        <option value="AM">Armenia</option>
        <option value="AW">Aruba</option>
        <option value="AU">Australia</option>
        <option value="AT">Austria</option>
        <option value="AZ">Azerbaijan</option>
        <option value="BS">Bahamas</option>
        <option value="BH">Bahrain</option>
        <option value="BD">Bangladesh</option>
        <option value="BB">Barbados</option>
        <option value="BY">Belarus</option>
        <option value="BE">Belgium</option>
        <option value="BZ">Belize</option>
        <option value="BJ">Benin</option>
        <option value="BM">Bermuda</option>
        <option value="BT">Bhutan</option>
        <option value="BO">Bolivia</option>
        <option value="BA">Bosnia and Herzegovina</option>
        <option value="BW">Botswana</option>
        <option value="BV">Bouvet Island</option>
        <option value="BR">Brazil</option>
        <option value="IO">British Indian Ocean Territory</option>
        <option value="BN">Brunei Darussalam</option>
        <option value="BG">Bulgaria</option>
        <option value="BF">Burkina Faso</option>
        <option value="BI">Burundi</option>
        <option value="KH">Cambodia</option>
        <option value="CM">Cameroon</option>
        <option value="CA">Canada</option>
        <option value="CV">Cape Verde</option>
        <option value="KY">Cayman Islands</option>
        <option value="CF">Central African Republic</option>
        <option value="TD">Chad</option>
        <option value="CL">Chile</option>
        <option value="CN">China</option>
        <option value="CX">Christmas Island</option>
        <option value="CC">Cocos (Keeling) Islands</option>
        <option value="CO">Colombia</option>
        <option value="KM">Comoros</option>
        <option value="CG">Congo</option>
        <option value="CD">Democratic Republic of the Congo</option>
        <option value="CK">Cook Islands</option>
        <option value="CR">Costa Rica</option>
        <option value="CI">Cote d'Ivoire</option>
        <option value="HR">Croatia</option>
        <option value="CU">Cuba</option>
        <option value="CW">Curacao</option>
        <option value="CY">Cyprus</option>
        <option value="CZ">Czech Republic</option>
        <option value="DK">Denmark</option>
        <option value="DJ">Djibouti</option>
        <option value="DM">Dominica</option>
        <option value="DO">Dominican Republic</option>
        <option value="EC">Ecuador</option>
        <option value="EG">Egypt</option>
        <option value="SV">El Salvador</option>
        <option value="GQ">Equatorial Guinea</option>
        <option value="ER">Eritrea</option>
        <option value="EE">Estonia</option>
        <option value="SZ">Eswatini</option>
        <option value="ET">Ethiopia</option>
        <option value="FK">Falkland Islands (Malvinas)</option>
        <option value="FO">Faroe Islands</option>
        <option value="FJ">Fiji</option>
        <option value="FI">Finland</option>
        <option value="FR">France</option>
        <option value="GF">French Guiana</option>
        <option value="PF">French Polynesia</option>
        <option value="TF">French Southern Territories</option>
        <option value="GA">Gabon</option>
        <option value="GM">Gambia</option>
        <option value="GE">Georgia</option>
        <option value="DE">Germany</option>
        <option value="GH">Ghana</option>
        <option value="GI">Gibraltar</option>
        <option value="GR">Greece</option>
        <option value="GL">Greenland</option>
        <option value="GD">Grenada</option>
        <option value="GP">Guadeloupe</option>
        <option value="GU">Guam</option>
        <option value="GT">Guatemala</option>
        <option value="GG">Guernsey</option>
        <option value="GN">Guinea</option>
        <option value="GW">Guinea-Bissau</option>
        <option value="GY">Guyana</option>
        <option value="HT">Haiti</option>
        <option value="HM">Heard Island</option>
        <option value="HN">Honduras</option>
        <option value="HK">Hong Kong</option>
        <option value="HU">Hungary</option>
        <option value="IS">Iceland</option>
        <option value="IN">India</option>
        <option value="ID">Indonesia</option>
        <option value="IR">Islamic Republic of Iran</option>
        <option value="IQ">Iraq</option>
        <option value="IE">Ireland</option>
        <option value="IM">Isle of Man</option>
        <option value="IL">Israel</option>
        <option value="IT">Italy</option>
        <option value="JM">Jamaica</option>
        <option value="JP">Japan</option>
        <option value="JE">Jersey</option>
        <option value="JO">Jordan</option>
        <option value="KZ">Kazakhstan</option>
        <option value="KE">Kenya</option>
        <option value="KI">Kiribati</option>
        <option value="KP">Democratic People's Republic of Korea</option>
        <option value="KR">Republic of Korea</option>
        <option value="KW">Kuwait</option>
        <option value="KG">Kyrgyzstan</option>
        <option value="LA">Lao People's Democratic Republic</option>
        <option value="LV">Latvia</option>
        <option value="LB">Lebanon</option>
        <option value="LS">Lesotho</option>
        <option value="LR">Liberia</option>
        <option value="LY">Libya</option>
        <option value="LI">Liechtenstein</option>
        <option value="LT">Lithuania</option>
        <option value="LU">Luxembourg</option>
        <option value="MO">Macao</option>
        <option value="MK">Macedonia</option>
        <option value="MG">Madagascar</option>
        <option value="MW">Malawi</option>
        <option value="MY">Malaysia</option>
        <option value="MV">Maldives</option>
        <option value="ML">Mali</option>
        <option value="MT">Malta</option>
        <option value="MH">Marshall Islands</option>
        <option value="MQ">Martinique</option>
        <option value="MR">Mauritania</option>
        <option value="MU">Mauritius</option>
        <option value="YT">Mayotte</option>
        <option value="MX">Mexico</option>
        <option value="FM">Federated States of Micronesia</option>
        <option value="MD">Republic of Moldova</option>
        <option value="MC">Monaco</option>
        <option value="MN">Mongolia</option>
        <option value="ME">Montenegro</option>
        <option value="MS">Montserrat</option>
        <option value="MA">Morocco</option>
        <option value="MZ">Mozambique</option>
        <option value="MM">Myanmar</option>
        <option value="NA">Namibia</option>
        <option value="NR">Nauru</option>
        <option value="NP">Nepal</option>
        <option value="NL">Netherlands</option>
        <option value="NC">New Caledonia</option>
        <option value="NZ">New Zealand</option>
        <option value="NI">Nicaragua</option>
        <option value="NE">Niger</option>
        <option value="NG">Nigeria</option>
        <option value="NU">Niue</option>
        <option value="NF">Norfolk Island</option>
        <option value="MP">Northern Mariana Islands</option>
        <option value="NO">Norway</option>
        <option value="OM">Oman</option>
        <option value="PK">Pakistan</option>
        <option value="PW">Palau</option>
        <option value="PS">State of Palestine</option>
        <option value="PA">Panama</option>
        <option value="PG">Papua New Guinea</option>
        <option value="PY">Paraguay</option>
        <option value="PE">Peru</option>
        <option value="PH">Philippines</option>
        <option value="PN">Pitcairn</option>
        <option value="PL">Poland</option>
        <option value="PT">Portugal</option>
        <option value="PR">Puerto Rico</option>
        <option value="QA">Qatar</option>
        <option value="RE">Reunion</option>
        <option value="RO">Romania</option>
        <option value="RU">Russian Federation</option>
        <option value="RW">Rwanda</option>
        <option value="BL">Saint Barthelemy</option>
        <option value="SH">Ascension and Tristan da Cunha Saint Helena</option>
        <option value="KN">Saint Kitts and Nevis</option>
        <option value="LC">Saint Lucia</option>
        <option value="MF">Saint Martin (French part)</option>
        <option value="PM">Saint Pierre and Miquelon</option>
        <option value="VC">Saint Vincent and the Grenadines</option>
        <option value="WS">Samoa</option>
        <option value="SM">San Marino</option>
        <option value="ST">Sao Tome and Principe</option>
        <option value="SA">Saudi Arabia</option>
        <option value="SN">Senegal</option>
        <option value="RS">Serbia</option>
        <option value="SC">Seychelles</option>
        <option value="SL">Sierra Leone</option>
        <option value="SG">Singapore</option>
        <option value="SX">Sint Maarten (Dutch part)</option>
        <option value="SK">Slovakia</option>
        <option value="SI">Slovenia</option>
        <option value="SB">Solomon Islands</option>
        <option value="SO">Somalia</option>
        <option value="ZA">South Africa</option>
        <option value="GS">South Georgia</option>
        <option value="SS">South Sudan</option>
        <option value="ES">Spain</option>
        <option value="LK">Sri Lanka</option>
        <option value="SD">Sudan</option>
        <option value="SR">Suriname</option>
        <option value="SJ">Svalbard and Jan Mayen</option>
        <option value="SE">Sweden</option>
        <option value="CH">Switzerland</option>
        <option value="SY">Syrian Arab Republic</option>
        <option value="TW">Taiwan</option>
        <option value="TJ">Tajikistan</option>
        <option value="TZ">United Republic of Tanzania</option>
        <option value="TH">Thailand</option>
        <option value="TL">Timor-Leste</option>
        <option value="TG">Togo</option>
        <option value="TK">Tokelau</option>
        <option value="TO">Tonga</option>
        <option value="TT">Trinidad and Tobago</option>
        <option value="TN">Tunisia</option>
        <option value="TR">Turkey</option>
        <option value="TM">Turkmenistan</option>
        <option value="TC">Turks and Caicos Islands</option>
        <option value="TV">Tuvalu</option>
        <option value="UG">Uganda</option>
        <option value="UA">Ukraine</option>
        <option value="AE">United Arab Emirates</option>
        <option value="GB">United Kingdom</option>
        <option value="US" selected="">United States</option>
        <option value="UM">United States Minor Outlying Islands</option>
        <option value="UY">Uruguay</option>
        <option value="UZ">Uzbekistan</option>
        <option value="VU">Vanuatu</option>
        <option value="VA">Vatican City</option>
        <option value="VE">Venezuela</option>
        <option value="VN">Viet Nam</option>
        <option value="VG">British Virgin Islands</option>
        <option value="VI">U.S. Virgin Islands</option>
        <option value="WF">Wallis and Futuna</option>
        <option value="EH">Western Sahara</option>
        <option value="YE">Yemen</option>
        <option value="ZM">Zambia</option>
        <option value="ZW">Zimbabwe</option>
      </select></div>
    <div class="field  street-address required"><label for="street-address"><span class="label">Address</span><span class="required-star">*</span></label><textarea id="street-address" name="street-address" class="required"></textarea></div>
    <div class="field text city required"><label for="city"><span class="label">City</span><span class="required-star">*</span></label><input id="city" name="city" class="required" type="text" data-us-label="City" data-bm-label="Parish"></div>
    <div class="field  state required"><label for="state">State<span class="required-star">*</span></label><select id="state" name="state" class="required">
        <option value=""></option>
        <option value="AL">Alabama</option>
        <option value="AK">Alaska</option>
        <option value="AS">American Samoa</option>
        <option value="AZ">Arizona</option>
        <option value="AR">Arkansas</option>
        <option value="AE">Armed Forces Africa, Canada, Europe, Middle East</option>
        <option value="AA">Armed Forces Americas (except Canada)</option>
        <option value="AP">Armed Forces Pacific</option>
        <option value="CA">California</option>
        <option value="CO">Colorado</option>
        <option value="CT">Connecticut</option>
        <option value="DE">Delaware</option>
        <option value="DC">District of Columbia</option>
        <option value="FL">Florida</option>
        <option value="GA">Georgia</option>
        <option value="GU">Guam</option>
        <option value="HI">Hawaii</option>
        <option value="ID">Idaho</option>
        <option value="IL">Illinois</option>
        <option value="IN">Indiana</option>
        <option value="IA">Iowa</option>
        <option value="KS">Kansas</option>
        <option value="KY">Kentucky</option>
        <option value="LA">Louisiana</option>
        <option value="ME">Maine</option>
        <option value="MD">Maryland</option>
        <option value="MA">Massachusetts</option>
        <option value="MI">Michigan</option>
        <option value="MN">Minnesota</option>
        <option value="MS">Mississippi</option>
        <option value="MO">Missouri</option>
        <option value="MT">Montana</option>
        <option value="NE">Nebraska</option>
        <option value="NV">Nevada</option>
        <option value="NH">New Hampshire</option>
        <option value="NJ">New Jersey</option>
        <option value="NM">New Mexico</option>
        <option value="NY">New York</option>
        <option value="NC">North Carolina</option>
        <option value="ND">North Dakota</option>
        <option value="OH">Ohio</option>
        <option value="OK">Oklahoma</option>
        <option value="OR">Oregon</option>
        <option value="PA">Pennsylvania</option>
        <option value="PR">Puerto Rico</option>
        <option value="RI">Rhode Island</option>
        <option value="SC">South Carolina</option>
        <option value="SD">South Dakota</option>
        <option value="TN">Tennessee</option>
        <option value="TX">Texas</option>
        <option value="VI">US Virgin Islands</option>
        <option value="UT">Utah</option>
        <option value="VT">Vermont</option>
        <option value="VA">Virginia</option>
        <option value="WA">Washington</option>
        <option value="WV">West Virginia</option>
        <option value="WI">Wisconsin</option>
        <option value="WY">Wyoming</option>
      </select></div>
    <div class="field  province required" style="display: none"><label for="province">Province<span class="required-star">*</span></label><select id="province" name="province" class="required">
        <option value=""></option>
        <option value="AB">Alberta</option>
        <option value="BC">British Columbia</option>
        <option value="MB">Manitoba</option>
        <option value="NB">New Brunswick</option>
        <option value="NL">Newfoundland and Labrador</option>
        <option value="NT">Northwest Territories</option>
        <option value="NS">Nova Scotia</option>
        <option value="NU">Nunavut</option>
        <option value="ON">Ontario</option>
        <option value="PE">Prince Edward Island</option>
        <option value="QC">Quebec</option>
        <option value="SK">Saskatchewan</option>
        <option value="YT">Yukon Territory</option>
      </select></div>
    <div class="field number zip-code required"><label for="zip-code"><span class="label">ZIP Code</span><span class="required-star">*</span></label><input id="zip-code" name="zip-code" class="zipcodeUS required" type="number" minlength="5"
        maxlength="10"></div>
    <div class="field text postal-code required" style="display: none"><label for="postal-code"><span class="label">Postal Code</span><span class="required-star">*</span></label><input id="postal-code" name="postal-code" class="required" type="text">
    </div>
  </div>
  <div class="section custom-fields">
    <h3>Additional Information</h3>
    <div class="field text CustomTransactionField_218066946"><label for="CustomTransactionField_218066946">Is this a Tribute/Memorial Gift?</label><select id="CustomTransactionField_218066946" name="CustomTransactionField_218066946">
        <option value=""></option>
        <option value="218065923">Yes</option>
      </select></div>
    <div class="field text CustomTransactionField_218066944"><label for="CustomTransactionField_218066944">Tribute Kind</label><select id="CustomTransactionField_218066944" name="CustomTransactionField_218066944">
        <option value=""></option>
        <option value="218065922">In Honor Of</option>
        <option value="218065921">In Memory Of</option>
      </select></div>
    <div class="field text CustomTransactionField_218066945"><label for="CustomTransactionField_218066945"><span class="label">Tribute Name</span></label><input id="CustomTransactionField_218066945" name="CustomTransactionField_218066945" type="text"
        maxlength="255"></div>
  </div>
  <div class="section comment">
    <div class="field text comment"><label for="comment"><span class="label">Comments</span></label><textarea id="comment" name="comment" type="text" value="Comments"></textarea></div>
  </div>
  <div class="section consent hidden">
    <div class="field checkbox consent-all"><label for="consent-all"><input id="consent-all" name="consent-all" type="checkbox" maxlength="255"><span class="label">I would like to receive or continue receiving updates from Independence
          Center</span></label></div>
    <div class="field checkbox consent-email" style="display: none"><label for="consent-email"><input id="consent-email" name="consent-email" type="checkbox" checked="checked" maxlength="255"><span class="label">by email</span></label></div>
    <div class="field checkbox consent-mail" style="display: none"><label for="consent-mail"><input id="consent-mail" name="consent-mail" type="checkbox" checked="checked" maxlength="255"><span class="label">by postal mail</span></label></div>
    <div class="field checkbox consent-phone" style="display: none"><label for="consent-phone"><input id="consent-phone" name="consent-phone" type="checkbox" checked="checked" maxlength="255"><span class="label">by phone</span></label></div>
  </div>
  <div class="section true-impact">
    <h3>Increase My Impact</h3>
    <div class="field checkbox true-impact"><label for="true-impact"><input id="true-impact" name="true-impact" type="checkbox" maxlength="255"><span class="label">Yes! Add <span class="fee-amount">$0</span> to help offset bank fees</span></label>
    </div>
  </div>
  <div class="section captcha"> <label id="noCaptchaResponseError" class="error noCaptchaResponseError" style="display: none">You must fill out the CAPTCHA</label>
    <div id="captcha392192">
      <div style="width: 304px; height: 78px;">
        <div><iframe title="reCAPTCHA"
            src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LcWYTcdAAAAAOnuTaXn8bUBFhBTxvQiaQMmnLjn&amp;co=aHR0cHM6Ly9pbmRlcGVuZGVuY2VjZW50ZXIub3JnOjQ0Mw..&amp;hl=de&amp;v=5qcenVbrhOy8zihcc2aHOWD4&amp;size=normal&amp;cb=qf9e1qttu82y"
            width="304" height="78" role="presentation" name="a-y8gq68d3v3ho" frameborder="0" scrolling="no" sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe>
        </div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
          style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
      </div><iframe style="display: none;"></iframe>
    </div>
  </div>
  <div class="btn-group"> <input class="btn btn-submit btn-submit-donation" type="submit" value="Enter Payment" id="express-submit"> </div>
</form>

<form class="spreedly-form" accept-charset="UTF-8" id="spreedly-modal-form" onsubmit="return false;">
  <div id="spreedly-frame-holder" class="spreedly-fields-holder ">
    <fieldset class="spreedly-fs-name">
      <div class="spreedly-field spreedly-field-name" id="spreedly-name-parent"> <label class="spreedly-label" for="spreedly-name" id="spreedly-name-label">Name</label> <input type="text" id="spreedly-name" name="full_name">
        <i class="spreedly-icon-validation" id="spreedly-name-info-icon"></i> </div>
    </fieldset>
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LATEST NEWS


INDEPENDENCE CENTER UNVEILS NEW ADA RAMP AND WELCOME CENTER

July 7, 2022


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INDEPENDENCE CENTER BUILDS NEW ADA RAMP TO PROMOTE INCLUSION AND ACCESSIBILITY

May 24, 2022


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