support.woundedwarriorproject.org
Open in
urlscan Pro
209.183.221.111
Public Scan
Submitted URL: http://click.email.woundedwarriorproject.org/?qs=3d658faad70458f78c5e05e79c1742a0fcd389ab905d4a7322fa489d6a6ed967051b4a9c7fec6341ad7c841e77cc...
Effective URL: https://support.woundedwarriorproject.org/default.aspx?tsid=11585&ovr_acv_id=9761&campaignSource=EMAIL&source=MWG20001
Submission: On May 10 via api from US — Scanned from DE
Effective URL: https://support.woundedwarriorproject.org/default.aspx?tsid=11585&ovr_acv_id=9761&campaignSource=EMAIL&source=MWG20001
Submission: On May 10 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /default.aspx?tsid=11585&ovr_acv_id=9761&campaignSource=EMAIL&source=MWG20001
<form method="post" action="/default.aspx?tsid=11585&ovr_acv_id=9761&campaignSource=EMAIL&source=MWG20001" onsubmit="javascript:return WebForm_OnSubmit();" id="aspnetForm" style="margin: 0px; padding: 0px; display: block;"
class="form-layout-2 clearfix one-time-gift-enabled">
<div class="aspNetHidden">
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
value="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">
</div>
<script type="text/javascript">
//<![CDATA[
var theForm = document.forms['aspnetForm'];
if (!theForm) {
theForm = document.aspnetForm;
}
function __doPostBack(eventTarget, eventArgument) {
if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
theForm.__EVENTTARGET.value = eventTarget;
theForm.__EVENTARGUMENT.value = eventArgument;
theForm.submit();
}
}
//]]>
</script>
<script src="/WebResource.axd?d=pynGkmcFUV13He1Qd6_TZOcSB5dIs3woD7XLeRiKjAqlZyK6SmwrkhMGuTJ7XjNeH3S78Z-zXRwRuKFzPD77fw2&t=637453888754849868" type="text/javascript"></script>
<script src="/ScriptResource.axd?d=nv7asgRUU0tRmHNR2D6t1FQ5uuNWZ7H-YE9bftjlutIxaTNH4ekbkrhtg6VPTBzTFZhtWOjCuIM-2SrwBvWF3kRyOWTlDWjTv6XAbTPpUe37u8RqWPFf3V2fV3FKfTN-uYKzrDVrow9ax5jD47EuFw2&t=ffffffffe191061b" type="text/javascript"></script>
<script src="/ScriptResource.axd?d=NJmAwtEo3Ipnlaxl6CMhvoChlWwDt62VEi8sZZIIT8WwpRfOImnhW_JzdCRqwhi01lQt2U9juv87r4wLNu78QA6Jb7THtxcG2OPgoZXnuOzMV5OijFZKBrI1rOI8CeY2GOuY_hr75Y3cCBb2XcsVbgcMJr0SfnkJ564VytKU9401&t=363be08" type="text/javascript">
</script>
<script src="/ScriptResource.axd?d=dwY9oWetJoJoVpgL6Zq8OEAZmkzvUzjP13RZ7U7T5MfE5_Vt0ULPCuQ_VK6SNoM_Yq_97GSacJArlNrUYcDEsEH-GkeLnA01hnQr1pfYq_hJPCz9717odefjlL1yjgHgAC4IbbIaRumydrH6hdT_WNAyyDBPHw7vKlrdWd5nNJ41&t=363be08" type="text/javascript">
</script>
<script src="api/WebFormsAjaxEndpoint.svc/js" type="text/javascript"></script>
<script src="api/LocationUIHelper.asmx/js" type="text/javascript"></script>
<script type="text/javascript">
//<![CDATA[
function WebForm_OnSubmit() {
if (typeof(ValidatorOnSubmit) == "function" && ValidatorOnSubmit() == false) return false;
return true;
}
//]]>
</script>
<div class="aspNetHidden">
<input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="CA0B0334">
<input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
value="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">
</div>
<script type="text/javascript">
//<![CDATA[
Sys.WebForms.PageRequestManager._initialize('ctl00$mp_scriptManager', 'aspnetForm', [], [], [], 90, 'ctl00');
//]]>
</script>
<input type="hidden" name="ctl00$mainFormContentArea$uniquePostId" id="ctl00_mainFormContentArea_uniquePostId" value="2022510123521178">
<input type="text" id="ahp_contact_email" name="ahp_contact_email" class="coreContactEmailEntryFields" tabindex="-1" autocomplete="off" style="display:none;">
<script type="text/javascript">
var SECTION_TYPES = {
PAYMENT_BLOCK: 11,
PAYMENT_SECTION_LEGACY: 4,
};
var WebFormContext = {
"AmountSectionMetaData": null,
"Form": {
"CoverFeeRate": 0,
"CurrencySymbol": "$",
"EnableDonorPayProcessingFee": false,
"Fields": [{
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267248",
"Id": 267248,
"Name": "source",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267249",
"Id": 267249,
"Name": "deviceWidth",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267250",
"Id": 267250,
"Name": "company",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267252",
"Id": 267252,
"Name": "numCardsSendMe",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267251",
"Id": 267251,
"Name": "campaignSource",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267254",
"Id": 267254,
"Name": "SendMeaCard",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267255",
"Id": 267255,
"Name": "ccOneTime",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267256",
"Id": 267256,
"Name": "ccMonthly",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267257",
"Id": 267257,
"Name": "achOneTime",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267258",
"Id": 267258,
"Name": "achMonthly",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267259",
"Id": 267259,
"Name": "tributecontentcontrol",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267289",
"Id": 267289,
"Name": "DynamicContentDriverhidden",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267292",
"Id": 267292,
"Name": "tributeTypeText",
"Section": {
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_radioButtonList_267231",
"Id": 267231,
"Name": "OneTimeGiftString",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 3,
"Name": "Radio Button"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_radioButtonList_267233",
"Id": 267233,
"Name": "MonthlyGiftString",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 3,
"Name": "Radio Button"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_344111",
"Id": 344111,
"Name": "giftamountother",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": true
},
"DomId": "ctl00_textBox_267288",
"Id": 267288,
"Name": "GiftAmountMappedHidden",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_contentBlock_269856",
"Id": 269856,
"Name": "MonthlyGiftMessage",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 16,
"Name": "Content Block"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_contentBlock_271181",
"Id": 271181,
"Name": "monthlydonorlabel",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 16,
"Name": "Content Block"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": true,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_radioButtonList_344110",
"Id": 344110,
"Name": "donationFreq",
"Section": {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 3,
"Name": "Radio Button"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_radioButtonList_267234",
"Id": 267234,
"Name": "ThankYouGift",
"Section": {
"DomId": "fieldset_19348",
"Id": 19348,
"Name": "Your Thank You Gift",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 3,
"Name": "Radio Button"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_checkBoxList_267220",
"Id": 267220,
"Name": "honorGiftToggle",
"Section": {
"DomId": "fieldset_19345",
"Id": 19345,
"Name": "Tribute Section",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 2,
"Name": "Check Box"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267198",
"Id": 267198,
"Name": "First Name",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267199",
"Id": 267199,
"Name": "Last Name",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267201",
"Id": 267201,
"Name": "Address 1",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267202",
"Id": 267202,
"Name": "Address 2",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysCountries_267206",
"Id": 267206,
"Name": "Country",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 14,
"Name": "Countries (system)"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267203",
"Id": 267203,
"Name": "Zip Code",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267204",
"Id": 267204,
"Name": "City",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": true,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysUsStates_267205",
"Id": 267205,
"Name": "State",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 13,
"Name": "States (system)"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267200",
"Id": 267200,
"Name": "Phone Number",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267235",
"Id": 267235,
"Name": "EmailAddress",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_checkBoxList_267236",
"Id": 267236,
"Name": "emailOptIn",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 2,
"Name": "Check Box"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_checkBoxList_267237",
"Id": 267237,
"Name": "companyDonation",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 2,
"Name": "Check Box"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267238",
"Id": 267238,
"Name": "companyFoundation",
"Section": {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": true,
"TransactionAmount": false
},
"DomId": "ctl00_radioButtonList_267240",
"Id": 267240,
"Name": "paymentType",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 3,
"Name": "Radio Button"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": true,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267207",
"Id": 267207,
"Name": "creditCardNumber",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": true,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysCreditCardTypes_267208",
"Id": 267208,
"Name": "cctype",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 17,
"Name": "Credit Card Types (system)"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": true,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysCreditCardExpirationMonths_267209",
"Id": 267209,
"Name": "expirationdate",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 18,
"Name": "Credit Card Exp Months (system)"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": true,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysCreditCardExpirationYears_267210",
"Id": 267210,
"Name": "expirationYear",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 19,
"Name": "Credit Card Exp Years (system)"
},
"Validation": {
"Currency": false,
"Required": true
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": true,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267241",
"Id": 267241,
"Name": "routingnumber",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": true,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267242",
"Id": 267242,
"Name": "accountnumber",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": true,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267243",
"Id": 267243,
"Name": "BankAccountType",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267244",
"Id": 267244,
"Name": "checkNumber",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": true,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267245",
"Id": 267245,
"Name": "achType",
"Section": {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_checkBoxList_267213",
"Id": 267213,
"Name": "billingInformationSame",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 2,
"Name": "Check Box"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267211",
"Id": 267211,
"Name": "billingAddressLine1",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267212",
"Id": 267212,
"Name": "billingAddress2",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysCountries_267217",
"Id": 267217,
"Name": "billingCountry",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 14,
"Name": "Countries (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267214",
"Id": 267214,
"Name": "billingZip",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267215",
"Id": 267215,
"Name": "billingCity",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_sysUsStates_267216",
"Id": 267216,
"Name": "BillingState",
"Section": {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 13,
"Name": "States (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_ddl_sysTributeType_267218",
"Id": 267218,
"Name": "TributeType",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 24,
"Name": "Tribute Type (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeName_267219",
"Id": 267219,
"Name": "TributeName",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 25,
"Name": "Tribute Name (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_checkBoxList_267229",
"Id": 267229,
"Name": "mailAcknowledgment",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 2,
"Name": "Check Box"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_contentBlock_267253",
"Id": 267253,
"Name": "Mailacknowledgementto",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 16,
"Name": "Content Block"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeAckFirstName_267221",
"Id": 267221,
"Name": "ackFirstName",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 34,
"Name": "Tribute Ack. First Name (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeAckLastName_267222",
"Id": 267222,
"Name": "AckLastName",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 36,
"Name": "Tribute Ack. Last Name (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeAckAddress1_267223",
"Id": 267223,
"Name": "ackAddressLine1",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 41,
"Name": "Tribute Ack. Address 1 (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeAckAddress2_267224",
"Id": 267224,
"Name": "AckLine2",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 42,
"Name": "Tribute Ack. Address 2 (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_ddl_sysTributeAckCountry_267230",
"Id": 267230,
"Name": "AckCountry",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 48,
"Name": "Tribute Ack. Country (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeAckPostalCode_267225",
"Id": 267225,
"Name": "AckZipCode",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 47,
"Name": "Tribute Ack. Postal Code (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_tb_sysTributeAckCity_267226",
"Id": 267226,
"Name": "AckCity",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 45,
"Name": "Tribute Ack. City (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_ddl_sysTributeAckState_267227",
"Id": 267227,
"Name": "AckState",
"Section": {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 46,
"Name": "Tribute Ack. State (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_contentBlock_267246",
"Id": 267246,
"Name": "addoptionstext",
"Section": {
"DomId": "fieldset_19347",
"Id": 19347,
"Name": "Additional Options to Honor",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 16,
"Name": "Content Block"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": false,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "ctl00_textBox_267247",
"Id": 267247,
"Name": "sendMeACard",
"Section": {
"DomId": "fieldset_19347",
"Id": 19347,
"Name": "Additional Options to Honor",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 1,
"Name": "Text"
},
"Validation": {
"Currency": false,
"Required": false
}
}, {
"DataMapping": {
"IsACHType": false,
"IsAccountNumber": false,
"IsAccountType": false,
"IsCVV": false,
"IsCardType": false,
"IsCreditCardNumber": false,
"IsDonationFrequency": false,
"IsDonorState": false,
"IsExpirationMonth": false,
"IsExpirationYear": false,
"IsNameOnAccount": false,
"IsNameOnCard": false,
"IsPayPal": true,
"IsRoutingNumber": false,
"PaymentMethod": false,
"TransactionAmount": false
},
"DomId": "paypalButton",
"Id": 267287,
"Name": "PayPalButton",
"Section": {
"DomId": "fieldset_19349",
"Id": 19349,
"Name": "PayPal Button Section",
"SystemSectionType": 0,
"Visible": true
},
"Type": {
"Id": 110,
"Name": "PayPal Payment Button (system)"
},
"Validation": {
"Currency": false,
"Required": false
}
}],
"Id": 11585,
"Name": "LIVE_ONLINE DR_PARENT_CAMPAIGN FORM (2019)_2019.03.22",
"ProcessingFeeFieldDomId": "ctl00_mainFormContentArea_processingFeeAmount",
"PromoCodeEntryFieldId": "",
"RenderMode": "Live",
"RenderedViewName": "Initial View",
"RenderedViewNumber": 1,
"Sections": [{
"DomId": "fieldset_0",
"Id": 0,
"Name": "",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19341",
"Id": 19341,
"Name": "Choose A Gift",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19348",
"Id": 19348,
"Name": "Your Thank You Gift",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19345",
"Id": 19345,
"Name": "Tribute Section",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19342",
"Id": 19342,
"Name": "Your Information",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19343",
"Id": 19343,
"Name": "Payment Information",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19346",
"Id": 19346,
"Name": "Billing Information",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19344",
"Id": 19344,
"Name": "Honor \/ Memory Acknowledgement Information",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19347",
"Id": 19347,
"Name": "Additional Options to Honor",
"SystemSectionType": 0,
"Visible": true
}, {
"DomId": "fieldset_19349",
"Id": 19349,
"Name": "PayPal Button Section",
"SystemSectionType": 0,
"Visible": true
}],
"StepName": "Initial Step",
"StepNumber": 1,
"Type": {
"Id": 1,
"Name": "Donation"
}
},
"PaymentSectionMetaData": null,
"SystemDateTime": "\/Date(1652200521178-0400)\/",
"VisitorLocation": {
"City": "Furth",
"Country": {
"DefaultCurrency": {
"Id": 0,
"Name": ""
},
"Id": 117,
"Name": "Germany"
},
"DemographicInfo": {
"LocationMedianIncomeCeiling": null,
"LocationMedianIncomeFloor": 0,
"LocationMedianIncomeGroup": "",
"LocationMedianIncomeGroup_Id": 0
},
"IPAddress": "80.255.10.198",
"StateProvince": "Bayern"
}
};
CharityEngineWebFormContextData = WebFormContext;
WebFormContext.Form.CurrencySymbol = '$';
</script>
<input type="hidden" name="ctl00$mainFormContentArea$processingFeeAmount" id="ctl00_mainFormContentArea_processingFeeAmount">
<script type="text/javascript">
var gl_overrideValidatorsHiddenFieldId = 'ctl00_mainFormContentArea_ts_override_validators';
var gl_nextButtonId = 'ctl00_nextButt';
var gl_paypalMode = 'production';
var gl_paypalAccount_id = 414;
var gl_form_id = 11585;
function displayError(message) {
var errDiv = document.getElementById('topErrorMessage');
if (errDiv != null && !isBlank(message)) {
errDiv.innerHTML = message;
errDiv.show();
}
}
function clearError() {
var errDiv = document.getElementById('topErrorMessage');
if (errDiv != null && !isBlank(message)) {
errDiv.innerHTML = '';
errDiv.vanish();
}
}
</script>
<input type="hidden" name="ctl00$mainFormContentArea$themeStateStorageField" id="ctl00_mainFormContentArea_themeStateStorageField">
<script type="text/javascript">
var gl_themeStateStorageElementId = 'ctl00_mainFormContentArea_themeStateStorageField';
</script>
<script type="text/javascript">
function ts_custFields_replaceCharacters() {
var retVal = true;
var elemObj;
elemObj = document.getElementById('ctl00_textBox_267248');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267249');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267250');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267252');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267251');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267254');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267255');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267256');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267257');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267258');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267259');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267289');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267292');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_344111');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
elemObj.value = elemObj.value.replace('$', '');
}
elemObj = document.getElementById('ctl00_textBox_267288');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
elemObj.value = elemObj.value.replace('$', '');
}
elemObj = document.getElementById('ctl00_textBox_267198');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267199');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267201');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267202');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267203');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267204');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267200');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267235');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267238');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267207');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267241');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267242');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267243');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267244');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267245');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267211');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267212');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267214');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267215');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeName_267219');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeAckFirstName_267221');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeAckLastName_267222');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeAckAddress1_267223');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeAckAddress2_267224');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeAckPostalCode_267225');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_tb_sysTributeAckCity_267226');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
elemObj = document.getElementById('ctl00_textBox_267247');
if (elemObj != undefined) {
elemObj.value = ts_clapi_escapeSpecialCharacterPatterns(elemObj.value);
}
return retVal;
}
function client_cust_ccNum_validationForField_267207(sender, args) {
var valObjRef_267207 = document.getElementById('ctl00_textBox_267207');
if (valObjRef_267207 && ts_api_isElementVisible(valObjRef_267207)) {
args.IsValid = isValidCreditCardNumber(valObjRef_267207.value);
if (!args.IsValid) {
sender.errormessage = 'Credit Card Number invalid format';
}
}
}
function client_cust_routing_validationForField_267241(sender, args) {
var valObjRef_267241 = document.getElementById('ctl00_textBox_267241');
if (valObjRef_267241 && ts_api_isElementVisible(valObjRef_267241)) {
args.IsValid = isValidRoutingNumber(valObjRef_267241.value);
if (!args.IsValid) {
sender.errormessage = 'Routing Number invalid format';
}
}
}
function client_cust_account_validationForField_267242(sender, args) {
var valObjRef_267242 = document.getElementById('ctl00_textBox_267242');
if (valObjRef_267242 && ts_api_isElementVisible(valObjRef_267242)) {
args.IsValid = isValidBankAccountNumber(valObjRef_267242.value);
if (!args.IsValid) {
sender.errormessage = 'Account Number invalid format';
}
}
}
function ts_clientCustom_onSubmit_preValidation_encapsulate() {
if (typeof ts_clapi_onSubmit_preValidation == 'function') ts_clapi_onSubmit_preValidation();
}
function ts_clientCustom_onSubmit_encapsulate(sender, args) {
cleanValidatedInputFields();
args.IsValid = true;
for (i = 0; i < Page_Validators.length; i++) {
if (!Page_Validators[i].isvalid) {
if (document.getElementById(Page_Validators[i].controltovalidate) != null) console.log('validator ' + Page_Validators[i].id + ' failed for control ' + document.getElementById(Page_Validators[i].controltovalidate).id + ' with value: ' +
document.getElementById(Page_Validators[i].controltovalidate).value);
else console.log('validator ' + Page_Validators[i].id + ' referencing undefined control: ' + Page_Validators[i].controltovalidate);
args.IsValid = false;
}
updateAriaInvalid(Page_Validators[i]);
}
if (args.IsValid && typeof validateDonationAmountGreaterThanMinAmount !== 'undefined') {
var amountValid = validateDonationAmountGreaterThanMinAmount(5);
args.IsValid = amountValid;
if (!amountValid) {
addErrorMessageToSummary(
'The minimum donation for a credit card transaction is $5. If you would like to send your donation by check, please send it to the address shown below.<br/><br/>Wounded Warrior Project<br/>P.O. Box 758517<br/>Topeka, Kansas 66675')
args.ErrorMessage =
'The minimum donation for a credit card transaction is $5. If you would like to send your donation by check, please send it to the address shown below.<br/><br/>Wounded Warrior Project<br/>P.O. Box 758517<br/>Topeka, Kansas 66675';
}
}
//first call custom framework onsubmit override and set validation properties
if (args.IsValid) {
if (typeof ts_clapi_onSubmit_postValidation == 'function') args.IsValid = ts_clapi_onSubmit_postValidation();
if (typeof ts_clientCustom_onSubmit == 'function') args.IsValid = ts_clientCustom_onSubmit();
}
ts_custFields_replaceCharacters();
if (typeof(ts_global_jsFw_ticketElements) != 'undefined' && ts_global_jsFw_ticketElements != null) {
ts_clapi_calculateFormTicketValuesEnterResultInSystemTicketFields(ts_global_jsFw_ticketElements);
}
//next check client side validator controls and perform enable/disable logic
//enable/disable submit button
if (!args.IsValid) {
//enable
document.getElementById('ctl00_nextButt').style.visibility = 'visible';
document.getElementById('ctl00_nextButt').style.opacity = '1';
document.getElementById('ctl00_nextButt').style.pointerEvents = 'all';
} else {
//disable
document.getElementById('ctl00_nextButt').style.visibility = 'hidden';
document.getElementById('ctl00_nextButt').style.opacity = '0.5';
document.getElementById('ctl00_nextButt').style.pointerEvents = 'none';
}
Form.trySaveFormUIState();
}
</script>
<input type="hidden" name="ctl00$mainFormContentArea$ts_override_validators" id="ctl00_mainFormContentArea_ts_override_validators">
<div id="topErrorMessage"></div>
<ul class="tsCustomValidationSummaryMessages errormessage hidden"></ul>
<h1 class="tsPageTitles" id="tsLandingPageTitle">Donate Now</h1>
<!--START FORM HEADER--><!--END FORM HEADER--><!--START FORM CONTENT-->
<div class="tsPageMainFormContent" id="tsPageMainFormContent">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
if (typeof(ts_global_jsFw_systemField_customerCountry) != 'undefined') {
var cCntDD = document.getElementById(ts_global_jsFw_systemField_customerCountry);
if (cCntDD != null) {
//toggle on page load
togglePostalCodeValidationForCountryChangeEvent(cCntDD);
//bind change event
cCntDD.addEventListener('change', function() {
togglePostalCodeValidationForCountryChangeEvent(this);
})
}
}
if (typeof(ts_global_jsFw_systemField_billingCountry) != 'undefined') {
var bCntDD = document.getElementById(ts_global_jsFw_systemField_billingCountry);
if (bCntDD != null) {
//toggle on page load
togglePostalCodeValidationForCountryChangeEvent(bCntDD);
//bind change event
bCntDD.addEventListener('change', function() {
togglePostalCodeValidationForCountryChangeEvent(this);
})
}
}
setBodyIfPreviewingStep();
document.getElementById('topErrorMessage').vanish();
});
</script>
<input type="hidden" name="ctl00$mainFormContentArea$PaypalGatewayToken" id="ctl00_mainFormContentArea_PaypalGatewayToken">
<input type="hidden" name="ctl00$mainFormContentArea$paypalGatewayPayerId" id="ctl00_mainFormContentArea_paypalGatewayPayerId">
<script src="/_includes/_thirdparty/paypal/checkout.js?v=1" type="text/javascript" data-version-4=""></script>
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
console.log('Initialize paypal form logic');
//CODE FROM LEGACY PAYPAL INIT (DELETE)
//while (typeof Form === 'undefined' || Form.we)
// setTimeout(function () { console.log('Waiting for form to initialize') }, 100);
//var paypalContainer = document.querySelector('div.paypal-button-container');
//if (paypalContainer) {
//
// var paypalContainerFormRow = paypalContainer.parentNode;
//
// if (Form.paymentSection != null && Form.paymentSection.isPaymentBlockPresent()) {
//
// Form.paymentSection.onPaymentMethodChanged(function (d) {
//
// if (d.paymentMethodId == PAYMENT_METHODS.PAYPAL.toString())
// paypalContainerFormRow.style.display = '';
// else
// paypalContainerFormRow.style.display = 'none';
//
// });
//
// paypalContainerFormRow.style.display = Form.paymentSection.getSelectedPaymentMethodId() == PAYMENT_METHODS.PAYPAL ? '' : 'none';
//
// }
//
//}
//else
// console.log('Paypal button not found (check for div with class paypal-button-container)');
//CODE FROM LEGACY PAYPAL INIT (DELETE)
console.log('Initialize paypal button');
paypal.Button.render({
env: gl_paypalMode,
style: {
size: 'medium',
color: 'blue',
shape: 'rect'
},
payment: function(resolve, reject) {
document.getElementById('ctl00_mainFormContentArea_PaypalGatewayToken').setValue('');
document.getElementById('ctl00_mainFormContentArea_paypalGatewayPayerId').setValue('');
return new paypal.Promise(function(resolve, reject) {
//TODO: validate form API across all form types - i.e. do we need to use the WebFormContext JSON object to query dom directly?
var ppAmt = Form.getTransactionAmount();
console.log('pp Form.Amt: ' + ppAmt);
var ppFrmFreqId = 0;
var frequencyField = getFrequencyFieldElement();
if (frequencyField != null) {
if (frequencyField.hasClassName('tsDropDownLists')) {
ppFrmFreqId = getSelectedValue(frequencyField);
} else if (frequencyField.hasClassName('tsRadioButtonLists')) {
ppFrmFreqId = getRadioButtonSelectedValue(frequencyField);
}
}
console.log('ppFrmFreqId: ' + ppFrmFreqId);
var enablePayPalRec = 0;
if (ppFrmFreqId > 0) enablePayPalRec = 1;
var params = {
"ajaxParams": {
"PaypalGatewayId": 414,
"PaymentAmount": ppAmt,
"EnableRecurringBilling": enablePayPalRec,
"AppTypeId": 5,
"AppId": 11585
}
};
postJsonDataAsync('/api/WebAppUIAjaxEndpoint.svc/GetPaypalAuthorizationToken', JSON.stringify(params), function(result) {
console.log('result: ' + JSON.stringify(result));
if (result != null && result.Success) {
document.getElementById('ctl00_mainFormContentArea_PaypalGatewayToken').setValue(result.PaypalToken);
resolve(result.PaypalToken);
} else reject(result.ErrorMessage);
}, function(error) {
console.log('error: ' + error);
reject(error);
});
});
},
onAuthorize: function(data) {
document.getElementById('ctl00_mainFormContentArea_paypalGatewayPayerId').setValue(data.payerID);
handlePaypalPaymentAuthorized();
},
onCancel: function(data, actions) {
console.log('paypal payment cancelled');
},
onError: function(err) {
console.error('paypal payment error', err);
}
}, '#ctl00_paypalecButtonContainer_267287');
});
function handlePaypalPaymentAuthorized() {
console.log('paypal payment authorized');
var creditCardFieldsData = getFieldGroup(WebFormContext, FIELD_GROUPS.CREDIT_CARD);
var achFieldsData = getFieldGroup(WebFormContext, FIELD_GROUPS.ACH);
var billingFieldsData = document.querySelectorAll('.isBillingStreetAddress1,.isBillingStreetAddress2,.isCountry,.isZip,.isCity,.isState');
//disable cc fields
creditCardFieldsData.forEach(function(f) {
enableOrDisableRequiredValidatorByFieldJson(f, 'disable');
});
//disable ach fields
achFieldsData.forEach(function(f) {
enableOrDisableRequiredValidatorByFieldJson(f, 'disable');
});
billingFieldsData.forEach(function(f) {
enableOrDisableRequiredValidator(f, 'disable');
})
if (Page_ClientValidate()) {
console.log('form validated - simulate next click');
Form.nextButton.click();
} else console.log('validation failure - abort');
}
</script>
<input type="hidden" name="ctl00$processedTransactionId" id="processedTransactionId"><input type="hidden" name="ctl00$donorPeerToPeerTeamPageId" id="donorPeerToPeerTeamPageId">
<div id="ctl00_tsFormRow_1" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267248" id="ctl00_label_267248" class="tsFormLabels ce-label hidden-label appeal-code" title="paymentSourceCode" style="">paymentSourceCode</label><input name="ctl00$textBox_267248" type="text" value="MWG20001"
id="ctl00_textBox_267248" class="tsTextBoxes ce-input isTrackingCode1 hidden-label appeal-code">
</div>
<div id="ctl00_tsFormRow_3" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267249" id="ctl00_label_267249" class="tsFormLabels ce-label insert-device-width hidden-label" title="Device Width">Device Width</label><input name="ctl00$textBox_267249" type="text" id="ctl00_textBox_267249"
class="tsTextBoxes ce-input insert-device-width hidden-label">
</div>
<div id="ctl00_tsFormRow_4" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267250" id="ctl00_label_267250" class="tsFormLabels ce-label hidden-label" title="companySource">companySource</label><input name="ctl00$textBox_267250" type="text" id="ctl00_textBox_267250"
class="tsTextBoxes ce-input isTrackingCode2 hidden-label">
</div>
<div id="ctl00_tsFormRow_5" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267252" id="ctl00_label_267252" class="tsFormLabels ce-label hidden-label" title="Number of cards to send me">Number of cards to send me</label><input name="ctl00$textBox_267252" type="text" id="ctl00_textBox_267252"
class="tsTextBoxes ce-input isTrackingCode4 hidden-label">
</div>
<div id="ctl00_tsFormRow_6" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267251" id="ctl00_label_267251" class="tsFormLabels ce-label hidden-label" title="campaignSource">campaignSource</label><input name="ctl00$textBox_267251" type="text" value="EMAIL" id="ctl00_textBox_267251"
class="tsTextBoxes ce-input isTrackingCode3 hidden-label">
</div>
<div id="ctl00_tsFormRow_7" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267254" id="ctl00_label_267254" class="tsFormLabels ce-label send-me-a-card" title="Send Me a Card">Send Me a Card</label><input name="ctl00$textBox_267254" type="text" id="ctl00_textBox_267254"
class="tsTextBoxes ce-input send-me-a-card">
</div>
<div id="ctl00_tsFormRow_8" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267255" id="ctl00_label_267255" class="tsFormLabels ce-label ccOneTime hidden-label" title="CC One Time flag for email">CC One Time flag for email</label><input name="ctl00$textBox_267255" type="text"
id="ctl00_textBox_267255" class="tsTextBoxes ce-input ccOneTime hidden-label">
</div>
<div id="ctl00_tsFormRow_9" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267256" id="ctl00_label_267256" class="tsFormLabels ce-label ccMonthly hidden-label" title="CC Monthly flag for email">CC Monthly flag for email</label><input name="ctl00$textBox_267256" type="text"
id="ctl00_textBox_267256" class="tsTextBoxes ce-input ccMonthly hidden-label">
</div>
<div id="ctl00_tsFormRow_10" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267257" id="ctl00_label_267257" class="tsFormLabels ce-label achOneTime hidden-label" title="ACH One Time flag for email">ACH One Time flag for email</label><input name="ctl00$textBox_267257" type="text"
id="ctl00_textBox_267257" class="tsTextBoxes ce-input achOneTime hidden-label">
</div>
<div id="ctl00_tsFormRow_11" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267258" id="ctl00_label_267258" class="tsFormLabels ce-label achMonthly hidden-label" title="ACH Monthly flag for email">ACH Monthly flag for email</label><input name="ctl00$textBox_267258" type="text"
id="ctl00_textBox_267258" class="tsTextBoxes ce-input achMonthly hidden-label">
</div>
<div id="ctl00_tsFormRow_12" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267259" id="ctl00_label_267259" class="tsFormLabels ce-label tribute-content-control" title="tribute content control">tribute content control</label><input name="ctl00$textBox_267259" type="text" value="99"
id="ctl00_textBox_267259" class="tsTextBoxes ce-input tribute-content-control">
</div>
<div id="ctl00_tsFormRow_13" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267289" id="ctl00_label_267289" class="tsFormLabels ce-label dynamicContentDriver" title="Dynamic Content Driver (hidden)">Dynamic Content Driver (hidden)</label><input name="ctl00$textBox_267289" type="text"
id="ctl00_textBox_267289" class="tsTextBoxes ce-input dynamicContentDriver">
</div>
<div id="ctl00_tsFormRow_14" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267292" id="ctl00_label_267292" class="tsFormLabels ce-label insert-tribute-type-text" title="Tribute Type Text (hidden)">Tribute Type Text (hidden)</label><input name="ctl00$textBox_267292" type="text"
id="ctl00_textBox_267292" class="tsTextBoxes ce-input insert-tribute-type-text">
</div>
<div id="ctl00_mainFormContentArea_valSummary" class="tsValidationSummaryMessages" style="display:none;">
</div><span id="cstm-errors"></span>
<fieldset id="fieldset_19341" class="tsFieldSets ce-fieldset fieldset1 first-fieldset" data-step="step1">
<legend id="legend_19341" class="tsLegends ce-legend">
<div class="mobile-legend-number">1</div>Choose A Gift
</legend>
<div id="ctl00_tsFormRow_21" class="tsFormRows recurring-frequency-row border-bottom-row btn-row children-2 divs-2 spans-3 labels-0 no-label">
<input id="ctl00_radioButtonList_344110_selectedIndexValue" name="ctl00_radioButtonList_344110_selectedIndexValue" type="hidden" value="0"><span id="ctl00_radioButtonList_344110"
class="tsRadioButtonLists isRecurringFrequency horizontal-btn-row" data-value="0"><span fieldoption_id="685030" onchange="on_radioButtonList_344110_changed(this);" data-index="0" data-parent="ctl00_radioButtonList_344110"
class="radio-btn-span-active"><input id="ctl00_radioButtonList_344110_0" type="radio" name="ctl00$radioButtonList_344110" value="0" checked="checked"
onclick="document.getElementById('ctl00_radioButtonList_344110_selectedIndexValue').value = 0;"><label for="ctl00_radioButtonList_344110_0" class="remaining-width-minus-checkbox">One-Time Gift</label></span><span fieldoption_id="685031"
onchange="on_radioButtonList_344110_changed(this);" data-index="1" data-parent="ctl00_radioButtonList_344110"><input id="ctl00_radioButtonList_344110_1" type="radio" name="ctl00$radioButtonList_344110" value="4"
onclick="document.getElementById('ctl00_radioButtonList_344110_selectedIndexValue').value = 1;"><label for="ctl00_radioButtonList_344110_1" class="remaining-width-minus-checkbox">Monthly Gift</label></span></span>
<script>
function on_radioButtonList_344110_changed(elem) {
var parentElem = document.getElementById(elem.getAttribute('data-parent'));
if (parentElem) {
var currentChecked = parentElem.querySelector('input[type="radio"]:checked');
if (currentChecked) {
document.getElementById('ctl00_radioButtonList_344110_selectedIndexValue').value = elem.getAttribute('data-index');
parentElem.setAttribute('data-value', currentChecked.value);
}
}
}
(function on_radioButtonList_344110_loaded() {
//IE11 polyfill for dispatchEvent
(function() {
if (typeof window.Event === 'function') return false;
function Event(event, params) {
params = params || {
bubbles: false,
cancelable: false,
detail: null
};
var evt = document.createEvent('Event');
evt.initEvent('change', true, true);
return evt;
}
window.Event = Event;
})();
var elem = document.getElementById('ctl00_radioButtonList_344110');
if (elem) {
var defaultChecked = elem.querySelector('input:checked')
if (defaultChecked) elem.setAttribute('data-value', defaultChecked.value)
elem.getValue = function() {
return document.getElementById('ctl00_radioButtonList_344110').getAttribute('data-value');
}
//Set value
elem.setValue = function(value) {
//get control ref
var me = document.getElementById('ctl00_radioButtonList_344110');
//get radio that matches the given value
var matchedOption = me.querySelector('input[type="radio"][value="' + value + '"]');
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
}
//Set value by the label
elem.setValueFor = function(label, value) {
var me = document.getElementById('ctl00_radioButtonList_344110');
var givenLabel = document.evaluate('//label[text()="' + label + '"]', me, null, XPathResult.ANY_TYPE, null).iterateNext();
if (givenLabel) {
var matchedOption = document.getElementById(givenLabel.getAttribute('for'));
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
} else {
console.error('cant find option "' + label + '" on control ctl00_radioButtonList_344110');
}
}
}
})();
</script>
<div id="ctl00_tsFormRow_19" class="tsFormRows one-time-gift-row monthly-arrow-row children-0 divs-1 spans-0 labels-0 no-label">
<div id="ctl00_contentBlock_269856" class="tsContentBlocks">
<table id="month-gift-arrow-table" border="0">
<tbody>
<tr>
<td id="month-gift-arrow-table-td1">
<p>You'll make the most impact for our wounded warriors when you support them with a monthly gift. <b>As a monthly donor of $19 or more, you will receive a Wounded Warrior Project<sup>®</sup> fleece blanket.</b></p>
</td>
<td id="month-gift-arrow-table-td2">
<img src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2019/4/29/red-arrow.svg" alt="" id="monthly-arrow-up">
</td>
</tr>
</tbody>
</table>
</div>
<div id="ctl00_tsFormRow_17" class="tsFormRows other-donation-amount-container children-1 divs-0 spans-1 labels-0 no-label">
<span id="ctl00_regexFieldValCost_344111" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
</div>
</div>
<div id="ctl00_tsFormRow_15" class="tsFormRows one-time-gift-row gift-amount-btns-row border-bottom-row btn-row children-6 divs-0 spans-8 labels-0 no-label">
<input id="ctl00_radioButtonList_267231_selectedIndexValue" name="ctl00_radioButtonList_267231_selectedIndexValue" type="hidden" value="4"><span id="ctl00_radioButtonList_267231"
class="tsRadioButtonLists gift-amount-btns default-50 horizontal-btn-row" data-value="50"><span fieldoption_id="642593" onchange="on_radioButtonList_267231_changed(this);" data-index="0" data-parent="ctl00_radioButtonList_267231"><input
id="ctl00_radioButtonList_267231_0" type="radio" name="ctl00$radioButtonList_267231" value="250" onclick="document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = 0;"><label for="ctl00_radioButtonList_267231_0"
class="remaining-width-minus-checkbox">$250</label></span><span fieldoption_id="642594" onchange="on_radioButtonList_267231_changed(this);" data-index="1" data-parent="ctl00_radioButtonList_267231"><input
id="ctl00_radioButtonList_267231_1" type="radio" name="ctl00$radioButtonList_267231" value="150" onclick="document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = 1;"><label for="ctl00_radioButtonList_267231_1"
class="remaining-width-minus-checkbox">$150</label></span><span fieldoption_id="642595" onchange="on_radioButtonList_267231_changed(this);" data-index="2" data-parent="ctl00_radioButtonList_267231"><input
id="ctl00_radioButtonList_267231_2" type="radio" name="ctl00$radioButtonList_267231" value="100" onclick="document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = 2;"><label for="ctl00_radioButtonList_267231_2"
class="remaining-width-minus-checkbox">$100</label></span><span fieldoption_id="642596" onchange="on_radioButtonList_267231_changed(this);" data-index="3" data-parent="ctl00_radioButtonList_267231"><input
id="ctl00_radioButtonList_267231_3" type="radio" name="ctl00$radioButtonList_267231" value="75" onclick="document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = 3;"><label for="ctl00_radioButtonList_267231_3"
class="remaining-width-minus-checkbox">$75</label></span><span fieldoption_id="658253" onchange="on_radioButtonList_267231_changed(this);" data-index="4" data-parent="ctl00_radioButtonList_267231" class="radio-btn-span-active"><input
id="ctl00_radioButtonList_267231_4" type="radio" name="ctl00$radioButtonList_267231" value="50" onclick="document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = 4;"><label for="ctl00_radioButtonList_267231_4"
class="remaining-width-minus-checkbox">$50</label></span><span fieldoption_id="642598" onchange="on_radioButtonList_267231_changed(this);" data-index="5" data-parent="ctl00_radioButtonList_267231" class="other-amount-span"><input
id="ctl00_radioButtonList_267231_5" type="radio" name="ctl00$radioButtonList_267231" value="0" onclick="document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = 5;"><label for="ctl00_radioButtonList_267231_5"
class="remaining-width-minus-checkbox">YOUR BEST GIFT</label></span><span class="insert-other">
<div class="visible-xs" id="other-amount-divider-container">
<hr id="other-amount-divider">
<div class="other-amount-or">or</div>
</div>
<div id="other-amount-wrapper"><input name="ctl00$textBox_344111" type="text" id="ctl00_textBox_344111" class="tsTextBoxes ce-input other-donation-amount-textbox" placeholder="Your Best Gift"
style="height: 41px !important; line-height: 41px !important; width: 100% !important;"><span id="other-dollar-sign" style="height: 41px !important; line-height: 41px !important;">$</span></div>
</span></span>
<script>
function on_radioButtonList_267231_changed(elem) {
var parentElem = document.getElementById(elem.getAttribute('data-parent'));
if (parentElem) {
var currentChecked = parentElem.querySelector('input[type="radio"]:checked');
if (currentChecked) {
document.getElementById('ctl00_radioButtonList_267231_selectedIndexValue').value = elem.getAttribute('data-index');
parentElem.setAttribute('data-value', currentChecked.value);
}
}
}
(function on_radioButtonList_267231_loaded() {
//IE11 polyfill for dispatchEvent
(function() {
if (typeof window.Event === 'function') return false;
function Event(event, params) {
params = params || {
bubbles: false,
cancelable: false,
detail: null
};
var evt = document.createEvent('Event');
evt.initEvent('change', true, true);
return evt;
}
window.Event = Event;
})();
var elem = document.getElementById('ctl00_radioButtonList_267231');
if (elem) {
var defaultChecked = elem.querySelector('input:checked')
if (defaultChecked) elem.setAttribute('data-value', defaultChecked.value)
elem.getValue = function() {
return document.getElementById('ctl00_radioButtonList_267231').getAttribute('data-value');
}
//Set value
elem.setValue = function(value) {
//get control ref
var me = document.getElementById('ctl00_radioButtonList_267231');
//get radio that matches the given value
var matchedOption = me.querySelector('input[type="radio"][value="' + value + '"]');
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
}
//Set value by the label
elem.setValueFor = function(label, value) {
var me = document.getElementById('ctl00_radioButtonList_267231');
var givenLabel = document.evaluate('//label[text()="' + label + '"]', me, null, XPathResult.ANY_TYPE, null).iterateNext();
if (givenLabel) {
var matchedOption = document.getElementById(givenLabel.getAttribute('for'));
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
} else {
console.error('cant find option "' + label + '" on control ctl00_radioButtonList_267231');
}
}
}
})();
</script>
</div>
<div id="ctl00_tsFormRow_16" class="tsFormRows monthly-gift-row gift-amount-btns-row monthly-gift-string-row border-bottom-row btn-row children-4 divs-0 spans-10 labels-0 no-label" style="display: none;">
<input id="ctl00_radioButtonList_267233_selectedIndexValue" name="ctl00_radioButtonList_267233_selectedIndexValue" type="hidden" value="-1"><span class="monthly-msg-text">As a monthly donor of $19 or more, you will receive a Wounded Warrior
Project<sup>®</sup> (WWP) fleece blanket.</span><span id="ctl00_radioButtonList_267233" class="tsRadioButtonLists gift-amount-btns default-19 horizontal-btn-row"><span fieldoption_id="642599"
onchange="on_radioButtonList_267233_changed(this);" data-index="0" data-parent="ctl00_radioButtonList_267233"><input id="ctl00_radioButtonList_267233_0" type="radio" name="ctl00$radioButtonList_267233" value="19"
onclick="document.getElementById('ctl00_radioButtonList_267233_selectedIndexValue').value = 0;"><label for="ctl00_radioButtonList_267233_0" class="remaining-width-minus-checkbox"><span class="mgift-amount">$19</span> <em
class="monthly-word">Monthly</em></label></span><span fieldoption_id="642600" onchange="on_radioButtonList_267233_changed(this);" data-index="1" data-parent="ctl00_radioButtonList_267233"><input id="ctl00_radioButtonList_267233_1"
type="radio" name="ctl00$radioButtonList_267233" value="25" onclick="document.getElementById('ctl00_radioButtonList_267233_selectedIndexValue').value = 1;"><label for="ctl00_radioButtonList_267233_1"
class="remaining-width-minus-checkbox"><span class="mgift-amount">$25</span> <em class="monthly-word">Monthly</em></label></span><span fieldoption_id="642601" onchange="on_radioButtonList_267233_changed(this);" data-index="2"
data-parent="ctl00_radioButtonList_267233"><input id="ctl00_radioButtonList_267233_2" type="radio" name="ctl00$radioButtonList_267233" value="30"
onclick="document.getElementById('ctl00_radioButtonList_267233_selectedIndexValue').value = 2;"><label for="ctl00_radioButtonList_267233_2" class="remaining-width-minus-checkbox"><span class="mgift-amount">$30</span> <em
class="monthly-word">Monthly</em></label></span><span fieldoption_id="642602" onchange="on_radioButtonList_267233_changed(this);" data-index="3" data-parent="ctl00_radioButtonList_267233" class="other-amount-span"><input
id="ctl00_radioButtonList_267233_3" type="radio" name="ctl00$radioButtonList_267233" value="0" onclick="document.getElementById('ctl00_radioButtonList_267233_selectedIndexValue').value = 3;"><label for="ctl00_radioButtonList_267233_3"
class="remaining-width-minus-checkbox">YOUR BEST GIFT</label></span><span class="insert-other">
<div class="visible-xs" id="other-amount-divider-container">
<hr id="other-amount-divider">
<div class="other-amount-or">or</div>
</div>
</span></span>
<script>
function on_radioButtonList_267233_changed(elem) {
var parentElem = document.getElementById(elem.getAttribute('data-parent'));
if (parentElem) {
var currentChecked = parentElem.querySelector('input[type="radio"]:checked');
if (currentChecked) {
document.getElementById('ctl00_radioButtonList_267233_selectedIndexValue').value = elem.getAttribute('data-index');
parentElem.setAttribute('data-value', currentChecked.value);
}
}
}
(function on_radioButtonList_267233_loaded() {
//IE11 polyfill for dispatchEvent
(function() {
if (typeof window.Event === 'function') return false;
function Event(event, params) {
params = params || {
bubbles: false,
cancelable: false,
detail: null
};
var evt = document.createEvent('Event');
evt.initEvent('change', true, true);
return evt;
}
window.Event = Event;
})();
var elem = document.getElementById('ctl00_radioButtonList_267233');
if (elem) {
var defaultChecked = elem.querySelector('input:checked')
if (defaultChecked) elem.setAttribute('data-value', defaultChecked.value)
elem.getValue = function() {
return document.getElementById('ctl00_radioButtonList_267233').getAttribute('data-value');
}
//Set value
elem.setValue = function(value) {
//get control ref
var me = document.getElementById('ctl00_radioButtonList_267233');
//get radio that matches the given value
var matchedOption = me.querySelector('input[type="radio"][value="' + value + '"]');
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
}
//Set value by the label
elem.setValueFor = function(label, value) {
var me = document.getElementById('ctl00_radioButtonList_267233');
var givenLabel = document.evaluate('//label[text()="' + label + '"]', me, null, XPathResult.ANY_TYPE, null).iterateNext();
if (givenLabel) {
var matchedOption = document.getElementById(givenLabel.getAttribute('for'));
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
} else {
console.error('cant find option "' + label + '" on control ctl00_radioButtonList_267233');
}
}
}
})();
</script>
</div>
<div id="ctl00_tsFormRow_18" class="tsFormRows hidden-row children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_textBox_267288" id="ctl00_label_267288" class="tsFormLabels ce-label" title="Donation Amount">Donation Amount</label><input name="ctl00$textBox_267288" type="text" id="ctl00_textBox_267288"
class="tsTextBoxes ce-input isCost isTaxDeductibleAmount isRecurringAmount isRecurringTaxDeductibleAmount"><span id="ctl00_regexFieldValCost_267288" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_20" class="tsFormRows monthly-gift-row hidden-row children-0 divs-1 spans-1 labels-0 no-label" style="display: none;">
<div id="ctl00_contentBlock_271181" class="tsContentBlocks">
<span class="wwp-red-text">As a monthly donor of $19 or more, you will receive a Wounded Warrior Project<sup>®</sup> (WWP) fleece blanket.</span>
</div>
</div>
</fieldset>
<fieldset id="fieldset_19348" class="tsFieldSets ce-fieldset fieldset2 monthly-gift-row" data-step="step2" style="display: none;">
<legend id="legend_19348" class="tsLegends ce-legend">Your Thank You Gift</legend>
<div id="ctl00_tsFormRow_22" class="tsFormRows gift-row border-bottom-row btn-row children-2 divs-0 spans-7 labels-0 no-label monthly-gift-row" style="display: none;">
<input id="ctl00_radioButtonList_267234_selectedIndexValue" name="ctl00_radioButtonList_267234_selectedIndexValue" type="hidden" value="1"><span id="ctl00_radioButtonList_267234"
class="tsRadioButtonLists isTrackingCode7 gift horizontal-btn-row" data-value="BL" data-gifts="2"><span fieldoption_id="642603" onchange="on_radioButtonList_267234_changed(this);" data-index="0" data-parent="ctl00_radioButtonList_267234"
class="monthly-gift-row" style="display: none !important;"><input id="ctl00_radioButtonList_267234_0" type="radio" name="ctl00$radioButtonList_267234" value="BL" checked="checked"
onclick="document.getElementById('ctl00_radioButtonList_267234_selectedIndexValue').value = 0;"><label for="ctl00_radioButtonList_267234_0" class="remaining-width-minus-checkbox"><img
src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2019/5/14/wwp-blanket-jpg.jpg" alt="Wounded Warrior Project Blanket" data-price="19" data-frequency="m" data-product="Wounded Warrior Project® (WWP) fleece blanket"
data-selected-index-value="0">
<span class="gift-title" style="width: 100% !important;">WWP Blanket</span>
<span class="gift-subtext" style="width: 100% !important;">Please allow 4 - 6 weeks for your gift to arrive.</span></label></span><span fieldoption_id="642604" onchange="on_radioButtonList_267234_changed(this);" data-index="1"
data-parent="ctl00_radioButtonList_267234" class="radio-btn-span-active"><input id="ctl00_radioButtonList_267234_1" type="radio" name="ctl00$radioButtonList_267234" value="NF"
onclick="document.getElementById('ctl00_radioButtonList_267234_selectedIndexValue').value = 1;"><label for="ctl00_radioButtonList_267234_1" class="remaining-width-minus-checkbox"><img
src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2019/5/14/wwp-no-gift-jpg.jpg" alt="No gift" data-price="0" data-selected-index-value="1">
<span class="gift-title" style="width: 100% !important;">Please Do Not Send Me A Gift</span>
<span class="gift-subtext" style="width: 100% !important;">Make my gift go further!</span></label></span></span>
<script>
function on_radioButtonList_267234_changed(elem) {
var parentElem = document.getElementById(elem.getAttribute('data-parent'));
if (parentElem) {
var currentChecked = parentElem.querySelector('input[type="radio"]:checked');
if (currentChecked) {
document.getElementById('ctl00_radioButtonList_267234_selectedIndexValue').value = elem.getAttribute('data-index');
parentElem.setAttribute('data-value', currentChecked.value);
}
}
}
(function on_radioButtonList_267234_loaded() {
//IE11 polyfill for dispatchEvent
(function() {
if (typeof window.Event === 'function') return false;
function Event(event, params) {
params = params || {
bubbles: false,
cancelable: false,
detail: null
};
var evt = document.createEvent('Event');
evt.initEvent('change', true, true);
return evt;
}
window.Event = Event;
})();
var elem = document.getElementById('ctl00_radioButtonList_267234');
if (elem) {
var defaultChecked = elem.querySelector('input:checked')
if (defaultChecked) elem.setAttribute('data-value', defaultChecked.value)
elem.getValue = function() {
return document.getElementById('ctl00_radioButtonList_267234').getAttribute('data-value');
}
//Set value
elem.setValue = function(value) {
//get control ref
var me = document.getElementById('ctl00_radioButtonList_267234');
//get radio that matches the given value
var matchedOption = me.querySelector('input[type="radio"][value="' + value + '"]');
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
}
//Set value by the label
elem.setValueFor = function(label, value) {
var me = document.getElementById('ctl00_radioButtonList_267234');
var givenLabel = document.evaluate('//label[text()="' + label + '"]', me, null, XPathResult.ANY_TYPE, null).iterateNext();
if (givenLabel) {
var matchedOption = document.getElementById(givenLabel.getAttribute('for'));
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
} else {
console.error('cant find option "' + label + '" on control ctl00_radioButtonList_267234');
}
}
}
})();
</script>
</div>
</fieldset>
<fieldset id="fieldset_19345" class="tsFieldSets ce-fieldset tribute-checkbox-section fieldset3" data-step="step3">
<legend id="legend_19345" class="tsLegends ce-legend">Tribute Section</legend>
<div id="ctl00_tsFormRow_23" class="tsFormRows is-tribute-checkbox-row checkbox-row btn-row children-1 divs-0 spans-3 labels-0 no-label">
<span id="ctl00_checkBoxList_267220" class="tsCheckBoxLists is-tribute-checkbox horizontal-btn-row"><span fieldoption_id="642589"><input id="ctl00_checkBoxList_267220_0" type="checkbox" name="ctl00$checkBoxList_267220$0" value="1"><label
for="ctl00_checkBoxList_267220_0" class="remaining-width-minus-checkbox">Make this a gift in <span style="color: #000;">honor or memory</span> of an individual.</label><img
src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2017/4/6/tooltip-icon.jpg" alt="tooltip" class="ach-tooltip tooltipstered" id="tooltip-tribute"></span></span>
</div>
</fieldset>
<fieldset id="fieldset_19342" class="tsFieldSets ce-fieldset fieldset4" data-step="step4">
<legend id="legend_19342" class="tsLegends ce-legend">
<div class="mobile-legend-number">2</div>Your Information
</legend>
<div id="ctl00_tsFormRow_24" class="tsFormRows width50 left-half children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_textBox_267198" id="ctl00_label_267198" class="tsFormLabels ce-label" title="First Name">First Name</label><input name="ctl00$textBox_267198" type="text" maxlength="250" id="ctl00_textBox_267198"
class="tsTextBoxes ce-input isFName isDonorFirstName ts_requiredField" aria-required="true" aria-invalid="false" data-validation-message=""><span id="ctl00_reqFieldVal_267198" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_25" class="tsFormRows width50 right-half children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_textBox_267199" id="ctl00_label_267199" class="tsFormLabels ce-label" title="Last Name">Last Name</label><input name="ctl00$textBox_267199" type="text" maxlength="250" id="ctl00_textBox_267199"
class="tsTextBoxes ce-input isLName isDonorLastName ts_requiredField" aria-required="true" aria-invalid="false" data-validation-message=""><span id="ctl00_reqFieldVal_267199" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_26" class="tsFormRows width50 left-half children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_textBox_267201" id="ctl00_label_267201" class="tsFormLabels ce-label" title="Address Line 1">Address Line 1</label><input name="ctl00$textBox_267201" type="text" id="ctl00_textBox_267201"
class="tsTextBoxes ce-input isDonorAddress1 ts_requiredField" aria-required="true" aria-invalid="false" data-validation-message="" data-geo="street_addr" placeholder="Street address, P.O. box, c/o"><span id="ctl00_reqFieldVal_267201"
class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_27" class="tsFormRows width50 right-half children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_textBox_267202" id="ctl00_label_267202" class="tsFormLabels ce-label insert-not-required" title="Address Line 2">Address Line 2<span class="not-required-indicator">(Not Required)</span></label><input
name="ctl00$textBox_267202" type="text" id="ctl00_textBox_267202" class="tsTextBoxes ce-input isDonorAddress2 insert-not-required" data-geo="subpremise" placeholder="Apt, suite, unit, building, floor, etc.">
</div>
<div id="ctl00_tsFormRow_28" class="tsFormRows width50 left-half children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_sysCountries_267206" id="ctl00_label_267206" class="tsFormLabels ce-label" title="Country">Country</label><select name="ctl00$sysCountries_267206" id="ctl00_sysCountries_267206"
class="tsDropDownLists ts_requiredField tsDropDownLists_countries isDonorCountry_id" aria-required="true" aria-invalid="false" data-validation-message="" data-geo="country" onchange="setState(this,'36');">
<option value=""></option>
<option value="United States" fieldoption_id="36">United States</option>
<option value="Afghanistan" fieldoption_id="37">Afghanistan</option>
<option value="Albania" fieldoption_id="38">Albania</option>
<option value="Algeria" fieldoption_id="39">Algeria</option>
<option value="American Samoa" fieldoption_id="40">American Samoa</option>
<option value="Andorra" fieldoption_id="41">Andorra</option>
<option value="Angola" fieldoption_id="42">Angola</option>
<option value="Anguilla" fieldoption_id="43">Anguilla</option>
<option value="Antarctica" fieldoption_id="44">Antarctica</option>
<option value="Antigua and Barbuda" fieldoption_id="45">Antigua and Barbuda</option>
<option value="Argentina" fieldoption_id="46">Argentina</option>
<option value="Armenia" fieldoption_id="47">Armenia</option>
<option value="Aruba" fieldoption_id="48">Aruba</option>
<option value="Australia" fieldoption_id="49">Australia</option>
<option value="Austria" fieldoption_id="50">Austria</option>
<option value="Azerbaijan" fieldoption_id="51">Azerbaijan</option>
<option value="Bahamas" fieldoption_id="52">Bahamas</option>
<option value="Bahrain" fieldoption_id="53">Bahrain</option>
<option value="Bangladesh" fieldoption_id="54">Bangladesh</option>
<option value="Barbados" fieldoption_id="55">Barbados</option>
<option value="Belarus" fieldoption_id="56">Belarus</option>
<option value="Belgium" fieldoption_id="57">Belgium</option>
<option value="Belize" fieldoption_id="58">Belize</option>
<option value="Benin" fieldoption_id="59">Benin</option>
<option value="Bermuda" fieldoption_id="60">Bermuda</option>
<option value="Bhutan" fieldoption_id="61">Bhutan</option>
<option value="Bolivia" fieldoption_id="62">Bolivia</option>
<option value="Bosnia and Herzegovina" fieldoption_id="63">Bosnia and Herzegovina</option>
<option value="Botswana" fieldoption_id="64">Botswana</option>
<option value="Brazil" fieldoption_id="65">Brazil</option>
<option value="British Indian Ocean Territory" fieldoption_id="66">British Indian Ocean Territory</option>
<option value="Brunei" fieldoption_id="67">Brunei</option>
<option value="Bulgaria" fieldoption_id="68">Bulgaria</option>
<option value="Burkina Faso" fieldoption_id="69">Burkina Faso</option>
<option value="Burundi" fieldoption_id="70">Burundi</option>
<option value="Cambodia" fieldoption_id="71">Cambodia</option>
<option value="Cameroon" fieldoption_id="72">Cameroon</option>
<option value="Canada" fieldoption_id="73">Canada</option>
<option value="Cape Verde" fieldoption_id="74">Cape Verde</option>
<option value="Cayman Islands" fieldoption_id="75">Cayman Islands</option>
<option value="Central African Republic" fieldoption_id="76">Central African Republic</option>
<option value="Chad" fieldoption_id="77">Chad</option>
<option value="Chile" fieldoption_id="78">Chile</option>
<option value="China" fieldoption_id="79">China</option>
<option value="Christmas Islands" fieldoption_id="80">Christmas Islands</option>
<option value="Cocos (Keeling) Islands" fieldoption_id="81">Cocos (Keeling) Islands</option>
<option value="Colombia" fieldoption_id="82">Colombia</option>
<option value="Comoros" fieldoption_id="83">Comoros</option>
<option value="Congo" fieldoption_id="84">Congo</option>
<option value="Congo, Democratic Republic of" fieldoption_id="85">Congo, Democratic Republic of</option>
<option value="Cook Island" fieldoption_id="86">Cook Island</option>
<option value="Costa Rica" fieldoption_id="87">Costa Rica</option>
<option value="Cote Divoire" fieldoption_id="88">Cote Divoire</option>
<option value="Croatia" fieldoption_id="89">Croatia</option>
<option value="Cuba" fieldoption_id="90">Cuba</option>
<option value="Cyprus" fieldoption_id="91">Cyprus</option>
<option value="Czech Republic" fieldoption_id="92">Czech Republic</option>
<option value="Denmark" fieldoption_id="93">Denmark</option>
<option value="Djibouti" fieldoption_id="94">Djibouti</option>
<option value="Dominica" fieldoption_id="95">Dominica</option>
<option value="Dominican Republic" fieldoption_id="96">Dominican Republic</option>
<option value="East Timor" fieldoption_id="97">East Timor</option>
<option value="Egypt" fieldoption_id="98">Egypt</option>
<option value="El Salvador" fieldoption_id="99">El Salvador</option>
<option value="Equador" fieldoption_id="100">Equador</option>
<option value="Equatorial Guinea" fieldoption_id="101">Equatorial Guinea</option>
<option value="Eritrea" fieldoption_id="102">Eritrea</option>
<option value="Estonia" fieldoption_id="103">Estonia</option>
<option value="Ethiopia" fieldoption_id="104">Ethiopia</option>
<option value="Falkland Islands" fieldoption_id="105">Falkland Islands</option>
<option value="Faroe Islands" fieldoption_id="106">Faroe Islands</option>
<option value="Federated States of Micronesia" fieldoption_id="107">Federated States of Micronesia</option>
<option value="Fiji" fieldoption_id="108">Fiji</option>
<option value="Finland" fieldoption_id="109">Finland</option>
<option value="France" fieldoption_id="110">France</option>
<option value="French Guiana" fieldoption_id="111">French Guiana</option>
<option value="French Polynesia" fieldoption_id="112">French Polynesia</option>
<option value="French Southern Territories" fieldoption_id="113">French Southern Territories</option>
<option value="Gabon" fieldoption_id="114">Gabon</option>
<option value="Gambia" fieldoption_id="115">Gambia</option>
<option value="Georgia" fieldoption_id="116">Georgia</option>
<option value="Germany" fieldoption_id="117">Germany</option>
<option value="Ghana" fieldoption_id="118">Ghana</option>
<option value="Gibraltar" fieldoption_id="119">Gibraltar</option>
<option value="Greece" fieldoption_id="120">Greece</option>
<option value="Greenland" fieldoption_id="121">Greenland</option>
<option value="Grenada" fieldoption_id="122">Grenada</option>
<option value="Guadeloupe" fieldoption_id="123">Guadeloupe</option>
<option value="Guam" fieldoption_id="124">Guam</option>
<option value="Guatemala" fieldoption_id="125">Guatemala</option>
<option value="Guinea" fieldoption_id="126">Guinea</option>
<option value="Guinea-Bissau" fieldoption_id="127">Guinea-Bissau</option>
<option value="Guyana" fieldoption_id="128">Guyana</option>
<option value="Haiti" fieldoption_id="129">Haiti</option>
<option value="Heard and Macdonald Islands" fieldoption_id="130">Heard and Macdonald Islands</option>
<option value="Honduras" fieldoption_id="131">Honduras</option>
<option value="Hong Kong" fieldoption_id="132">Hong Kong</option>
<option value="Hungary" fieldoption_id="133">Hungary</option>
<option value="Iceland" fieldoption_id="134">Iceland</option>
<option value="India" fieldoption_id="135">India</option>
<option value="Indonesia" fieldoption_id="136">Indonesia</option>
<option value="Iran" fieldoption_id="137">Iran</option>
<option value="Iraq" fieldoption_id="138">Iraq</option>
<option value="Ireland" fieldoption_id="139">Ireland</option>
<option value="Israel" fieldoption_id="140">Israel</option>
<option value="Italy" fieldoption_id="141">Italy</option>
<option value="Jamaica" fieldoption_id="142">Jamaica</option>
<option value="Japan" fieldoption_id="143">Japan</option>
<option value="Jordan" fieldoption_id="144">Jordan</option>
<option value="Kazakhstan" fieldoption_id="145">Kazakhstan</option>
<option value="Kenya" fieldoption_id="146">Kenya</option>
<option value="Kiribati" fieldoption_id="147">Kiribati</option>
<option value="Korea, North" fieldoption_id="148">Korea, North</option>
<option value="Korea, South" fieldoption_id="149">Korea, South</option>
<option value="Kuwait" fieldoption_id="150">Kuwait</option>
<option value="Kyrgyzstan" fieldoption_id="151">Kyrgyzstan</option>
<option value="Laos" fieldoption_id="152">Laos</option>
<option value="Latvia" fieldoption_id="153">Latvia</option>
<option value="Lebanon" fieldoption_id="154">Lebanon</option>
<option value="Lesotho" fieldoption_id="155">Lesotho</option>
<option value="Liberia" fieldoption_id="156">Liberia</option>
<option value="Libya" fieldoption_id="157">Libya</option>
<option value="Liechtenstein" fieldoption_id="158">Liechtenstein</option>
<option value="Lithuania" fieldoption_id="159">Lithuania</option>
<option value="Luxembourg" fieldoption_id="160">Luxembourg</option>
<option value="Macau" fieldoption_id="161">Macau</option>
<option value="Macedonia (Rep. of Fmr Yugoslav)" fieldoption_id="162">Macedonia (Rep. of Fmr Yugoslav)</option>
<option value="Madagascar" fieldoption_id="163">Madagascar</option>
<option value="Malawi" fieldoption_id="164">Malawi</option>
<option value="Malaysia" fieldoption_id="165">Malaysia</option>
<option value="Maldives" fieldoption_id="166">Maldives</option>
<option value="Mali" fieldoption_id="167">Mali</option>
<option value="Malta" fieldoption_id="168">Malta</option>
<option value="Marshall Islands" fieldoption_id="169">Marshall Islands</option>
<option value="Martinique" fieldoption_id="170">Martinique</option>
<option value="Mauritania" fieldoption_id="171">Mauritania</option>
<option value="Mauritius" fieldoption_id="172">Mauritius</option>
<option value="Mayotte" fieldoption_id="173">Mayotte</option>
<option value="Metropolitan France" fieldoption_id="174">Metropolitan France</option>
<option value="Mexico" fieldoption_id="175">Mexico</option>
<option value="Moldova" fieldoption_id="176">Moldova</option>
<option value="Monaco" fieldoption_id="177">Monaco</option>
<option value="Mongolia" fieldoption_id="178">Mongolia</option>
<option value="Montenegro" fieldoption_id="277">Montenegro</option>
<option value="Montserrat" fieldoption_id="179">Montserrat</option>
<option value="Morocco" fieldoption_id="180">Morocco</option>
<option value="Mozambique" fieldoption_id="181">Mozambique</option>
<option value="Myanmar" fieldoption_id="182">Myanmar</option>
<option value="Namibia" fieldoption_id="183">Namibia</option>
<option value="Nauru" fieldoption_id="184">Nauru</option>
<option value="Nepal" fieldoption_id="185">Nepal</option>
<option value="Netherlands" fieldoption_id="186">Netherlands</option>
<option value="Netherlands Antilles" fieldoption_id="187">Netherlands Antilles</option>
<option value="New Caledonia" fieldoption_id="188">New Caledonia</option>
<option value="New Zealand" fieldoption_id="189">New Zealand</option>
<option value="Nicaragua" fieldoption_id="190">Nicaragua</option>
<option value="Niger" fieldoption_id="192">Niger</option>
<option value="Nigeria" fieldoption_id="193">Nigeria</option>
<option value="Niue" fieldoption_id="191">Niue</option>
<option value="Norfolk Island" fieldoption_id="194">Norfolk Island</option>
<option value="Northern Mariana Islands" fieldoption_id="195">Northern Mariana Islands</option>
<option value="Norway" fieldoption_id="196">Norway</option>
<option value="Oman" fieldoption_id="197">Oman</option>
<option value="Pakistan" fieldoption_id="198">Pakistan</option>
<option value="Palau" fieldoption_id="199">Palau</option>
<option value="Palestinian Territory, Occupied" fieldoption_id="200">Palestinian Territory, Occupied</option>
<option value="Panama" fieldoption_id="201">Panama</option>
<option value="Papua New Guinea" fieldoption_id="202">Papua New Guinea</option>
<option value="Paraguay" fieldoption_id="203">Paraguay</option>
<option value="Peru" fieldoption_id="204">Peru</option>
<option value="Philippines" fieldoption_id="205">Philippines</option>
<option value="Pitcairn" fieldoption_id="206">Pitcairn</option>
<option value="Poland" fieldoption_id="207">Poland</option>
<option value="Portugal" fieldoption_id="208">Portugal</option>
<option value="Puerto Rico" fieldoption_id="209">Puerto Rico</option>
<option value="Qatar" fieldoption_id="210">Qatar</option>
<option value="Reunion" fieldoption_id="211">Reunion</option>
<option value="Romania" fieldoption_id="212">Romania</option>
<option value="Russia" fieldoption_id="213">Russia</option>
<option value="Rwanda" fieldoption_id="214">Rwanda</option>
<option value="S. Georgia and S. Sandwich Islands" fieldoption_id="215">S. Georgia and S. Sandwich Islands</option>
<option value="Samoa" fieldoption_id="216">Samoa</option>
<option value="San Marino" fieldoption_id="217">San Marino</option>
<option value="Sao Tome and Principe" fieldoption_id="218">Sao Tome and Principe</option>
<option value="Saudi Arabia" fieldoption_id="219">Saudi Arabia</option>
<option value="Senegal" fieldoption_id="220">Senegal</option>
<option value="Serbia" fieldoption_id="276">Serbia</option>
<option value="Seychelles" fieldoption_id="221">Seychelles</option>
<option value="Sierra Leone" fieldoption_id="222">Sierra Leone</option>
<option value="Singapore" fieldoption_id="223">Singapore</option>
<option value="Slovakia" fieldoption_id="224">Slovakia</option>
<option value="Slovenia" fieldoption_id="225">Slovenia</option>
<option value="Solomon Islands" fieldoption_id="226">Solomon Islands</option>
<option value="Somalia" fieldoption_id="227">Somalia</option>
<option value="South Africa" fieldoption_id="228">South Africa</option>
<option value="Spain" fieldoption_id="229">Spain</option>
<option value="Sri Lanka" fieldoption_id="230">Sri Lanka</option>
<option value="St Helena" fieldoption_id="231">St Helena</option>
<option value="St Kitts and Nevis" fieldoption_id="232">St Kitts and Nevis</option>
<option value="St Lucia" fieldoption_id="233">St Lucia</option>
<option value="St Pierre and Miquelon" fieldoption_id="234">St Pierre and Miquelon</option>
<option value="St Vincent and the Grenadines" fieldoption_id="235">St Vincent and the Grenadines</option>
<option value="Sudan" fieldoption_id="236">Sudan</option>
<option value="Suriname" fieldoption_id="237">Suriname</option>
<option value="Svalbard and Jan Mayen Islands" fieldoption_id="238">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland" fieldoption_id="239">Swaziland</option>
<option value="Sweden" fieldoption_id="240">Sweden</option>
<option value="Switzerland" fieldoption_id="241">Switzerland</option>
<option value="Syria" fieldoption_id="242">Syria</option>
<option value="Taiwan" fieldoption_id="243">Taiwan</option>
<option value="Tajikistan" fieldoption_id="244">Tajikistan</option>
<option value="Tanzania" fieldoption_id="245">Tanzania</option>
<option value="Thailand" fieldoption_id="246">Thailand</option>
<option value="Togo" fieldoption_id="247">Togo</option>
<option value="Tokelau" fieldoption_id="248">Tokelau</option>
<option value="Tonga" fieldoption_id="249">Tonga</option>
<option value="Trinidad and Tobago" fieldoption_id="250">Trinidad and Tobago</option>
<option value="Tunisia" fieldoption_id="251">Tunisia</option>
<option value="Turkey" fieldoption_id="252">Turkey</option>
<option value="Turkmenistan" fieldoption_id="253">Turkmenistan</option>
<option value="Turks and Caicos Islands" fieldoption_id="254">Turks and Caicos Islands</option>
<option value="Tuvalu" fieldoption_id="255">Tuvalu</option>
<option value="Uganda" fieldoption_id="256">Uganda</option>
<option value="Ukraine" fieldoption_id="257">Ukraine</option>
<option value="United Arab Emirates" fieldoption_id="258">United Arab Emirates</option>
<option value="United Kingdom" fieldoption_id="259">United Kingdom</option>
<option value="United States Minor Outlying Islands" fieldoption_id="260">United States Minor Outlying Islands</option>
<option value="Uruguay" fieldoption_id="261">Uruguay</option>
<option value="Uzbekistan" fieldoption_id="262">Uzbekistan</option>
<option value="Vanuatu" fieldoption_id="263">Vanuatu</option>
<option value="Vatican City" fieldoption_id="264">Vatican City</option>
<option value="Venezuela" fieldoption_id="265">Venezuela</option>
<option value="Vietnam" fieldoption_id="266">Vietnam</option>
<option value="Virgin Islands - British" fieldoption_id="267">Virgin Islands - British</option>
<option value="Virgin Islands - US" fieldoption_id="268">Virgin Islands - US</option>
<option value="Wallis and Futuna Islands" fieldoption_id="269">Wallis and Futuna Islands</option>
<option value="Western Sahara" fieldoption_id="270">Western Sahara</option>
<option value="Yemen" fieldoption_id="271">Yemen</option>
<option value="Yugoslavia" fieldoption_id="272">Yugoslavia</option>
<option value="Zaire" fieldoption_id="273">Zaire</option>
<option value="Zambia" fieldoption_id="274">Zambia</option>
<option value="Zimbabwe" fieldoption_id="275">Zimbabwe</option>
</select>
<script>
document.addEventListener('DOMContentLoaded', function() {
setState(document.getElementById('ctl00_sysCountries_267206'), '36', true);
});
</script><span id="ctl00_reqFieldVal_267206" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_29" class="tsFormRows width50 right-half children-1 divs-0 spans-2 labels-1 has-label">
<label for="ctl00_textBox_267203" id="ctl00_label_267203" class="tsFormLabels ce-label" title="ZIP Code">ZIP Code</label><input name="ctl00$textBox_267203" type="text" maxlength="50" id="ctl00_textBox_267203"
class="tsTextBoxes ce-input isDonorZipCode ts_requiredField PopulateCityStateEnabled" aria-required="true" aria-invalid="false" data-validation-message="" data-geo="postal_code" onchange="populateCityState(this);"><span
id="ctl00_reqFieldVal_267203" class="tsVal_itemMarker" style="display: inline;">*</span><span id="ctl00_regexFieldValZip_267203" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_30" class="tsFormRows width50 left-half city-state-row children-1 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_textBox_267204" id="ctl00_label_267204" class="tsFormLabels ce-label" title="City">City</label><input name="ctl00$textBox_267204" type="text" maxlength="250" id="ctl00_textBox_267204"
class="tsTextBoxes ce-input isDonorCity ts_requiredField" aria-required="true" aria-invalid="false" data-validation-message="" data-geo="locality"><span id="ctl00_reqFieldVal_267204" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_31" class="tsFormRows width50 right-half city-state-row children-2 divs-0 spans-1 labels-1 has-label">
<label for="ctl00_sysUsStates_267205" id="ctl00_label_267205" class="tsFormLabels ce-label" title="State">State</label><select name="ctl00$sysUsStates_267205" id="ctl00_sysUsStates_267205"
class="tsDropDownLists ts_requiredField tsDropDownLists_usStates isDonorState_id" data-defaultvaluelabel="" data-hasdefaultvalue="true" aria-required="true" aria-invalid="false" data-validation-message=""
data-geo="administrative_area_level_1">
<option value="0"></option>
<option value=""></option>
<option value="Alabama" fieldoption_id="5" data-state-abrv="AL">Alabama</option>
<option value="Alaska" fieldoption_id="4" data-state-abrv="AK">Alaska</option>
<option value="American Samoa" fieldoption_id="53" data-state-abrv="AS">American Samoa</option>
<option value="Arizona" fieldoption_id="29" data-state-abrv="AZ">Arizona</option>
<option value="Arkansas" fieldoption_id="13" data-state-abrv="AR">Arkansas</option>
<option value="Armed Forces Europe" fieldoption_id="60" data-state-abrv="AE">Armed Forces Europe</option>
<option value="Armed Forces Pacific" fieldoption_id="61" data-state-abrv="AP">Armed Forces Pacific</option>
<option value="Armed Forces the Americas" fieldoption_id="59" data-state-abrv="AA">Armed Forces the Americas</option>
<option value="California" fieldoption_id="10" data-state-abrv="CA">California</option>
<option value="Colorado" fieldoption_id="34" data-state-abrv="CO">Colorado</option>
<option value="Connecticut" fieldoption_id="14" data-state-abrv="CT">Connecticut</option>
<option value="Delaware" fieldoption_id="35" data-state-abrv="DE">Delaware</option>
<option value="District of Columbia" fieldoption_id="2" data-state-abrv="DC">District of Columbia</option>
<option value="Fed. States of Micronesia" fieldoption_id="54" data-state-abrv="FM">Fed. States of Micronesia</option>
<option value="Florida" fieldoption_id="21" data-state-abrv="FL">Florida</option>
<option value="Georgia" fieldoption_id="30" data-state-abrv="GA">Georgia</option>
<option value="Guam" fieldoption_id="55" data-state-abrv="GU">Guam</option>
<option value="Hawaii" fieldoption_id="9" data-state-abrv="HI">Hawaii</option>
<option value="Idaho" fieldoption_id="36" data-state-abrv="ID">Idaho</option>
<option value="Illinois" fieldoption_id="25" data-state-abrv="IL">Illinois</option>
<option value="Indiana" fieldoption_id="26" data-state-abrv="IN">Indiana</option>
<option value="Iowa" fieldoption_id="37" data-state-abrv="IA">Iowa</option>
<option value="Kansas" fieldoption_id="8" data-state-abrv="KS">Kansas</option>
<option value="Kentucky" fieldoption_id="28" data-state-abrv="KY">Kentucky</option>
<option value="Louisiana" fieldoption_id="38" data-state-abrv="LA">Louisiana</option>
<option value="Maine" fieldoption_id="39" data-state-abrv="ME">Maine</option>
<option value="Marshall Islands" fieldoption_id="56" data-state-abrv="MH">Marshall Islands</option>
<option value="Maryland" fieldoption_id="1" data-state-abrv="MD">Maryland</option>
<option value="Massachusetts" fieldoption_id="41" data-state-abrv="MA">Massachusetts</option>
<option value="Michigan" fieldoption_id="6" data-state-abrv="MI">Michigan</option>
<option value="Minnesota" fieldoption_id="42" data-state-abrv="MN">Minnesota</option>
<option value="Mississippi" fieldoption_id="7" data-state-abrv="MS">Mississippi</option>
<option value="Missouri" fieldoption_id="12" data-state-abrv="MO">Missouri</option>
<option value="Montana" fieldoption_id="40" data-state-abrv="MT">Montana</option>
<option value="Nebraska" fieldoption_id="43" data-state-abrv="NE">Nebraska</option>
<option value="Nevada" fieldoption_id="44" data-state-abrv="NV">Nevada</option>
<option value="New Hampshire" fieldoption_id="31" data-state-abrv="NH">New Hampshire</option>
<option value="New Jersey" fieldoption_id="23" data-state-abrv="NJ">New Jersey</option>
<option value="New Mexico" fieldoption_id="45" data-state-abrv="NM">New Mexico</option>
<option value="New York" fieldoption_id="24" data-state-abrv="NY">New York</option>
<option value="North Carolina" fieldoption_id="19" data-state-abrv="NC">North Carolina</option>
<option value="North Dakota" fieldoption_id="17" data-state-abrv="ND">North Dakota</option>
<option value="Northern Mariana Is." fieldoption_id="57" data-state-abrv="NP">Northern Mariana Is.</option>
<option value="Northern Mariana Islands" fieldoption_id="62" data-state-abrv="MP">Northern Mariana Islands</option>
<option value="Ohio" fieldoption_id="33" data-state-abrv="OH">Ohio</option>
<option value="Oklahoma" fieldoption_id="52" data-state-abrv="OK">Oklahoma</option>
<option value="Oregon" fieldoption_id="15" data-state-abrv="OR">Oregon</option>
<option value="Palau" fieldoption_id="58" data-state-abrv="PW">Palau</option>
<option value="Pennsylvania" fieldoption_id="22" data-state-abrv="PA">Pennsylvania</option>
<option value="Puerto Rico" fieldoption_id="51" data-state-abrv="PR">Puerto Rico</option>
<option value="Rhode Island" fieldoption_id="46" data-state-abrv="RI">Rhode Island</option>
<option value="South Carolina" fieldoption_id="20" data-state-abrv="SC">South Carolina</option>
<option value="South Dakota" fieldoption_id="18" data-state-abrv="SD">South Dakota</option>
<option value="Tennessee" fieldoption_id="27" data-state-abrv="TN">Tennessee</option>
<option value="Texas" fieldoption_id="11" data-state-abrv="TX">Texas</option>
<option value="United States Minor Outlying Islands" fieldoption_id="64" data-state-abrv="UM">United States Minor Outlying Islands</option>
<option value="Utah" fieldoption_id="47" data-state-abrv="UT">Utah</option>
<option value="Vermont" fieldoption_id="32" data-state-abrv="VT">Vermont</option>
<option value="Virgin Islands" fieldoption_id="63" data-state-abrv="VI">Virgin Islands</option>
<option value="Virginia" fieldoption_id="3" data-state-abrv="VA">Virginia</option>
<option value="Washington" fieldoption_id="48" data-state-abrv="WA">Washington</option>
<option value="West Virginia" fieldoption_id="49" data-state-abrv="WV">West Virginia</option>
<option value="Wisconsin" fieldoption_id="16" data-state-abrv="WI">Wisconsin</option>
<option value="Wyoming" fieldoption_id="50" data-state-abrv="WY">Wyoming</option>
</select><input name="ctl00$stateSelected_267205" type="text" id="ctl00_stateSelected_267205" class="single-line-selected-state hidden" data-geo="administrative_area_level_1"><span id="ctl00_reqFieldVal_267205" class="tsVal_itemMarker"
style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_32" class="tsFormRows width50 left-half children-1 divs-0 spans-2 labels-1 has-label">
<label for="ctl00_textBox_267200" id="ctl00_label_267200" class="tsFormLabels ce-label insert-not-required" title="Phone Number">Phone Number<span class="not-required-indicator">(Not Required)</span></label><input name="ctl00$textBox_267200"
type="text" id="ctl00_textBox_267200" class="tsTextBoxes ce-input isDonorPhone insert-not-required"><span id="ctl00_regexFieldValPhone_267200" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_33" class="tsFormRows width50 right-half children-1 divs-0 spans-3 labels-1 has-label">
<label for="ctl00_textBox_267235" id="ctl00_label_267235" class="tsFormLabels ce-label" title="Email Address">Email Address</label><input name="ctl00$textBox_267235" type="text" maxlength="250" id="ctl00_textBox_267235"
class="tsTextBoxes ce-input isEmail ts_requiredField" aria-required="true" aria-invalid="false" data-validation-message=""><span id="email-subtext">Your donation receipt will be sent to this address.</span><span
id="ctl00_reqFieldVal_267235" class="tsVal_itemMarker" style="display:none;">*</span><span id="ctl00_regexFieldValEmail_267235" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<hr class="thin-border border-above">
<div id="ctl00_tsFormRow_34" class="tsFormRows insert-hr-above checkbox-row checked-checkbox-row btn-row children-1 divs-0 spans-2 labels-0 no-label">
<span id="ctl00_checkBoxList_267236" class="tsCheckBoxLists isEmailOptIn horizontal-btn-row"><span fieldoption_id="642605"><input id="ctl00_checkBoxList_267236_0" type="checkbox" name="ctl00$checkBoxList_267236$0" checked="checked"
value="1"><label for="ctl00_checkBoxList_267236_0" class="remaining-width-minus-checkbox">Yes, I would like to receive communications from WWP with updates on warriors and programs.</label></span></span>
</div>
<div id="ctl00_tsFormRow_35" class="tsFormRows checkbox-row btn-row children-1 divs-0 spans-2 labels-0 no-label">
<span id="ctl00_checkBoxList_267237" class="tsCheckBoxLists toggle-org-row-checkbox horizontal-btn-row"><span fieldoption_id="642606"><input id="ctl00_checkBoxList_267237_0" type="checkbox" name="ctl00$checkBoxList_267237$0" value="1"><label
for="ctl00_checkBoxList_267237_0" class="remaining-width-minus-checkbox">This donation is on behalf of a company.</label></span></span>
</div>
<div id="ctl00_tsFormRow_36" class="tsFormRows width50 left-half org-row insert-hr-below children-1 divs-0 spans-0 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267238" id="ctl00_label_267238" class="tsFormLabels ce-label required-if-visible" title="Company/Foundation">Company/Foundation</label><input name="ctl00$textBox_267238" type="text" id="ctl00_textBox_267238"
class="tsTextBoxes ce-input isDonorCompanyName required-if-visible">
</div>
<hr class="thin-border border-below">
</fieldset>
<fieldset id="fieldset_19343" class="tsFieldSets ce-fieldset payment-fieldset fieldset5" data-step="step5"><img src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2019/4/18/secured-by-geotrust2.png" alt="secured by geotrust"
id="payment-secured-img">
<legend id="legend_19343" class="tsLegends ce-legend">
<div class="mobile-legend-number">3</div>Payment Information
</legend>
<div id="ctl00_tsFormRow_37" class="tsFormRows payment-type-row btn-row children-3 divs-0 spans-4 labels-1 has-label">
<label for="ctl00_radioButtonList_267240" id="ctl00_label_267240" class="tsFormLabels ce-label hidden-label ce-radio-checkbox-set-label" title="Payment Method">Payment Method</label><input id="ctl00_radioButtonList_267240_selectedIndexValue"
name="ctl00_radioButtonList_267240_selectedIndexValue" type="hidden" value="0"><span id="ctl00_radioButtonList_267240" class="tsRadioButtonLists isPaymentType_id hidden-label horizontal-btn-row" data-value="1"><span fieldoption_id="642607"
onchange="on_radioButtonList_267240_changed(this);" data-index="0" data-parent="ctl00_radioButtonList_267240" class="pt-cc-span radio-btn-span-active visible-span"><input id="ctl00_radioButtonList_267240_0" type="radio"
name="ctl00$radioButtonList_267240" value="1" checked="checked" onclick="document.getElementById('ctl00_radioButtonList_267240_selectedIndexValue').value = 0;"><label for="ctl00_radioButtonList_267240_0"
class="remaining-width-minus-checkbox">Credit Card</label></span><span fieldoption_id="642609" onchange="on_radioButtonList_267240_changed(this);" data-index="1" data-parent="ctl00_radioButtonList_267240"
class="pt-paypal-span paypal-span visible-span" style="display: inline-block !important;"><input id="ctl00_radioButtonList_267240_1" type="radio" name="ctl00$radioButtonList_267240" value="9"
onclick="document.getElementById('ctl00_radioButtonList_267240_selectedIndexValue').value = 1;"><label for="ctl00_radioButtonList_267240_1" class="remaining-width-minus-checkbox">PayPal</label></span><span fieldoption_id="642608"
onchange="on_radioButtonList_267240_changed(this);" data-index="2" data-parent="ctl00_radioButtonList_267240" class="pt-echeck-span visible-span last-visible-span"><input id="ctl00_radioButtonList_267240_2" type="radio"
name="ctl00$radioButtonList_267240" value="2" onclick="document.getElementById('ctl00_radioButtonList_267240_selectedIndexValue').value = 2;"><label for="ctl00_radioButtonList_267240_2"
class="remaining-width-minus-checkbox">Check</label></span></span>
<script>
function on_radioButtonList_267240_changed(elem) {
var parentElem = document.getElementById(elem.getAttribute('data-parent'));
if (parentElem) {
var currentChecked = parentElem.querySelector('input[type="radio"]:checked');
if (currentChecked) {
document.getElementById('ctl00_radioButtonList_267240_selectedIndexValue').value = elem.getAttribute('data-index');
parentElem.setAttribute('data-value', currentChecked.value);
}
}
}
(function on_radioButtonList_267240_loaded() {
//IE11 polyfill for dispatchEvent
(function() {
if (typeof window.Event === 'function') return false;
function Event(event, params) {
params = params || {
bubbles: false,
cancelable: false,
detail: null
};
var evt = document.createEvent('Event');
evt.initEvent('change', true, true);
return evt;
}
window.Event = Event;
})();
var elem = document.getElementById('ctl00_radioButtonList_267240');
if (elem) {
var defaultChecked = elem.querySelector('input:checked')
if (defaultChecked) elem.setAttribute('data-value', defaultChecked.value)
elem.getValue = function() {
return document.getElementById('ctl00_radioButtonList_267240').getAttribute('data-value');
}
//Set value
elem.setValue = function(value) {
//get control ref
var me = document.getElementById('ctl00_radioButtonList_267240');
//get radio that matches the given value
var matchedOption = me.querySelector('input[type="radio"][value="' + value + '"]');
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
}
//Set value by the label
elem.setValueFor = function(label, value) {
var me = document.getElementById('ctl00_radioButtonList_267240');
var givenLabel = document.evaluate('//label[text()="' + label + '"]', me, null, XPathResult.ANY_TYPE, null).iterateNext();
if (givenLabel) {
var matchedOption = document.getElementById(givenLabel.getAttribute('for'));
if (matchedOption) {
matchedOption.checked = true;
me.setAttribute('data-value', value);
matchedOption.dispatchEvent(new Event('change'));
//clear previous highlighted
var prevChecked = me.querySelector('label.active');
if (prevChecked) {
prevChecked.classList.remove('active');
}
//highlight new value
var matchedOptionLabel = me.querySelector('label[for="' + matchedOption.id + '"]');
if (matchedOptionLabel) {
matchedOptionLabel.classList.add('active');
}
}
} else {
console.error('cant find option "' + label + '" on control ctl00_radioButtonList_267240');
}
}
}
})();
</script>
</div>
<div class="visible-xs" id="geotrust-mobile-container">
<hr id="geotrust-divider"><img src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2019/4/18/secured-by-geotrust2.png" alt="secured by geotrust" id="payment-secured-img-mobile">
</div>
<div id="ctl00_tsFormRow_38" class="tsFormRows width50 left-half cc-row children-2 divs-0 spans-3 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_textBox_267207" id="ctl00_label_267207" class="tsFormLabels ce-label required-if-visible" title="Credit Card Number">Credit Card Number</label><input name="ctl00$textBox_267207" type="text" id="ctl00_textBox_267207"
class="tsTextBoxes ce-input transCC required-if-visible" onkeyup="numericFilter(this);limit(this,16)" placeholder="•••• •••• •••• ••••" maxlength="16"><span id="ctl00_regexFieldValInteger_267207" class="tsVal_itemMarker"
style="display:none;">*</span><span id="ctl00_customCcNumNumVal_267207" class="tsVal_itemMarker" style="display:none;">*</span><select name="ctl00$sysCreditCardTypes_267208" id="ctl00_sysCreditCardTypes_267208"
class="tsDropDownLists ts_requiredField tsDropDownLists_creditCardTypes cc-type-images" aria-required="true" aria-invalid="false" data-validation-message="">
<option value="1">Visa</option>
<option value="2">MasterCard</option>
<option value="3">AmericanExpress</option>
<option value="4">Discover</option>
</select><span id="ctl00_reqFieldVal_267208" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_39" class="tsFormRows cc-row width50 right-half children-2 divs-0 spans-2 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_sysCreditCardExpirationMonths_267209" id="ctl00_label_267209" class="tsFormLabels ce-label" title="Expiration Date">Expiration Date</label><select name="ctl00$sysCreditCardExpirationMonths_267209"
id="ctl00_sysCreditCardExpirationMonths_267209" class="tsDropDownLists ts_requiredField tsDropDownLists_creditCardExpirationMonths" data-defaultvaluelabel="MM - Month" data-hasdefaultvalue="true" aria-required="true" aria-invalid="false"
data-validation-message="">
<option value="0">MM - Month</option>
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select><span id="ctl00_reqFieldVal_267209" class="tsVal_itemMarker" style="display:none;">*</span><select name="ctl00$sysCreditCardExpirationYears_267210" id="ctl00_sysCreditCardExpirationYears_267210"
class="tsDropDownLists hidden-label ts_requiredField tsDropDownLists_creditCardExpirationYears" data-defaultvaluelabel="YYYY - Year" data-hasdefaultvalue="true" aria-required="true" aria-invalid="false" data-validation-message="">
<option value="0">YYYY - Year</option>
<option value="22">2022</option>
<option value="23">2023</option>
<option value="24">2024</option>
<option value="25">2025</option>
<option value="26">2026</option>
<option value="27">2027</option>
<option value="28">2028</option>
<option value="29">2029</option>
<option value="30">2030</option>
<option value="31">2031</option>
<option value="32">2032</option>
<option value="33">2033</option>
<option value="34">2034</option>
<option value="35">2035</option>
<option value="36">2036</option>
<option value="37">2037</option>
</select><span id="ctl00_reqFieldVal_267210" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_40" class="tsFormRows width50 left-half ach-row children-1 divs-0 spans-1 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267241" id="ctl00_label_267241" class="tsFormLabels ce-label insert-tooltip-routing required-if-visible" title="Routing Number">Routing Number</label><img
src="https://support.woundedwarriorproject.org/_transactionServerFiles/745/2015/4/1/tooltip-icon.jpg" alt="tooltip" class="ach-tooltip tooltipstered" id="ach-tooltip-routing-number"><input name="ctl00$textBox_267241" type="text"
id="ctl00_textBox_267241" class="tsTextBoxes ce-input isAchRoutingNumber insert-tooltip-routing required-if-visible" onkeyup="numericFilter(this);"><span id="ctl00_customRoutingNumVal_267241" class="tsVal_itemMarker"
style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_41" class="tsFormRows width50 right-half ach-row children-1 divs-0 spans-1 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267242" id="ctl00_label_267242" class="tsFormLabels ce-label insert-tooltip-account required-if-visible" title="Account Number">Account Number</label><img
src="https://support.woundedwarriorproject.org/_transactionServerFiles/745/2015/4/1/tooltip-icon.jpg" alt="tooltip" class="ach-tooltip tooltipstered" id="ach-tooltip-account-number"><input name="ctl00$textBox_267242" type="text"
id="ctl00_textBox_267242" class="tsTextBoxes ce-input isAchAccountNumber insert-tooltip-account required-if-visible" onkeyup="numericFilter(this);"><span id="ctl00_customAccountNumVal_267242" class="tsVal_itemMarker"
style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_42" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267243" id="ctl00_label_267243" class="tsFormLabels ce-label hidden-label" title="Bank Account Type">Bank Account Type</label><input name="ctl00$textBox_267243" type="text" value="2" id="ctl00_textBox_267243"
class="tsTextBoxes ce-input isAchBankAccountType_id hidden-label">
</div>
<div id="ctl00_tsFormRow_43" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267244" id="ctl00_label_267244" class="tsFormLabels ce-label" title="Check Number">Check Number</label><input name="ctl00$textBox_267244" type="text" value="1" id="ctl00_textBox_267244"
class="tsTextBoxes ce-input isAchCheckNumber">
</div>
<div id="ctl00_tsFormRow_44" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267245" id="ctl00_label_267245" class="tsFormLabels ce-label" title="ACH Type">ACH Type</label><input name="ctl00$textBox_267245" type="text" value="3" id="ctl00_textBox_267245" class="tsTextBoxes ce-input">
</div>
</fieldset>
<fieldset id="fieldset_19346" class="tsFieldSets ce-fieldset billing-info-fieldset fieldset6" data-step="step6" style="display: inline-block !important;">
<legend id="legend_19346" class="tsLegends ce-legend">
<div class="mobile-legend-number">4</div>Billing Information
</legend>
<div id="ctl00_tsFormRow_45" class="tsFormRows checkbox-row checked-checkbox-row btn-row children-1 divs-0 spans-2 labels-0 no-label">
<span id="ctl00_checkBoxList_267213" class="tsCheckBoxLists billing-info-same-checkbox horizontal-btn-row"><span fieldoption_id="642588"><input id="ctl00_checkBoxList_267213_0" type="checkbox" name="ctl00$checkBoxList_267213$0"
checked="checked" value="1"><label for="ctl00_checkBoxList_267213_0" class="remaining-width-minus-checkbox">Uncheck if your billing address is not the same as your donor address.</label></span></span>
</div>
<div id="ctl00_tsFormRow_46" class="tsFormRows width50 left-half billing-row children-1 divs-0 spans-0 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267211" id="ctl00_label_267211" class="tsFormLabels ce-label" title="Billing Address Line 1">Billing Address Line 1</label><input name="ctl00$textBox_267211" type="text" id="ctl00_textBox_267211"
class="tsTextBoxes ce-input isBillingStreetAddress1">
</div>
<div id="ctl00_tsFormRow_47" class="tsFormRows width50 right-half billing-row children-1 divs-0 spans-1 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267212" id="ctl00_label_267212" class="tsFormLabels ce-label insert-not-required" title="Billing Address Line 2">Billing Address Line 2<span class="not-required-indicator">(Not Required)</span></label><input
name="ctl00$textBox_267212" type="text" id="ctl00_textBox_267212" class="tsTextBoxes ce-input isBillingStreetAddress2 insert-not-required">
</div>
<div id="ctl00_tsFormRow_48" class="tsFormRows billing-row width50 left-half children-1 divs-0 spans-0 labels-1 has-label" style="display: none !important;">
<label for="ctl00_sysCountries_267217" id="ctl00_label_267217" class="tsFormLabels ce-label" title="Billing Country">Billing Country</label><select name="ctl00$sysCountries_267217" id="ctl00_sysCountries_267217"
class="tsDropDownLists tsDropDownLists_countries isCountry" onchange="setState(this,'36');">
<option value=""></option>
<option value="United States" fieldoption_id="36">United States</option>
<option value="Afghanistan" fieldoption_id="37">Afghanistan</option>
<option value="Albania" fieldoption_id="38">Albania</option>
<option value="Algeria" fieldoption_id="39">Algeria</option>
<option value="American Samoa" fieldoption_id="40">American Samoa</option>
<option value="Andorra" fieldoption_id="41">Andorra</option>
<option value="Angola" fieldoption_id="42">Angola</option>
<option value="Anguilla" fieldoption_id="43">Anguilla</option>
<option value="Antarctica" fieldoption_id="44">Antarctica</option>
<option value="Antigua and Barbuda" fieldoption_id="45">Antigua and Barbuda</option>
<option value="Argentina" fieldoption_id="46">Argentina</option>
<option value="Armenia" fieldoption_id="47">Armenia</option>
<option value="Aruba" fieldoption_id="48">Aruba</option>
<option value="Australia" fieldoption_id="49">Australia</option>
<option value="Austria" fieldoption_id="50">Austria</option>
<option value="Azerbaijan" fieldoption_id="51">Azerbaijan</option>
<option value="Bahamas" fieldoption_id="52">Bahamas</option>
<option value="Bahrain" fieldoption_id="53">Bahrain</option>
<option value="Bangladesh" fieldoption_id="54">Bangladesh</option>
<option value="Barbados" fieldoption_id="55">Barbados</option>
<option value="Belarus" fieldoption_id="56">Belarus</option>
<option value="Belgium" fieldoption_id="57">Belgium</option>
<option value="Belize" fieldoption_id="58">Belize</option>
<option value="Benin" fieldoption_id="59">Benin</option>
<option value="Bermuda" fieldoption_id="60">Bermuda</option>
<option value="Bhutan" fieldoption_id="61">Bhutan</option>
<option value="Bolivia" fieldoption_id="62">Bolivia</option>
<option value="Bosnia and Herzegovina" fieldoption_id="63">Bosnia and Herzegovina</option>
<option value="Botswana" fieldoption_id="64">Botswana</option>
<option value="Brazil" fieldoption_id="65">Brazil</option>
<option value="British Indian Ocean Territory" fieldoption_id="66">British Indian Ocean Territory</option>
<option value="Brunei" fieldoption_id="67">Brunei</option>
<option value="Bulgaria" fieldoption_id="68">Bulgaria</option>
<option value="Burkina Faso" fieldoption_id="69">Burkina Faso</option>
<option value="Burundi" fieldoption_id="70">Burundi</option>
<option value="Cambodia" fieldoption_id="71">Cambodia</option>
<option value="Cameroon" fieldoption_id="72">Cameroon</option>
<option value="Canada" fieldoption_id="73">Canada</option>
<option value="Cape Verde" fieldoption_id="74">Cape Verde</option>
<option value="Cayman Islands" fieldoption_id="75">Cayman Islands</option>
<option value="Central African Republic" fieldoption_id="76">Central African Republic</option>
<option value="Chad" fieldoption_id="77">Chad</option>
<option value="Chile" fieldoption_id="78">Chile</option>
<option value="China" fieldoption_id="79">China</option>
<option value="Christmas Islands" fieldoption_id="80">Christmas Islands</option>
<option value="Cocos (Keeling) Islands" fieldoption_id="81">Cocos (Keeling) Islands</option>
<option value="Colombia" fieldoption_id="82">Colombia</option>
<option value="Comoros" fieldoption_id="83">Comoros</option>
<option value="Congo" fieldoption_id="84">Congo</option>
<option value="Congo, Democratic Republic of" fieldoption_id="85">Congo, Democratic Republic of</option>
<option value="Cook Island" fieldoption_id="86">Cook Island</option>
<option value="Costa Rica" fieldoption_id="87">Costa Rica</option>
<option value="Cote Divoire" fieldoption_id="88">Cote Divoire</option>
<option value="Croatia" fieldoption_id="89">Croatia</option>
<option value="Cuba" fieldoption_id="90">Cuba</option>
<option value="Cyprus" fieldoption_id="91">Cyprus</option>
<option value="Czech Republic" fieldoption_id="92">Czech Republic</option>
<option value="Denmark" fieldoption_id="93">Denmark</option>
<option value="Djibouti" fieldoption_id="94">Djibouti</option>
<option value="Dominica" fieldoption_id="95">Dominica</option>
<option value="Dominican Republic" fieldoption_id="96">Dominican Republic</option>
<option value="East Timor" fieldoption_id="97">East Timor</option>
<option value="Egypt" fieldoption_id="98">Egypt</option>
<option value="El Salvador" fieldoption_id="99">El Salvador</option>
<option value="Equador" fieldoption_id="100">Equador</option>
<option value="Equatorial Guinea" fieldoption_id="101">Equatorial Guinea</option>
<option value="Eritrea" fieldoption_id="102">Eritrea</option>
<option value="Estonia" fieldoption_id="103">Estonia</option>
<option value="Ethiopia" fieldoption_id="104">Ethiopia</option>
<option value="Falkland Islands" fieldoption_id="105">Falkland Islands</option>
<option value="Faroe Islands" fieldoption_id="106">Faroe Islands</option>
<option value="Federated States of Micronesia" fieldoption_id="107">Federated States of Micronesia</option>
<option value="Fiji" fieldoption_id="108">Fiji</option>
<option value="Finland" fieldoption_id="109">Finland</option>
<option value="France" fieldoption_id="110">France</option>
<option value="French Guiana" fieldoption_id="111">French Guiana</option>
<option value="French Polynesia" fieldoption_id="112">French Polynesia</option>
<option value="French Southern Territories" fieldoption_id="113">French Southern Territories</option>
<option value="Gabon" fieldoption_id="114">Gabon</option>
<option value="Gambia" fieldoption_id="115">Gambia</option>
<option value="Georgia" fieldoption_id="116">Georgia</option>
<option value="Germany" fieldoption_id="117">Germany</option>
<option value="Ghana" fieldoption_id="118">Ghana</option>
<option value="Gibraltar" fieldoption_id="119">Gibraltar</option>
<option value="Greece" fieldoption_id="120">Greece</option>
<option value="Greenland" fieldoption_id="121">Greenland</option>
<option value="Grenada" fieldoption_id="122">Grenada</option>
<option value="Guadeloupe" fieldoption_id="123">Guadeloupe</option>
<option value="Guam" fieldoption_id="124">Guam</option>
<option value="Guatemala" fieldoption_id="125">Guatemala</option>
<option value="Guinea" fieldoption_id="126">Guinea</option>
<option value="Guinea-Bissau" fieldoption_id="127">Guinea-Bissau</option>
<option value="Guyana" fieldoption_id="128">Guyana</option>
<option value="Haiti" fieldoption_id="129">Haiti</option>
<option value="Heard and Macdonald Islands" fieldoption_id="130">Heard and Macdonald Islands</option>
<option value="Honduras" fieldoption_id="131">Honduras</option>
<option value="Hong Kong" fieldoption_id="132">Hong Kong</option>
<option value="Hungary" fieldoption_id="133">Hungary</option>
<option value="Iceland" fieldoption_id="134">Iceland</option>
<option value="India" fieldoption_id="135">India</option>
<option value="Indonesia" fieldoption_id="136">Indonesia</option>
<option value="Iran" fieldoption_id="137">Iran</option>
<option value="Iraq" fieldoption_id="138">Iraq</option>
<option value="Ireland" fieldoption_id="139">Ireland</option>
<option value="Israel" fieldoption_id="140">Israel</option>
<option value="Italy" fieldoption_id="141">Italy</option>
<option value="Jamaica" fieldoption_id="142">Jamaica</option>
<option value="Japan" fieldoption_id="143">Japan</option>
<option value="Jordan" fieldoption_id="144">Jordan</option>
<option value="Kazakhstan" fieldoption_id="145">Kazakhstan</option>
<option value="Kenya" fieldoption_id="146">Kenya</option>
<option value="Kiribati" fieldoption_id="147">Kiribati</option>
<option value="Korea, North" fieldoption_id="148">Korea, North</option>
<option value="Korea, South" fieldoption_id="149">Korea, South</option>
<option value="Kuwait" fieldoption_id="150">Kuwait</option>
<option value="Kyrgyzstan" fieldoption_id="151">Kyrgyzstan</option>
<option value="Laos" fieldoption_id="152">Laos</option>
<option value="Latvia" fieldoption_id="153">Latvia</option>
<option value="Lebanon" fieldoption_id="154">Lebanon</option>
<option value="Lesotho" fieldoption_id="155">Lesotho</option>
<option value="Liberia" fieldoption_id="156">Liberia</option>
<option value="Libya" fieldoption_id="157">Libya</option>
<option value="Liechtenstein" fieldoption_id="158">Liechtenstein</option>
<option value="Lithuania" fieldoption_id="159">Lithuania</option>
<option value="Luxembourg" fieldoption_id="160">Luxembourg</option>
<option value="Macau" fieldoption_id="161">Macau</option>
<option value="Macedonia (Rep. of Fmr Yugoslav)" fieldoption_id="162">Macedonia (Rep. of Fmr Yugoslav)</option>
<option value="Madagascar" fieldoption_id="163">Madagascar</option>
<option value="Malawi" fieldoption_id="164">Malawi</option>
<option value="Malaysia" fieldoption_id="165">Malaysia</option>
<option value="Maldives" fieldoption_id="166">Maldives</option>
<option value="Mali" fieldoption_id="167">Mali</option>
<option value="Malta" fieldoption_id="168">Malta</option>
<option value="Marshall Islands" fieldoption_id="169">Marshall Islands</option>
<option value="Martinique" fieldoption_id="170">Martinique</option>
<option value="Mauritania" fieldoption_id="171">Mauritania</option>
<option value="Mauritius" fieldoption_id="172">Mauritius</option>
<option value="Mayotte" fieldoption_id="173">Mayotte</option>
<option value="Metropolitan France" fieldoption_id="174">Metropolitan France</option>
<option value="Mexico" fieldoption_id="175">Mexico</option>
<option value="Moldova" fieldoption_id="176">Moldova</option>
<option value="Monaco" fieldoption_id="177">Monaco</option>
<option value="Mongolia" fieldoption_id="178">Mongolia</option>
<option value="Montenegro" fieldoption_id="277">Montenegro</option>
<option value="Montserrat" fieldoption_id="179">Montserrat</option>
<option value="Morocco" fieldoption_id="180">Morocco</option>
<option value="Mozambique" fieldoption_id="181">Mozambique</option>
<option value="Myanmar" fieldoption_id="182">Myanmar</option>
<option value="Namibia" fieldoption_id="183">Namibia</option>
<option value="Nauru" fieldoption_id="184">Nauru</option>
<option value="Nepal" fieldoption_id="185">Nepal</option>
<option value="Netherlands" fieldoption_id="186">Netherlands</option>
<option value="Netherlands Antilles" fieldoption_id="187">Netherlands Antilles</option>
<option value="New Caledonia" fieldoption_id="188">New Caledonia</option>
<option value="New Zealand" fieldoption_id="189">New Zealand</option>
<option value="Nicaragua" fieldoption_id="190">Nicaragua</option>
<option value="Niger" fieldoption_id="192">Niger</option>
<option value="Nigeria" fieldoption_id="193">Nigeria</option>
<option value="Niue" fieldoption_id="191">Niue</option>
<option value="Norfolk Island" fieldoption_id="194">Norfolk Island</option>
<option value="Northern Mariana Islands" fieldoption_id="195">Northern Mariana Islands</option>
<option value="Norway" fieldoption_id="196">Norway</option>
<option value="Oman" fieldoption_id="197">Oman</option>
<option value="Pakistan" fieldoption_id="198">Pakistan</option>
<option value="Palau" fieldoption_id="199">Palau</option>
<option value="Palestinian Territory, Occupied" fieldoption_id="200">Palestinian Territory, Occupied</option>
<option value="Panama" fieldoption_id="201">Panama</option>
<option value="Papua New Guinea" fieldoption_id="202">Papua New Guinea</option>
<option value="Paraguay" fieldoption_id="203">Paraguay</option>
<option value="Peru" fieldoption_id="204">Peru</option>
<option value="Philippines" fieldoption_id="205">Philippines</option>
<option value="Pitcairn" fieldoption_id="206">Pitcairn</option>
<option value="Poland" fieldoption_id="207">Poland</option>
<option value="Portugal" fieldoption_id="208">Portugal</option>
<option value="Puerto Rico" fieldoption_id="209">Puerto Rico</option>
<option value="Qatar" fieldoption_id="210">Qatar</option>
<option value="Reunion" fieldoption_id="211">Reunion</option>
<option value="Romania" fieldoption_id="212">Romania</option>
<option value="Russia" fieldoption_id="213">Russia</option>
<option value="Rwanda" fieldoption_id="214">Rwanda</option>
<option value="S. Georgia and S. Sandwich Islands" fieldoption_id="215">S. Georgia and S. Sandwich Islands</option>
<option value="Samoa" fieldoption_id="216">Samoa</option>
<option value="San Marino" fieldoption_id="217">San Marino</option>
<option value="Sao Tome and Principe" fieldoption_id="218">Sao Tome and Principe</option>
<option value="Saudi Arabia" fieldoption_id="219">Saudi Arabia</option>
<option value="Senegal" fieldoption_id="220">Senegal</option>
<option value="Serbia" fieldoption_id="276">Serbia</option>
<option value="Seychelles" fieldoption_id="221">Seychelles</option>
<option value="Sierra Leone" fieldoption_id="222">Sierra Leone</option>
<option value="Singapore" fieldoption_id="223">Singapore</option>
<option value="Slovakia" fieldoption_id="224">Slovakia</option>
<option value="Slovenia" fieldoption_id="225">Slovenia</option>
<option value="Solomon Islands" fieldoption_id="226">Solomon Islands</option>
<option value="Somalia" fieldoption_id="227">Somalia</option>
<option value="South Africa" fieldoption_id="228">South Africa</option>
<option value="Spain" fieldoption_id="229">Spain</option>
<option value="Sri Lanka" fieldoption_id="230">Sri Lanka</option>
<option value="St Helena" fieldoption_id="231">St Helena</option>
<option value="St Kitts and Nevis" fieldoption_id="232">St Kitts and Nevis</option>
<option value="St Lucia" fieldoption_id="233">St Lucia</option>
<option value="St Pierre and Miquelon" fieldoption_id="234">St Pierre and Miquelon</option>
<option value="St Vincent and the Grenadines" fieldoption_id="235">St Vincent and the Grenadines</option>
<option value="Sudan" fieldoption_id="236">Sudan</option>
<option value="Suriname" fieldoption_id="237">Suriname</option>
<option value="Svalbard and Jan Mayen Islands" fieldoption_id="238">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland" fieldoption_id="239">Swaziland</option>
<option value="Sweden" fieldoption_id="240">Sweden</option>
<option value="Switzerland" fieldoption_id="241">Switzerland</option>
<option value="Syria" fieldoption_id="242">Syria</option>
<option value="Taiwan" fieldoption_id="243">Taiwan</option>
<option value="Tajikistan" fieldoption_id="244">Tajikistan</option>
<option value="Tanzania" fieldoption_id="245">Tanzania</option>
<option value="Thailand" fieldoption_id="246">Thailand</option>
<option value="Togo" fieldoption_id="247">Togo</option>
<option value="Tokelau" fieldoption_id="248">Tokelau</option>
<option value="Tonga" fieldoption_id="249">Tonga</option>
<option value="Trinidad and Tobago" fieldoption_id="250">Trinidad and Tobago</option>
<option value="Tunisia" fieldoption_id="251">Tunisia</option>
<option value="Turkey" fieldoption_id="252">Turkey</option>
<option value="Turkmenistan" fieldoption_id="253">Turkmenistan</option>
<option value="Turks and Caicos Islands" fieldoption_id="254">Turks and Caicos Islands</option>
<option value="Tuvalu" fieldoption_id="255">Tuvalu</option>
<option value="Uganda" fieldoption_id="256">Uganda</option>
<option value="Ukraine" fieldoption_id="257">Ukraine</option>
<option value="United Arab Emirates" fieldoption_id="258">United Arab Emirates</option>
<option value="United Kingdom" fieldoption_id="259">United Kingdom</option>
<option value="United States Minor Outlying Islands" fieldoption_id="260">United States Minor Outlying Islands</option>
<option value="Uruguay" fieldoption_id="261">Uruguay</option>
<option value="Uzbekistan" fieldoption_id="262">Uzbekistan</option>
<option value="Vanuatu" fieldoption_id="263">Vanuatu</option>
<option value="Vatican City" fieldoption_id="264">Vatican City</option>
<option value="Venezuela" fieldoption_id="265">Venezuela</option>
<option value="Vietnam" fieldoption_id="266">Vietnam</option>
<option value="Virgin Islands - British" fieldoption_id="267">Virgin Islands - British</option>
<option value="Virgin Islands - US" fieldoption_id="268">Virgin Islands - US</option>
<option value="Wallis and Futuna Islands" fieldoption_id="269">Wallis and Futuna Islands</option>
<option value="Western Sahara" fieldoption_id="270">Western Sahara</option>
<option value="Yemen" fieldoption_id="271">Yemen</option>
<option value="Yugoslavia" fieldoption_id="272">Yugoslavia</option>
<option value="Zaire" fieldoption_id="273">Zaire</option>
<option value="Zambia" fieldoption_id="274">Zambia</option>
<option value="Zimbabwe" fieldoption_id="275">Zimbabwe</option>
</select>
<script>
document.addEventListener('DOMContentLoaded', function() {
setState(document.getElementById('ctl00_sysCountries_267217'), '36', true);
});
</script>
</div>
<div id="ctl00_tsFormRow_49" class="tsFormRows billing-row width50 right-half children-1 divs-0 spans-1 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267214" id="ctl00_label_267214" class="tsFormLabels ce-label" title="Billing ZIP Code">Billing ZIP Code</label><input name="ctl00$textBox_267214" type="text" id="ctl00_textBox_267214"
class="tsTextBoxes ce-input isZip PopulateCityStateEnabled" onchange="populateCityState(this);"><span id="ctl00_regexFieldValZip_267214" class="tsVal_itemMarker" style="display:none;">*</span>
</div>
<div id="ctl00_tsFormRow_50" class="tsFormRows billing-row width50 left-half children-1 divs-0 spans-0 labels-1 has-label" style="display: none !important;">
<label for="ctl00_textBox_267215" id="ctl00_label_267215" class="tsFormLabels ce-label" title="Billing City">Billing City</label><input name="ctl00$textBox_267215" type="text" id="ctl00_textBox_267215" class="tsTextBoxes ce-input isCity">
</div>
<div id="ctl00_tsFormRow_51" class="tsFormRows billing-row width50 right-half children-1 divs-0 spans-0 labels-1 has-label" style="display: none !important;">
<label for="ctl00_sysUsStates_267216" id="ctl00_label_267216" class="tsFormLabels ce-label" title="Billing State">Billing State</label><select name="ctl00$sysUsStates_267216" id="ctl00_sysUsStates_267216"
class="tsDropDownLists tsDropDownLists_usStates isState" data-defaultvaluelabel="" data-hasdefaultvalue="true">
<option value="0"></option>
<option value=""></option>
<option value="Alabama" fieldoption_id="5" data-state-abrv="AL">Alabama</option>
<option value="Alaska" fieldoption_id="4" data-state-abrv="AK">Alaska</option>
<option value="American Samoa" fieldoption_id="53" data-state-abrv="AS">American Samoa</option>
<option value="Arizona" fieldoption_id="29" data-state-abrv="AZ">Arizona</option>
<option value="Arkansas" fieldoption_id="13" data-state-abrv="AR">Arkansas</option>
<option value="Armed Forces Europe" fieldoption_id="60" data-state-abrv="AE">Armed Forces Europe</option>
<option value="Armed Forces Pacific" fieldoption_id="61" data-state-abrv="AP">Armed Forces Pacific</option>
<option value="Armed Forces the Americas" fieldoption_id="59" data-state-abrv="AA">Armed Forces the Americas</option>
<option value="California" fieldoption_id="10" data-state-abrv="CA">California</option>
<option value="Colorado" fieldoption_id="34" data-state-abrv="CO">Colorado</option>
<option value="Connecticut" fieldoption_id="14" data-state-abrv="CT">Connecticut</option>
<option value="Delaware" fieldoption_id="35" data-state-abrv="DE">Delaware</option>
<option value="District of Columbia" fieldoption_id="2" data-state-abrv="DC">District of Columbia</option>
<option value="Fed. States of Micronesia" fieldoption_id="54" data-state-abrv="FM">Fed. States of Micronesia</option>
<option value="Florida" fieldoption_id="21" data-state-abrv="FL">Florida</option>
<option value="Georgia" fieldoption_id="30" data-state-abrv="GA">Georgia</option>
<option value="Guam" fieldoption_id="55" data-state-abrv="GU">Guam</option>
<option value="Hawaii" fieldoption_id="9" data-state-abrv="HI">Hawaii</option>
<option value="Idaho" fieldoption_id="36" data-state-abrv="ID">Idaho</option>
<option value="Illinois" fieldoption_id="25" data-state-abrv="IL">Illinois</option>
<option value="Indiana" fieldoption_id="26" data-state-abrv="IN">Indiana</option>
<option value="Iowa" fieldoption_id="37" data-state-abrv="IA">Iowa</option>
<option value="Kansas" fieldoption_id="8" data-state-abrv="KS">Kansas</option>
<option value="Kentucky" fieldoption_id="28" data-state-abrv="KY">Kentucky</option>
<option value="Louisiana" fieldoption_id="38" data-state-abrv="LA">Louisiana</option>
<option value="Maine" fieldoption_id="39" data-state-abrv="ME">Maine</option>
<option value="Marshall Islands" fieldoption_id="56" data-state-abrv="MH">Marshall Islands</option>
<option value="Maryland" fieldoption_id="1" data-state-abrv="MD">Maryland</option>
<option value="Massachusetts" fieldoption_id="41" data-state-abrv="MA">Massachusetts</option>
<option value="Michigan" fieldoption_id="6" data-state-abrv="MI">Michigan</option>
<option value="Minnesota" fieldoption_id="42" data-state-abrv="MN">Minnesota</option>
<option value="Mississippi" fieldoption_id="7" data-state-abrv="MS">Mississippi</option>
<option value="Missouri" fieldoption_id="12" data-state-abrv="MO">Missouri</option>
<option value="Montana" fieldoption_id="40" data-state-abrv="MT">Montana</option>
<option value="Nebraska" fieldoption_id="43" data-state-abrv="NE">Nebraska</option>
<option value="Nevada" fieldoption_id="44" data-state-abrv="NV">Nevada</option>
<option value="New Hampshire" fieldoption_id="31" data-state-abrv="NH">New Hampshire</option>
<option value="New Jersey" fieldoption_id="23" data-state-abrv="NJ">New Jersey</option>
<option value="New Mexico" fieldoption_id="45" data-state-abrv="NM">New Mexico</option>
<option value="New York" fieldoption_id="24" data-state-abrv="NY">New York</option>
<option value="North Carolina" fieldoption_id="19" data-state-abrv="NC">North Carolina</option>
<option value="North Dakota" fieldoption_id="17" data-state-abrv="ND">North Dakota</option>
<option value="Northern Mariana Is." fieldoption_id="57" data-state-abrv="NP">Northern Mariana Is.</option>
<option value="Northern Mariana Islands" fieldoption_id="62" data-state-abrv="MP">Northern Mariana Islands</option>
<option value="Ohio" fieldoption_id="33" data-state-abrv="OH">Ohio</option>
<option value="Oklahoma" fieldoption_id="52" data-state-abrv="OK">Oklahoma</option>
<option value="Oregon" fieldoption_id="15" data-state-abrv="OR">Oregon</option>
<option value="Palau" fieldoption_id="58" data-state-abrv="PW">Palau</option>
<option value="Pennsylvania" fieldoption_id="22" data-state-abrv="PA">Pennsylvania</option>
<option value="Puerto Rico" fieldoption_id="51" data-state-abrv="PR">Puerto Rico</option>
<option value="Rhode Island" fieldoption_id="46" data-state-abrv="RI">Rhode Island</option>
<option value="South Carolina" fieldoption_id="20" data-state-abrv="SC">South Carolina</option>
<option value="South Dakota" fieldoption_id="18" data-state-abrv="SD">South Dakota</option>
<option value="Tennessee" fieldoption_id="27" data-state-abrv="TN">Tennessee</option>
<option value="Texas" fieldoption_id="11" data-state-abrv="TX">Texas</option>
<option value="United States Minor Outlying Islands" fieldoption_id="64" data-state-abrv="UM">United States Minor Outlying Islands</option>
<option value="Utah" fieldoption_id="47" data-state-abrv="UT">Utah</option>
<option value="Vermont" fieldoption_id="32" data-state-abrv="VT">Vermont</option>
<option value="Virgin Islands" fieldoption_id="63" data-state-abrv="VI">Virgin Islands</option>
<option value="Virginia" fieldoption_id="3" data-state-abrv="VA">Virginia</option>
<option value="Washington" fieldoption_id="48" data-state-abrv="WA">Washington</option>
<option value="West Virginia" fieldoption_id="49" data-state-abrv="WV">West Virginia</option>
<option value="Wisconsin" fieldoption_id="16" data-state-abrv="WI">Wisconsin</option>
<option value="Wyoming" fieldoption_id="50" data-state-abrv="WY">Wyoming</option>
</select>
</div>
</fieldset>
<fieldset id="fieldset_19344" class="tsFieldSets ce-fieldset tribute-fieldset fieldset7" data-step="step7" style="display: none !important;">
<legend id="legend_19344" class="tsLegends ce-legend">Honor / Memory Acknowledgement Information</legend>
<div id="ctl00_tsFormRow_52" class="tsFormRows width50 left-half children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_ddl_sysTributeType_267218" id="ctl00_label_267218" class="tsFormLabels ce-label required-if-visible" title="Tribute Type">Tribute Type</label><select name="ctl00$ddl_sysTributeType_267218"
id="ctl00_ddl_sysTributeType_267218" class="tsDropDownLists required-if-visible tsDropDownLists_sysTributeType" data-defaultvaluelabel="" data-hasdefaultvalue="true">
<option value="0"></option>
<option value="1" fieldoption_id="1">In Honor of</option>
<option value="2" fieldoption_id="2">In Memory of</option>
</select>
</div>
<div id="ctl00_tsFormRow_53" class="tsFormRows width50 right-half children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_tb_sysTributeName_267219" id="ctl00_label_267219" class="tsFormLabels ce-label required-if-visible" title="Tribute's Name">Tribute's Name</label><input name="ctl00$tb_sysTributeName_267219" type="text" maxlength="150"
id="ctl00_tb_sysTributeName_267219" class="tsTextBoxes tsTextBoxes_sysTributeName required-if-visible">
</div>
<div id="ctl00_tsFormRow_54" class="tsFormRows width100 checkbox-row checked-checkbox-row btn-row children-1 divs-0 spans-2 labels-0 no-label">
<span id="ctl00_checkBoxList_267229" class="tsCheckBoxLists tribute-announcement-type horizontal-btn-row"><span fieldoption_id="642592"><input id="ctl00_checkBoxList_267229_0" type="checkbox" name="ctl00$checkBoxList_267229$0"
checked="checked" value="1"><label for="ctl00_checkBoxList_267229_0" class="remaining-width-minus-checkbox">Mail an acknowledgement of my donation.</label></span></span>
</div>
<div id="ctl00_tsFormRow_55" class="tsFormRows tribute-mail-row no-margin-bottom children-0 divs-1 spans-0 labels-0 no-label" style="display: inline-block !important;">
<div id="ctl00_contentBlock_267253" class="tsContentBlocks"> Mail acknowledgement to: </div>
</div>
<div id="ctl00_tsFormRow_56" class="tsFormRows width50 left-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_tb_sysTributeAckFirstName_267221" id="ctl00_label_267221" class="tsFormLabels ce-label required-if-visible" title="Recipient First Name">Recipient First Name</label><input name="ctl00$tb_sysTributeAckFirstName_267221"
type="text" maxlength="100" id="ctl00_tb_sysTributeAckFirstName_267221" class="tsTextBoxes tsTextBoxes_sysTributeAckFirstName required-if-visible" placeholder="First Name">
</div>
<div id="ctl00_tsFormRow_57" class="tsFormRows width50 right-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_tb_sysTributeAckLastName_267222" id="ctl00_label_267222" class="tsFormLabels ce-label" title="Recipient Last Name">Recipient Last Name</label><input name="ctl00$tb_sysTributeAckLastName_267222" type="text" maxlength="100"
id="ctl00_tb_sysTributeAckLastName_267222" class="tsTextBoxes tsTextBoxes_sysTributeAckLastName" placeholder="Last Name">
</div>
<div id="ctl00_tsFormRow_58" class="tsFormRows width50 left-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_tb_sysTributeAckAddress1_267223" id="ctl00_label_267223" class="tsFormLabels ce-label required-if-visible" title="Recipient Address Line 1">Recipient Address Line 1</label><input name="ctl00$tb_sysTributeAckAddress1_267223"
type="text" maxlength="100" id="ctl00_tb_sysTributeAckAddress1_267223" class="tsTextBoxes tsTextBoxes_sysTributeAckAddress1 required-if-visible">
</div>
<div id="ctl00_tsFormRow_59" class="tsFormRows width50 right-half tribute-mail-row children-1 divs-0 spans-1 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_tb_sysTributeAckAddress2_267224" id="ctl00_label_267224" class="tsFormLabels ce-label insert-not-required" title="Recipient Address Line 2">Recipient Address Line 2<span class="not-required-indicator">(Not
Required)</span></label><input name="ctl00$tb_sysTributeAckAddress2_267224" type="text" maxlength="100" id="ctl00_tb_sysTributeAckAddress2_267224" class="tsTextBoxes tsTextBoxes_sysTributeAckAddress2 insert-not-required">
</div>
<div id="ctl00_tsFormRow_60" class="tsFormRows width50 left-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_ddl_sysTributeAckCountry_267230" id="ctl00_label_267230" class="tsFormLabels ce-label" title="Recipient Country">Recipient Country</label><select name="ctl00$ddl_sysTributeAckCountry_267230"
id="ctl00_ddl_sysTributeAckCountry_267230" class="tsDropDownLists tsDropDownLists_sysTributeAckCountry tsDropDownLists_countries" onchange="setState(this,'36');">
<option value=""></option>
<option value="United States" fieldoption_id="36">United States</option>
<option value="Afghanistan" fieldoption_id="37">Afghanistan</option>
<option value="Albania" fieldoption_id="38">Albania</option>
<option value="Algeria" fieldoption_id="39">Algeria</option>
<option value="American Samoa" fieldoption_id="40">American Samoa</option>
<option value="Andorra" fieldoption_id="41">Andorra</option>
<option value="Angola" fieldoption_id="42">Angola</option>
<option value="Anguilla" fieldoption_id="43">Anguilla</option>
<option value="Antarctica" fieldoption_id="44">Antarctica</option>
<option value="Antigua and Barbuda" fieldoption_id="45">Antigua and Barbuda</option>
<option value="Argentina" fieldoption_id="46">Argentina</option>
<option value="Armenia" fieldoption_id="47">Armenia</option>
<option value="Aruba" fieldoption_id="48">Aruba</option>
<option value="Australia" fieldoption_id="49">Australia</option>
<option value="Austria" fieldoption_id="50">Austria</option>
<option value="Azerbaijan" fieldoption_id="51">Azerbaijan</option>
<option value="Bahamas" fieldoption_id="52">Bahamas</option>
<option value="Bahrain" fieldoption_id="53">Bahrain</option>
<option value="Bangladesh" fieldoption_id="54">Bangladesh</option>
<option value="Barbados" fieldoption_id="55">Barbados</option>
<option value="Belarus" fieldoption_id="56">Belarus</option>
<option value="Belgium" fieldoption_id="57">Belgium</option>
<option value="Belize" fieldoption_id="58">Belize</option>
<option value="Benin" fieldoption_id="59">Benin</option>
<option value="Bermuda" fieldoption_id="60">Bermuda</option>
<option value="Bhutan" fieldoption_id="61">Bhutan</option>
<option value="Bolivia" fieldoption_id="62">Bolivia</option>
<option value="Bosnia and Herzegovina" fieldoption_id="63">Bosnia and Herzegovina</option>
<option value="Botswana" fieldoption_id="64">Botswana</option>
<option value="Brazil" fieldoption_id="65">Brazil</option>
<option value="British Indian Ocean Territory" fieldoption_id="66">British Indian Ocean Territory</option>
<option value="Brunei" fieldoption_id="67">Brunei</option>
<option value="Bulgaria" fieldoption_id="68">Bulgaria</option>
<option value="Burkina Faso" fieldoption_id="69">Burkina Faso</option>
<option value="Burundi" fieldoption_id="70">Burundi</option>
<option value="Cambodia" fieldoption_id="71">Cambodia</option>
<option value="Cameroon" fieldoption_id="72">Cameroon</option>
<option value="Canada" fieldoption_id="73">Canada</option>
<option value="Cape Verde" fieldoption_id="74">Cape Verde</option>
<option value="Cayman Islands" fieldoption_id="75">Cayman Islands</option>
<option value="Central African Republic" fieldoption_id="76">Central African Republic</option>
<option value="Chad" fieldoption_id="77">Chad</option>
<option value="Chile" fieldoption_id="78">Chile</option>
<option value="China" fieldoption_id="79">China</option>
<option value="Christmas Islands" fieldoption_id="80">Christmas Islands</option>
<option value="Cocos (Keeling) Islands" fieldoption_id="81">Cocos (Keeling) Islands</option>
<option value="Colombia" fieldoption_id="82">Colombia</option>
<option value="Comoros" fieldoption_id="83">Comoros</option>
<option value="Congo" fieldoption_id="84">Congo</option>
<option value="Congo, Democratic Republic of" fieldoption_id="85">Congo, Democratic Republic of</option>
<option value="Cook Island" fieldoption_id="86">Cook Island</option>
<option value="Costa Rica" fieldoption_id="87">Costa Rica</option>
<option value="Cote Divoire" fieldoption_id="88">Cote Divoire</option>
<option value="Croatia" fieldoption_id="89">Croatia</option>
<option value="Cuba" fieldoption_id="90">Cuba</option>
<option value="Cyprus" fieldoption_id="91">Cyprus</option>
<option value="Czech Republic" fieldoption_id="92">Czech Republic</option>
<option value="Denmark" fieldoption_id="93">Denmark</option>
<option value="Djibouti" fieldoption_id="94">Djibouti</option>
<option value="Dominica" fieldoption_id="95">Dominica</option>
<option value="Dominican Republic" fieldoption_id="96">Dominican Republic</option>
<option value="East Timor" fieldoption_id="97">East Timor</option>
<option value="Egypt" fieldoption_id="98">Egypt</option>
<option value="El Salvador" fieldoption_id="99">El Salvador</option>
<option value="Equador" fieldoption_id="100">Equador</option>
<option value="Equatorial Guinea" fieldoption_id="101">Equatorial Guinea</option>
<option value="Eritrea" fieldoption_id="102">Eritrea</option>
<option value="Estonia" fieldoption_id="103">Estonia</option>
<option value="Ethiopia" fieldoption_id="104">Ethiopia</option>
<option value="Falkland Islands" fieldoption_id="105">Falkland Islands</option>
<option value="Faroe Islands" fieldoption_id="106">Faroe Islands</option>
<option value="Federated States of Micronesia" fieldoption_id="107">Federated States of Micronesia</option>
<option value="Fiji" fieldoption_id="108">Fiji</option>
<option value="Finland" fieldoption_id="109">Finland</option>
<option value="France" fieldoption_id="110">France</option>
<option value="French Guiana" fieldoption_id="111">French Guiana</option>
<option value="French Polynesia" fieldoption_id="112">French Polynesia</option>
<option value="French Southern Territories" fieldoption_id="113">French Southern Territories</option>
<option value="Gabon" fieldoption_id="114">Gabon</option>
<option value="Gambia" fieldoption_id="115">Gambia</option>
<option value="Georgia" fieldoption_id="116">Georgia</option>
<option value="Germany" fieldoption_id="117">Germany</option>
<option value="Ghana" fieldoption_id="118">Ghana</option>
<option value="Gibraltar" fieldoption_id="119">Gibraltar</option>
<option value="Greece" fieldoption_id="120">Greece</option>
<option value="Greenland" fieldoption_id="121">Greenland</option>
<option value="Grenada" fieldoption_id="122">Grenada</option>
<option value="Guadeloupe" fieldoption_id="123">Guadeloupe</option>
<option value="Guam" fieldoption_id="124">Guam</option>
<option value="Guatemala" fieldoption_id="125">Guatemala</option>
<option value="Guinea" fieldoption_id="126">Guinea</option>
<option value="Guinea-Bissau" fieldoption_id="127">Guinea-Bissau</option>
<option value="Guyana" fieldoption_id="128">Guyana</option>
<option value="Haiti" fieldoption_id="129">Haiti</option>
<option value="Heard and Macdonald Islands" fieldoption_id="130">Heard and Macdonald Islands</option>
<option value="Honduras" fieldoption_id="131">Honduras</option>
<option value="Hong Kong" fieldoption_id="132">Hong Kong</option>
<option value="Hungary" fieldoption_id="133">Hungary</option>
<option value="Iceland" fieldoption_id="134">Iceland</option>
<option value="India" fieldoption_id="135">India</option>
<option value="Indonesia" fieldoption_id="136">Indonesia</option>
<option value="Iran" fieldoption_id="137">Iran</option>
<option value="Iraq" fieldoption_id="138">Iraq</option>
<option value="Ireland" fieldoption_id="139">Ireland</option>
<option value="Israel" fieldoption_id="140">Israel</option>
<option value="Italy" fieldoption_id="141">Italy</option>
<option value="Jamaica" fieldoption_id="142">Jamaica</option>
<option value="Japan" fieldoption_id="143">Japan</option>
<option value="Jordan" fieldoption_id="144">Jordan</option>
<option value="Kazakhstan" fieldoption_id="145">Kazakhstan</option>
<option value="Kenya" fieldoption_id="146">Kenya</option>
<option value="Kiribati" fieldoption_id="147">Kiribati</option>
<option value="Korea, North" fieldoption_id="148">Korea, North</option>
<option value="Korea, South" fieldoption_id="149">Korea, South</option>
<option value="Kuwait" fieldoption_id="150">Kuwait</option>
<option value="Kyrgyzstan" fieldoption_id="151">Kyrgyzstan</option>
<option value="Laos" fieldoption_id="152">Laos</option>
<option value="Latvia" fieldoption_id="153">Latvia</option>
<option value="Lebanon" fieldoption_id="154">Lebanon</option>
<option value="Lesotho" fieldoption_id="155">Lesotho</option>
<option value="Liberia" fieldoption_id="156">Liberia</option>
<option value="Libya" fieldoption_id="157">Libya</option>
<option value="Liechtenstein" fieldoption_id="158">Liechtenstein</option>
<option value="Lithuania" fieldoption_id="159">Lithuania</option>
<option value="Luxembourg" fieldoption_id="160">Luxembourg</option>
<option value="Macau" fieldoption_id="161">Macau</option>
<option value="Macedonia (Rep. of Fmr Yugoslav)" fieldoption_id="162">Macedonia (Rep. of Fmr Yugoslav)</option>
<option value="Madagascar" fieldoption_id="163">Madagascar</option>
<option value="Malawi" fieldoption_id="164">Malawi</option>
<option value="Malaysia" fieldoption_id="165">Malaysia</option>
<option value="Maldives" fieldoption_id="166">Maldives</option>
<option value="Mali" fieldoption_id="167">Mali</option>
<option value="Malta" fieldoption_id="168">Malta</option>
<option value="Marshall Islands" fieldoption_id="169">Marshall Islands</option>
<option value="Martinique" fieldoption_id="170">Martinique</option>
<option value="Mauritania" fieldoption_id="171">Mauritania</option>
<option value="Mauritius" fieldoption_id="172">Mauritius</option>
<option value="Mayotte" fieldoption_id="173">Mayotte</option>
<option value="Metropolitan France" fieldoption_id="174">Metropolitan France</option>
<option value="Mexico" fieldoption_id="175">Mexico</option>
<option value="Moldova" fieldoption_id="176">Moldova</option>
<option value="Monaco" fieldoption_id="177">Monaco</option>
<option value="Mongolia" fieldoption_id="178">Mongolia</option>
<option value="Montenegro" fieldoption_id="277">Montenegro</option>
<option value="Montserrat" fieldoption_id="179">Montserrat</option>
<option value="Morocco" fieldoption_id="180">Morocco</option>
<option value="Mozambique" fieldoption_id="181">Mozambique</option>
<option value="Myanmar" fieldoption_id="182">Myanmar</option>
<option value="Namibia" fieldoption_id="183">Namibia</option>
<option value="Nauru" fieldoption_id="184">Nauru</option>
<option value="Nepal" fieldoption_id="185">Nepal</option>
<option value="Netherlands" fieldoption_id="186">Netherlands</option>
<option value="Netherlands Antilles" fieldoption_id="187">Netherlands Antilles</option>
<option value="New Caledonia" fieldoption_id="188">New Caledonia</option>
<option value="New Zealand" fieldoption_id="189">New Zealand</option>
<option value="Nicaragua" fieldoption_id="190">Nicaragua</option>
<option value="Niger" fieldoption_id="192">Niger</option>
<option value="Nigeria" fieldoption_id="193">Nigeria</option>
<option value="Niue" fieldoption_id="191">Niue</option>
<option value="Norfolk Island" fieldoption_id="194">Norfolk Island</option>
<option value="Northern Mariana Islands" fieldoption_id="195">Northern Mariana Islands</option>
<option value="Norway" fieldoption_id="196">Norway</option>
<option value="Oman" fieldoption_id="197">Oman</option>
<option value="Pakistan" fieldoption_id="198">Pakistan</option>
<option value="Palau" fieldoption_id="199">Palau</option>
<option value="Palestinian Territory, Occupied" fieldoption_id="200">Palestinian Territory, Occupied</option>
<option value="Panama" fieldoption_id="201">Panama</option>
<option value="Papua New Guinea" fieldoption_id="202">Papua New Guinea</option>
<option value="Paraguay" fieldoption_id="203">Paraguay</option>
<option value="Peru" fieldoption_id="204">Peru</option>
<option value="Philippines" fieldoption_id="205">Philippines</option>
<option value="Pitcairn" fieldoption_id="206">Pitcairn</option>
<option value="Poland" fieldoption_id="207">Poland</option>
<option value="Portugal" fieldoption_id="208">Portugal</option>
<option value="Puerto Rico" fieldoption_id="209">Puerto Rico</option>
<option value="Qatar" fieldoption_id="210">Qatar</option>
<option value="Reunion" fieldoption_id="211">Reunion</option>
<option value="Romania" fieldoption_id="212">Romania</option>
<option value="Russia" fieldoption_id="213">Russia</option>
<option value="Rwanda" fieldoption_id="214">Rwanda</option>
<option value="S. Georgia and S. Sandwich Islands" fieldoption_id="215">S. Georgia and S. Sandwich Islands</option>
<option value="Samoa" fieldoption_id="216">Samoa</option>
<option value="San Marino" fieldoption_id="217">San Marino</option>
<option value="Sao Tome and Principe" fieldoption_id="218">Sao Tome and Principe</option>
<option value="Saudi Arabia" fieldoption_id="219">Saudi Arabia</option>
<option value="Senegal" fieldoption_id="220">Senegal</option>
<option value="Serbia" fieldoption_id="276">Serbia</option>
<option value="Seychelles" fieldoption_id="221">Seychelles</option>
<option value="Sierra Leone" fieldoption_id="222">Sierra Leone</option>
<option value="Singapore" fieldoption_id="223">Singapore</option>
<option value="Slovakia" fieldoption_id="224">Slovakia</option>
<option value="Slovenia" fieldoption_id="225">Slovenia</option>
<option value="Solomon Islands" fieldoption_id="226">Solomon Islands</option>
<option value="Somalia" fieldoption_id="227">Somalia</option>
<option value="South Africa" fieldoption_id="228">South Africa</option>
<option value="Spain" fieldoption_id="229">Spain</option>
<option value="Sri Lanka" fieldoption_id="230">Sri Lanka</option>
<option value="St Helena" fieldoption_id="231">St Helena</option>
<option value="St Kitts and Nevis" fieldoption_id="232">St Kitts and Nevis</option>
<option value="St Lucia" fieldoption_id="233">St Lucia</option>
<option value="St Pierre and Miquelon" fieldoption_id="234">St Pierre and Miquelon</option>
<option value="St Vincent and the Grenadines" fieldoption_id="235">St Vincent and the Grenadines</option>
<option value="Sudan" fieldoption_id="236">Sudan</option>
<option value="Suriname" fieldoption_id="237">Suriname</option>
<option value="Svalbard and Jan Mayen Islands" fieldoption_id="238">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland" fieldoption_id="239">Swaziland</option>
<option value="Sweden" fieldoption_id="240">Sweden</option>
<option value="Switzerland" fieldoption_id="241">Switzerland</option>
<option value="Syria" fieldoption_id="242">Syria</option>
<option value="Taiwan" fieldoption_id="243">Taiwan</option>
<option value="Tajikistan" fieldoption_id="244">Tajikistan</option>
<option value="Tanzania" fieldoption_id="245">Tanzania</option>
<option value="Thailand" fieldoption_id="246">Thailand</option>
<option value="Togo" fieldoption_id="247">Togo</option>
<option value="Tokelau" fieldoption_id="248">Tokelau</option>
<option value="Tonga" fieldoption_id="249">Tonga</option>
<option value="Trinidad and Tobago" fieldoption_id="250">Trinidad and Tobago</option>
<option value="Tunisia" fieldoption_id="251">Tunisia</option>
<option value="Turkey" fieldoption_id="252">Turkey</option>
<option value="Turkmenistan" fieldoption_id="253">Turkmenistan</option>
<option value="Turks and Caicos Islands" fieldoption_id="254">Turks and Caicos Islands</option>
<option value="Tuvalu" fieldoption_id="255">Tuvalu</option>
<option value="Uganda" fieldoption_id="256">Uganda</option>
<option value="Ukraine" fieldoption_id="257">Ukraine</option>
<option value="United Arab Emirates" fieldoption_id="258">United Arab Emirates</option>
<option value="United Kingdom" fieldoption_id="259">United Kingdom</option>
<option value="United States Minor Outlying Islands" fieldoption_id="260">United States Minor Outlying Islands</option>
<option value="Uruguay" fieldoption_id="261">Uruguay</option>
<option value="Uzbekistan" fieldoption_id="262">Uzbekistan</option>
<option value="Vanuatu" fieldoption_id="263">Vanuatu</option>
<option value="Vatican City" fieldoption_id="264">Vatican City</option>
<option value="Venezuela" fieldoption_id="265">Venezuela</option>
<option value="Vietnam" fieldoption_id="266">Vietnam</option>
<option value="Virgin Islands - British" fieldoption_id="267">Virgin Islands - British</option>
<option value="Virgin Islands - US" fieldoption_id="268">Virgin Islands - US</option>
<option value="Wallis and Futuna Islands" fieldoption_id="269">Wallis and Futuna Islands</option>
<option value="Western Sahara" fieldoption_id="270">Western Sahara</option>
<option value="Yemen" fieldoption_id="271">Yemen</option>
<option value="Yugoslavia" fieldoption_id="272">Yugoslavia</option>
<option value="Zaire" fieldoption_id="273">Zaire</option>
<option value="Zambia" fieldoption_id="274">Zambia</option>
<option value="Zimbabwe" fieldoption_id="275">Zimbabwe</option>
</select>
</div>
<div id="ctl00_tsFormRow_61" class="tsFormRows width50 right-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_tb_sysTributeAckPostalCode_267225" id="ctl00_label_267225" class="tsFormLabels ce-label required-if-visible" title="Recipient ZIP Code">Recipient ZIP Code</label><input name="ctl00$tb_sysTributeAckPostalCode_267225"
type="text" maxlength="20" id="ctl00_tb_sysTributeAckPostalCode_267225" class="tsTextBoxes tsTextBoxes_sysTributeAckPostalCode required-if-visible PopulateCityStateEnabled" onchange="populateCityState(this);">
</div>
<div id="ctl00_tsFormRow_62" class="tsFormRows width50 left-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_tb_sysTributeAckCity_267226" id="ctl00_label_267226" class="tsFormLabels ce-label required-if-visible" title="Recipient City">Recipient City</label><input name="ctl00$tb_sysTributeAckCity_267226" type="text" maxlength="50"
id="ctl00_tb_sysTributeAckCity_267226" class="tsTextBoxes tsTextBoxes_sysTributeAckCity required-if-visible">
</div>
<div id="ctl00_tsFormRow_63" class="tsFormRows width50 right-half tribute-mail-row children-1 divs-0 spans-0 labels-1 has-label" style="display: inline-block !important;">
<label for="ctl00_ddl_sysTributeAckState_267227" id="ctl00_label_267227" class="tsFormLabels ce-label required-if-visible" title="Recipient State">Recipient State</label><select name="ctl00$ddl_sysTributeAckState_267227"
id="ctl00_ddl_sysTributeAckState_267227" class="tsDropDownLists required-if-visible tsDropDownLists_sysTributeAckState" data-defaultvaluelabel="" data-hasdefaultvalue="true">
<option value="0"></option>
<option value=""></option>
<option value="Armed Forces the Americas" fieldoption_id="59" data-state-abrv="AA">Armed Forces the Americas</option>
<option value="Armed Forces Europe" fieldoption_id="60" data-state-abrv="AE">Armed Forces Europe</option>
<option value="Alaska" fieldoption_id="4" data-state-abrv="AK">Alaska</option>
<option value="Alabama" fieldoption_id="5" data-state-abrv="AL">Alabama</option>
<option value="Armed Forces Pacific" fieldoption_id="61" data-state-abrv="AP">Armed Forces Pacific</option>
<option value="Arkansas" fieldoption_id="13" data-state-abrv="AR">Arkansas</option>
<option value="American Samoa" fieldoption_id="53" data-state-abrv="AS">American Samoa</option>
<option value="Arizona" fieldoption_id="29" data-state-abrv="AZ">Arizona</option>
<option value="California" fieldoption_id="10" data-state-abrv="CA">California</option>
<option value="Colorado" fieldoption_id="34" data-state-abrv="CO">Colorado</option>
<option value="Connecticut" fieldoption_id="14" data-state-abrv="CT">Connecticut</option>
<option value="District of Columbia" fieldoption_id="2" data-state-abrv="DC">District of Columbia</option>
<option value="Delaware" fieldoption_id="35" data-state-abrv="DE">Delaware</option>
<option value="Florida" fieldoption_id="21" data-state-abrv="FL">Florida</option>
<option value="Fed. States of Micronesia" fieldoption_id="54" data-state-abrv="FM">Fed. States of Micronesia</option>
<option value="Georgia" fieldoption_id="30" data-state-abrv="GA">Georgia</option>
<option value="Guam" fieldoption_id="55" data-state-abrv="GU">Guam</option>
<option value="Hawaii" fieldoption_id="9" data-state-abrv="HI">Hawaii</option>
<option value="Iowa" fieldoption_id="37" data-state-abrv="IA">Iowa</option>
<option value="Idaho" fieldoption_id="36" data-state-abrv="ID">Idaho</option>
<option value="Illinois" fieldoption_id="25" data-state-abrv="IL">Illinois</option>
<option value="Indiana" fieldoption_id="26" data-state-abrv="IN">Indiana</option>
<option value="Kansas" fieldoption_id="8" data-state-abrv="KS">Kansas</option>
<option value="Kentucky" fieldoption_id="28" data-state-abrv="KY">Kentucky</option>
<option value="Louisiana" fieldoption_id="38" data-state-abrv="LA">Louisiana</option>
<option value="Massachusetts" fieldoption_id="41" data-state-abrv="MA">Massachusetts</option>
<option value="Maryland" fieldoption_id="1" data-state-abrv="MD">Maryland</option>
<option value="Maine" fieldoption_id="39" data-state-abrv="ME">Maine</option>
<option value="Marshall Islands" fieldoption_id="56" data-state-abrv="MH">Marshall Islands</option>
<option value="Michigan" fieldoption_id="6" data-state-abrv="MI">Michigan</option>
<option value="Minnesota" fieldoption_id="42" data-state-abrv="MN">Minnesota</option>
<option value="Missouri" fieldoption_id="12" data-state-abrv="MO">Missouri</option>
<option value="Northern Mariana Islands" fieldoption_id="62" data-state-abrv="MP">Northern Mariana Islands</option>
<option value="Mississippi" fieldoption_id="7" data-state-abrv="MS">Mississippi</option>
<option value="Montana" fieldoption_id="40" data-state-abrv="MT">Montana</option>
<option value="North Carolina" fieldoption_id="19" data-state-abrv="NC">North Carolina</option>
<option value="North Dakota" fieldoption_id="17" data-state-abrv="ND">North Dakota</option>
<option value="Nebraska" fieldoption_id="43" data-state-abrv="NE">Nebraska</option>
<option value="New Hampshire" fieldoption_id="31" data-state-abrv="NH">New Hampshire</option>
<option value="New Jersey" fieldoption_id="23" data-state-abrv="NJ">New Jersey</option>
<option value="New Mexico" fieldoption_id="45" data-state-abrv="NM">New Mexico</option>
<option value="Northern Mariana Is." fieldoption_id="57" data-state-abrv="NP">Northern Mariana Is.</option>
<option value="Nevada" fieldoption_id="44" data-state-abrv="NV">Nevada</option>
<option value="New York" fieldoption_id="24" data-state-abrv="NY">New York</option>
<option value="Ohio" fieldoption_id="33" data-state-abrv="OH">Ohio</option>
<option value="Oklahoma" fieldoption_id="52" data-state-abrv="OK">Oklahoma</option>
<option value="Oregon" fieldoption_id="15" data-state-abrv="OR">Oregon</option>
<option value="Pennsylvania" fieldoption_id="22" data-state-abrv="PA">Pennsylvania</option>
<option value="Puerto Rico" fieldoption_id="51" data-state-abrv="PR">Puerto Rico</option>
<option value="Palau" fieldoption_id="58" data-state-abrv="PW">Palau</option>
<option value="Rhode Island" fieldoption_id="46" data-state-abrv="RI">Rhode Island</option>
<option value="South Carolina" fieldoption_id="20" data-state-abrv="SC">South Carolina</option>
<option value="South Dakota" fieldoption_id="18" data-state-abrv="SD">South Dakota</option>
<option value="Tennessee" fieldoption_id="27" data-state-abrv="TN">Tennessee</option>
<option value="Texas" fieldoption_id="11" data-state-abrv="TX">Texas</option>
<option value="United States Minor Outlying Islands" fieldoption_id="64" data-state-abrv="UM">United States Minor Outlying Islands</option>
<option value="Utah" fieldoption_id="47" data-state-abrv="UT">Utah</option>
<option value="Virginia" fieldoption_id="3" data-state-abrv="VA">Virginia</option>
<option value="Virgin Islands" fieldoption_id="63" data-state-abrv="VI">Virgin Islands</option>
<option value="Vermont" fieldoption_id="32" data-state-abrv="VT">Vermont</option>
<option value="Washington" fieldoption_id="48" data-state-abrv="WA">Washington</option>
<option value="Wisconsin" fieldoption_id="16" data-state-abrv="WI">Wisconsin</option>
<option value="West Virginia" fieldoption_id="49" data-state-abrv="WV">West Virginia</option>
<option value="Wyoming" fieldoption_id="50" data-state-abrv="WY">Wyoming</option>
</select>
</div>
</fieldset>
<fieldset id="fieldset_19347" class="tsFieldSets ce-fieldset tribute-fieldset fieldset8" data-step="step8" style="display: none !important;">
<legend id="legend_19347" class="tsLegends ce-legend">Additional Options to Honor</legend>
<div id="ctl00_tsFormRow_64" class="tsFormRows children-2 divs-5 spans-0 labels-0 no-label">
<div id="ctl00_contentBlock_267246" class="tsContentBlocks">
<div class="row" id="additional-options-container">
<div class="col-md-6 col-xs-12" id="additional-options-left-col">
<p>You can receive a card that you can give to the honoree.</p>
<a href="https://media2.charityengine.net/WF/_transactionServerFiles/745/2017/11/27/wwp-honor-card-spread.jpg" data-lightbox="optional-card1" data-title="Honoree Card">
<img src="https://media2.charityengine.net/WF/_transactionServerFiles/745/2017/11/27/wwp-thumbnail.jpg" alt="Optional Honoree Card" id="optional-card-img" style="border: 2px solid #eee; border-radius: 4px;">
Click to Enlarge</a>
<br class="hidden-mobile-br"><br>
<p id="tribute-note-p">Note: Your email confirmation will also contain a link to a page where you can download and print a card.</p>
</div>
<div class="col-md-6 col-xs-12" id="additional-options-right-col">
<table>
<tbody>
<tr>
<td style="vertical-align: top;">
<input type="checkbox" id="send-me-a-card-checkbox" name="send-me-a-card-checkbox" checked="checked">
</td>
<td>
<label for="send-me-a-card-checkbox">Please send me a card that I can give to my honoree. Select the number of cards below.</label>
</td>
</tr>
</tbody>
</table>
<div id="card-opt-in-container">
<p>I would like to order <label for="number-of-cards" class="hidden-label">Number of cards to order</label>
<select id="number-of-cards" name="number-of-cards">
<option value="0" selected="">0</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> mail cards, to be sent to the mailing address shown above.
</p>
<p>* You can get one card for every $10 donated. <br>* Cards take 2 - 3 weeks to arrive.</p>
</div>
</div>
</div>
</div>
</div>
<div id="ctl00_tsFormRow_65" class="tsFormRows hidden-row children-1 divs-0 spans-0 labels-1 has-label">
<label for="ctl00_textBox_267247" id="ctl00_label_267247" class="tsFormLabels ce-label hidden-label" title="Send Me a Card">Send Me a Card</label><input name="ctl00$textBox_267247" type="text" id="ctl00_textBox_267247"
class="tsTextBoxes ce-input hidden-label">
</div>
</fieldset>
<fieldset id="fieldset_19349" class="tsFieldSets ce-fieldset paypal-btn-fieldset fieldset9 last-fieldset" data-step="step9">
<legend id="legend_19349" class="tsLegends ce-legend">PayPal Button Section</legend>
<div id="ctl00_tsFormRow_66" class="tsFormRows paypal-row paypal-button-container children-0 divs-1 spans-0 labels-0 no-label" style="display: none !important;">
<div id="ctl00_paypalecButtonContainer_267287" class="paypal-button-container">
<div id="xcomponent-paypal-button-7addcc3b89" class="paypal-button paypal-button-context-iframe paypal-button-label-checkout paypal-button-size-medium paypal-button-layout-horizontal" style="">
<style>
#xcomponent-paypal-button-7addcc3b89 {
font-size: 0;
width: 100%;
}
#xcomponent-paypal-button-7addcc3b89.paypal-button-size-responsive {
text-align: center;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet {
display: inline-block;
min-width: 75px;
max-width: 750px;
position: relative;
}
#xcomponent-paypal-button-7addcc3b89.paypal-button-layout-vertical>.xcomponent-outlet {
min-width: 75px;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet {
width: 250px;
height: 53px;
}
#xcomponent-paypal-button-7addcc3b89.paypal-button-size-responsive>.xcomponent-outlet {
width: 100%;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet>iframe {
min-width: 100%;
max-width: 100%;
width: 75px;
height: 100%;
position: absolute;
top: 0;
left: 0;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet>iframe.xcomponent-component-frame {
z-index: 100;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet>iframe.xcomponent-prerender-frame {
transition: opacity .2s linear;
z-index: 200;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet>iframe.xcomponent-visible {
opacity: 1;
}
#xcomponent-paypal-button-7addcc3b89>.xcomponent-outlet>iframe.xcomponent-invisible {
opacity: 0;
pointer-events: none;
}
</style>
<div class="xcomponent-outlet" style=""><iframe class="xcomponent-component-frame xcomponent-visible" frameborder="0" allowtransparency="true"
name="xcomponent__ppbutton__4_0_212__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__"
title="ppbutton" scrolling="no" allowpaymentrequest="allowpaymentrequest"
src="https://www.paypal.com/webapps/hermes/button?env=production&style.size=medium&style.color=blue&style.shape=rect&sessionID=f7fdb30d0c_ge3dumzvhizde&buttonSessionID=f075ca3131_ge3dumzvhizde&funding.disallowed=venmo&locale.x=en_US&logLevel=warn&uid=7addcc3b89&version=4.0.212&xcomponent=1"
data-gtm-yt-inspected-7="true" data-gtm-yt-inspected-1383779_314="true" data-gtm-yt-inspected-1383779_370="true" style="background-color: transparent;"></iframe></div>
</div>
</div>
</div>
</fieldset><span id="ctl00_submitFormCustomValidationJs" style="visibility:hidden;"></span>
<hr class="thin-border border-above">
<div id="ctl00_tsFormFooterButtons" class="tsFormFooterButtons insert-hr-above" style="display: inline-block !important;">
<input type="button" name="ctl00$nextButt" value="Donate $50"
onclick="ts_clientCustom_onSubmit_preValidation_encapsulate();WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$nextButt", "", true, "", "", false, true))" id="ctl00_nextButt"
class="tsButtons nextButton" skipconfirmation="true">
</div>
</div><!--END FORM CONTENT--><!--START FORM FOOTER-->
<div class="tsPageCustomFooters" id="tsLandingPageFooter" style="width: 315px;">
<p class="text-center" id="below-donate-btn-text"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">By clicking donate, your gift will be processed.</span><br><span
style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">A donation receipt will be emailed to</span><br><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">the email address you provided.</span></p>
<style>
#fieldset_19348 {
margin-top: 0 !important;
}
#legend_19346,
#legend_19344,
#legend_19347 {
border-top: 1px solid #ddd !important;
padding-top: 30px;
}
</style>
<p>
<script>
jQuery(document).ready(function() {
setFieldSetHeaders();
jQuery('<span class="monthly-msg-text">As a monthly donor of $19 or more, you will receive a Wounded Warrior Project<sup>®</sup> (WWP) fleece blanket.</span>').insertBefore('.monthly-gift-string-row .gift-amount-btns');
jQuery('.tsRadioButtonLists span input, .tsRadioButtonLists span label').click(function() {
buildNumCardsSelect();
});
jQuery('input.other-donation-amount-textbox').keyup(function() {
buildNumCardsSelect();
});
});
function setFieldSetHeaders() {
// don't edit - IDs are unique to each form and will be updated automatically if form is cloned
jQuery('<div class="mobile-legend-number">1</div>').prependTo('#legend_19341');
jQuery('<div class="mobile-legend-number">2</div>').prependTo('#legend_19342');
jQuery('<div class="mobile-legend-number">3</div>').prependTo('#legend_19343');
jQuery('<div class="mobile-legend-number">4</div>').prependTo('#legend_19346');
}
/* special field validation functions */
function numericFilter(txb) {
txb.value = txb.value.replace(/[^\0-9]/ig, "");
}
function limit(element, max_chars) {
if (element.value.length > max_chars) {
element.value = element.value.substr(0, max_chars);
}
}
</script>
<!-- RH test footer wysiwyg 1/30/2020 -->
</p>
<!--Begin CharityEngine Web App Script Injection-->
<script type="text/javascript">
jQuery('#aspnetForm').addClass('form-layout-2');
</script>
<script type="text/javascript">
console.log('preceding javascript injected by CharityEngine Web App (see app configuration)');
</script>
<!--End CharityEngine Web App Script Injection-->
</div><!--END FORM FOOTER-->
<script type="text/javascript">
//<![CDATA[
var Page_ValidationSummaries = new Array(document.getElementById("ctl00_mainFormContentArea_valSummary"));
var Page_Validators = new Array(document.getElementById("ctl00_regexFieldValCost_344111"), document.getElementById("ctl00_regexFieldValCost_267288"), document.getElementById("ctl00_reqFieldVal_267198"), document.getElementById(
"ctl00_reqFieldVal_267199"), document.getElementById("ctl00_reqFieldVal_267201"), document.getElementById("ctl00_reqFieldVal_267206"), document.getElementById("ctl00_reqFieldVal_267203"), document.getElementById(
"ctl00_regexFieldValZip_267203"), document.getElementById("ctl00_reqFieldVal_267204"), document.getElementById("ctl00_reqFieldVal_267205"), document.getElementById("ctl00_regexFieldValPhone_267200"), document.getElementById(
"ctl00_reqFieldVal_267235"), document.getElementById("ctl00_regexFieldValEmail_267235"), document.getElementById("ctl00_regexFieldValInteger_267207"), document.getElementById("ctl00_customCcNumNumVal_267207"), document.getElementById(
"ctl00_reqFieldVal_267208"), document.getElementById("ctl00_reqFieldVal_267209"), document.getElementById("ctl00_reqFieldVal_267210"), document.getElementById("ctl00_customRoutingNumVal_267241"), document.getElementById(
"ctl00_customAccountNumVal_267242"), document.getElementById("ctl00_regexFieldValZip_267214"), document.getElementById("ctl00_submitFormCustomValidationJs"));
//]]>
</script>
<script type="text/javascript">
//<![CDATA[
var ctl00_mainFormContentArea_valSummary = document.all ? document.all["ctl00_mainFormContentArea_valSummary"] : document.getElementById("ctl00_mainFormContentArea_valSummary");
ctl00_mainFormContentArea_valSummary.headertext = "Please review all of the fields below that are marked with a \" * \".";
ctl00_mainFormContentArea_valSummary.displaymode = "List";
var ctl00_regexFieldValCost_344111 = document.all ? document.all["ctl00_regexFieldValCost_344111"] : document.getElementById("ctl00_regexFieldValCost_344111");
ctl00_regexFieldValCost_344111.controltovalidate = "ctl00_textBox_344111";
ctl00_regexFieldValCost_344111.errormessage = "Donation Amount invalid format (value must be a currency unit)";
ctl00_regexFieldValCost_344111.display = "Dynamic";
ctl00_regexFieldValCost_344111.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValCost_344111.validationexpression = "^\\d+(\\.\\d\\d)?$";
var ctl00_regexFieldValCost_267288 = document.all ? document.all["ctl00_regexFieldValCost_267288"] : document.getElementById("ctl00_regexFieldValCost_267288");
ctl00_regexFieldValCost_267288.controltovalidate = "ctl00_textBox_267288";
ctl00_regexFieldValCost_267288.errormessage = "Donation Amount invalid format (value must be a currency unit)";
ctl00_regexFieldValCost_267288.display = "Dynamic";
ctl00_regexFieldValCost_267288.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValCost_267288.validationexpression = "^\\d+(\\.\\d\\d)?$";
var ctl00_reqFieldVal_267198 = document.all ? document.all["ctl00_reqFieldVal_267198"] : document.getElementById("ctl00_reqFieldVal_267198");
ctl00_reqFieldVal_267198.controltovalidate = "ctl00_textBox_267198";
ctl00_reqFieldVal_267198.errormessage = "First Name required";
ctl00_reqFieldVal_267198.display = "Dynamic";
ctl00_reqFieldVal_267198.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267198.initialvalue = "";
var ctl00_reqFieldVal_267199 = document.all ? document.all["ctl00_reqFieldVal_267199"] : document.getElementById("ctl00_reqFieldVal_267199");
ctl00_reqFieldVal_267199.controltovalidate = "ctl00_textBox_267199";
ctl00_reqFieldVal_267199.errormessage = "Last Name required";
ctl00_reqFieldVal_267199.display = "Dynamic";
ctl00_reqFieldVal_267199.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267199.initialvalue = "";
var ctl00_reqFieldVal_267201 = document.all ? document.all["ctl00_reqFieldVal_267201"] : document.getElementById("ctl00_reqFieldVal_267201");
ctl00_reqFieldVal_267201.controltovalidate = "ctl00_textBox_267201";
ctl00_reqFieldVal_267201.errormessage = "Address Line 1 required";
ctl00_reqFieldVal_267201.display = "Dynamic";
ctl00_reqFieldVal_267201.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267201.initialvalue = "";
var ctl00_reqFieldVal_267206 = document.all ? document.all["ctl00_reqFieldVal_267206"] : document.getElementById("ctl00_reqFieldVal_267206");
ctl00_reqFieldVal_267206.controltovalidate = "ctl00_sysCountries_267206";
ctl00_reqFieldVal_267206.errormessage = "Country required";
ctl00_reqFieldVal_267206.display = "Dynamic";
ctl00_reqFieldVal_267206.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267206.initialvalue = "";
var ctl00_reqFieldVal_267203 = document.all ? document.all["ctl00_reqFieldVal_267203"] : document.getElementById("ctl00_reqFieldVal_267203");
ctl00_reqFieldVal_267203.controltovalidate = "ctl00_textBox_267203";
ctl00_reqFieldVal_267203.errormessage = "ZIP Code required";
ctl00_reqFieldVal_267203.display = "Dynamic";
ctl00_reqFieldVal_267203.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267203.initialvalue = "";
var ctl00_regexFieldValZip_267203 = document.all ? document.all["ctl00_regexFieldValZip_267203"] : document.getElementById("ctl00_regexFieldValZip_267203");
ctl00_regexFieldValZip_267203.controltovalidate = "ctl00_textBox_267203";
ctl00_regexFieldValZip_267203.errormessage = "ZIP Code invalid format (value must be a zip code)";
ctl00_regexFieldValZip_267203.display = "Dynamic";
ctl00_regexFieldValZip_267203.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValZip_267203.validationexpression = "^(\\d{5}-\\d{4}|\\d{5}|\\d{9})$|^([a-zA-Z]\\d[a-zA-Z] \\d[a-zA-Z]\\d)$";
var ctl00_reqFieldVal_267204 = document.all ? document.all["ctl00_reqFieldVal_267204"] : document.getElementById("ctl00_reqFieldVal_267204");
ctl00_reqFieldVal_267204.controltovalidate = "ctl00_textBox_267204";
ctl00_reqFieldVal_267204.errormessage = "City required";
ctl00_reqFieldVal_267204.display = "Dynamic";
ctl00_reqFieldVal_267204.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267204.initialvalue = "";
var ctl00_reqFieldVal_267205 = document.all ? document.all["ctl00_reqFieldVal_267205"] : document.getElementById("ctl00_reqFieldVal_267205");
ctl00_reqFieldVal_267205.controltovalidate = "ctl00_sysUsStates_267205";
ctl00_reqFieldVal_267205.errormessage = "State required";
ctl00_reqFieldVal_267205.display = "Dynamic";
ctl00_reqFieldVal_267205.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267205.initialvalue = "0";
var ctl00_regexFieldValPhone_267200 = document.all ? document.all["ctl00_regexFieldValPhone_267200"] : document.getElementById("ctl00_regexFieldValPhone_267200");
ctl00_regexFieldValPhone_267200.controltovalidate = "ctl00_textBox_267200";
ctl00_regexFieldValPhone_267200.errormessage = "Phone Number invalid format (value must be a valid phone number)";
ctl00_regexFieldValPhone_267200.display = "Dynamic";
ctl00_regexFieldValPhone_267200.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValPhone_267200.validationexpression = "^(?:\\+?1[-. ]?)?\\(?([2-9][0-8][0-9])\\)?[-. ]?([2-9][0-9]{2})[-. ]?([0-9]{4})|\\+?(?:[0-9-., ] ?){6,14}[0-9]$";
var ctl00_reqFieldVal_267235 = document.all ? document.all["ctl00_reqFieldVal_267235"] : document.getElementById("ctl00_reqFieldVal_267235");
ctl00_reqFieldVal_267235.controltovalidate = "ctl00_textBox_267235";
ctl00_reqFieldVal_267235.errormessage = "Email Address required";
ctl00_reqFieldVal_267235.display = "Dynamic";
ctl00_reqFieldVal_267235.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267235.initialvalue = "";
var ctl00_regexFieldValEmail_267235 = document.all ? document.all["ctl00_regexFieldValEmail_267235"] : document.getElementById("ctl00_regexFieldValEmail_267235");
ctl00_regexFieldValEmail_267235.controltovalidate = "ctl00_textBox_267235";
ctl00_regexFieldValEmail_267235.errormessage = "Email Address invalid format (value must be a valid email address)";
ctl00_regexFieldValEmail_267235.display = "Dynamic";
ctl00_regexFieldValEmail_267235.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValEmail_267235.validationexpression = "^[a-zA-Z0-9\'._%+-]+@[a-zA-Z0-9.-]+\\.[a-zA-Z]{2,}$";
var ctl00_regexFieldValInteger_267207 = document.all ? document.all["ctl00_regexFieldValInteger_267207"] : document.getElementById("ctl00_regexFieldValInteger_267207");
ctl00_regexFieldValInteger_267207.controltovalidate = "ctl00_textBox_267207";
ctl00_regexFieldValInteger_267207.errormessage = "Credit Card Number invalid format (value must be an integer)";
ctl00_regexFieldValInteger_267207.display = "Dynamic";
ctl00_regexFieldValInteger_267207.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValInteger_267207.validationexpression = "^\\d+$";
var ctl00_customCcNumNumVal_267207 = document.all ? document.all["ctl00_customCcNumNumVal_267207"] : document.getElementById("ctl00_customCcNumNumVal_267207");
ctl00_customCcNumNumVal_267207.errormessage = "Credit Card Number invalid format";
ctl00_customCcNumNumVal_267207.display = "Dynamic";
ctl00_customCcNumNumVal_267207.evaluationfunction = "CustomValidatorEvaluateIsValid";
ctl00_customCcNumNumVal_267207.clientvalidationfunction = "client_cust_ccNum_validationForField_267207";
var ctl00_reqFieldVal_267208 = document.all ? document.all["ctl00_reqFieldVal_267208"] : document.getElementById("ctl00_reqFieldVal_267208");
ctl00_reqFieldVal_267208.controltovalidate = "ctl00_sysCreditCardTypes_267208";
ctl00_reqFieldVal_267208.errormessage = "Credit Card Type required";
ctl00_reqFieldVal_267208.display = "Dynamic";
ctl00_reqFieldVal_267208.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267208.initialvalue = "";
var ctl00_reqFieldVal_267209 = document.all ? document.all["ctl00_reqFieldVal_267209"] : document.getElementById("ctl00_reqFieldVal_267209");
ctl00_reqFieldVal_267209.controltovalidate = "ctl00_sysCreditCardExpirationMonths_267209";
ctl00_reqFieldVal_267209.errormessage = "Expiration Date required";
ctl00_reqFieldVal_267209.display = "Dynamic";
ctl00_reqFieldVal_267209.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267209.initialvalue = "";
var ctl00_reqFieldVal_267210 = document.all ? document.all["ctl00_reqFieldVal_267210"] : document.getElementById("ctl00_reqFieldVal_267210");
ctl00_reqFieldVal_267210.controltovalidate = "ctl00_sysCreditCardExpirationYears_267210";
ctl00_reqFieldVal_267210.errormessage = "Expiration Year required";
ctl00_reqFieldVal_267210.display = "Dynamic";
ctl00_reqFieldVal_267210.evaluationfunction = "RequiredFieldValidatorEvaluateIsValid";
ctl00_reqFieldVal_267210.initialvalue = "";
var ctl00_customRoutingNumVal_267241 = document.all ? document.all["ctl00_customRoutingNumVal_267241"] : document.getElementById("ctl00_customRoutingNumVal_267241");
ctl00_customRoutingNumVal_267241.errormessage = "Routing Number invalid format";
ctl00_customRoutingNumVal_267241.display = "Dynamic";
ctl00_customRoutingNumVal_267241.evaluationfunction = "CustomValidatorEvaluateIsValid";
ctl00_customRoutingNumVal_267241.clientvalidationfunction = "client_cust_routing_validationForField_267241";
var ctl00_customAccountNumVal_267242 = document.all ? document.all["ctl00_customAccountNumVal_267242"] : document.getElementById("ctl00_customAccountNumVal_267242");
ctl00_customAccountNumVal_267242.errormessage = "Account Number invalid format";
ctl00_customAccountNumVal_267242.display = "Dynamic";
ctl00_customAccountNumVal_267242.evaluationfunction = "CustomValidatorEvaluateIsValid";
ctl00_customAccountNumVal_267242.clientvalidationfunction = "client_cust_account_validationForField_267242";
var ctl00_regexFieldValZip_267214 = document.all ? document.all["ctl00_regexFieldValZip_267214"] : document.getElementById("ctl00_regexFieldValZip_267214");
ctl00_regexFieldValZip_267214.controltovalidate = "ctl00_textBox_267214";
ctl00_regexFieldValZip_267214.errormessage = "Billing ZIP Code invalid format (value must be a zip code)";
ctl00_regexFieldValZip_267214.display = "Dynamic";
ctl00_regexFieldValZip_267214.evaluationfunction = "RegularExpressionValidatorEvaluateIsValid";
ctl00_regexFieldValZip_267214.validationexpression = "^(\\d{5}-\\d{4}|\\d{5}|\\d{9})$|^([a-zA-Z]\\d[a-zA-Z] \\d[a-zA-Z]\\d)$";
var ctl00_submitFormCustomValidationJs = document.all ? document.all["ctl00_submitFormCustomValidationJs"] : document.getElementById("ctl00_submitFormCustomValidationJs");
ctl00_submitFormCustomValidationJs.evaluationfunction = "CustomValidatorEvaluateIsValid";
ctl00_submitFormCustomValidationJs.clientvalidationfunction = "ts_clientCustom_onSubmit_encapsulate";
//]]>
</script>
<script type="text/javascript">
//<![CDATA[
(function(id) {
var e = document.getElementById(id);
if (e) {
e.dispose = function() {
Array.remove(Page_ValidationSummaries, document.getElementById(id));
}
e = null;
}
})('ctl00_mainFormContentArea_valSummary');
var Page_ValidationActive = false;
if (typeof(ValidatorOnLoad) == "function") {
ValidatorOnLoad();
}
function ValidatorOnSubmit() {
if (Page_ValidationActive) {
return ValidatorCommonOnSubmit();
} else {
return true;
}
}
document.getElementById('ctl00_regexFieldValCost_344111').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValCost_344111'));
}
document.getElementById('ctl00_regexFieldValCost_267288').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValCost_267288'));
}
document.getElementById('ctl00_reqFieldVal_267198').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267198'));
}
document.getElementById('ctl00_reqFieldVal_267199').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267199'));
}
document.getElementById('ctl00_reqFieldVal_267201').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267201'));
}
document.getElementById('ctl00_reqFieldVal_267206').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267206'));
}
document.getElementById('ctl00_reqFieldVal_267203').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267203'));
}
document.getElementById('ctl00_regexFieldValZip_267203').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValZip_267203'));
}
document.getElementById('ctl00_reqFieldVal_267204').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267204'));
}
document.getElementById('ctl00_reqFieldVal_267205').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267205'));
}
document.getElementById('ctl00_regexFieldValPhone_267200').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValPhone_267200'));
}
document.getElementById('ctl00_reqFieldVal_267235').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267235'));
}
document.getElementById('ctl00_regexFieldValEmail_267235').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValEmail_267235'));
}
document.getElementById('ctl00_regexFieldValInteger_267207').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValInteger_267207'));
}
document.getElementById('ctl00_customCcNumNumVal_267207').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_customCcNumNumVal_267207'));
}
document.getElementById('ctl00_reqFieldVal_267208').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267208'));
}
document.getElementById('ctl00_reqFieldVal_267209').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267209'));
}
document.getElementById('ctl00_reqFieldVal_267210').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_reqFieldVal_267210'));
}
document.getElementById('ctl00_customRoutingNumVal_267241').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_customRoutingNumVal_267241'));
}
document.getElementById('ctl00_customAccountNumVal_267242').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_customAccountNumVal_267242'));
}
document.getElementById('ctl00_regexFieldValZip_267214').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_regexFieldValZip_267214'));
}
document.getElementById('ctl00_submitFormCustomValidationJs').dispose = function() {
Array.remove(Page_Validators, document.getElementById('ctl00_submitFormCustomValidationJs'));
}
//]]>
</script>
</form>Text Content
Skip to content * * DONATE NOW * Donate by Phone: 855.448.3997 * Donate by Mail: Download Form Your generous, tax-deductible donation to WWP will change the lives of over 1 million injured warriors, caregivers, and family members. You will help bring independence back to our nation's most severely wounded veterans. DONATE NOW paymentSourceCode Device Width companySource Number of cards to send me campaignSource Send Me a Card CC One Time flag for email CC Monthly flag for email ACH One Time flag for email ACH Monthly flag for email tribute content control Dynamic Content Driver (hidden) Tribute Type Text (hidden) 1 Choose A Gift One-Time GiftMonthly Gift You'll make the most impact for our wounded warriors when you support them with a monthly gift. As a monthly donor of $19 or more, you will receive a Wounded Warrior Project® fleece blanket. * $250$150$100$75$50YOUR BEST GIFT -------------------------------------------------------------------------------- or $ As a monthly donor of $19 or more, you will receive a Wounded Warrior Project® (WWP) fleece blanket.$19 Monthly$25 Monthly$30 MonthlyYOUR BEST GIFT -------------------------------------------------------------------------------- or Donation Amount* As a monthly donor of $19 or more, you will receive a Wounded Warrior Project® (WWP) fleece blanket. Your Thank You Gift WWP Blanket Please allow 4 - 6 weeks for your gift to arrive. Please Do Not Send Me A Gift Make my gift go further! Tribute Section Make this a gift in honor or memory of an individual. 2 Your Information First Name* Last Name* Address Line 1* Address Line 2(Not Required) Country United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Islands Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Island Costa Rica Cote Divoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Egypt El Salvador Equador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Macdonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia (Rep. of Fmr Yugoslav) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Metropolitan France Mexico Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S. Georgia and S. Sandwich Islands Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St Helena St Kitts and Nevis St Lucia St Pierre and Miquelon St Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands - British Virgin Islands - US Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe * ZIP Code** City* State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces the Americas California Colorado Connecticut Delaware District of Columbia Fed. States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Is. Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming * Phone Number(Not Required)* Email AddressYour donation receipt will be sent to this address.** -------------------------------------------------------------------------------- Yes, I would like to receive communications from WWP with updates on warriors and programs. This donation is on behalf of a company. Company/Foundation -------------------------------------------------------------------------------- 3 Payment Information Payment MethodCredit CardPayPalCheck -------------------------------------------------------------------------------- Credit Card Number** Visa MasterCard AmericanExpress Discover * Expiration Date MM - Month 01 02 03 04 05 06 07 08 09 10 11 12 * YYYY - Year 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 * Routing Number* Account Number* Bank Account Type Check Number ACH Type 4 Billing Information Uncheck if your billing address is not the same as your donor address. Billing Address Line 1 Billing Address Line 2(Not Required) Billing Country United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Islands Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Island Costa Rica Cote Divoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Egypt El Salvador Equador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Macdonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia (Rep. of Fmr Yugoslav) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Metropolitan France Mexico Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S. Georgia and S. Sandwich Islands Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St Helena St Kitts and Nevis St Lucia St Pierre and Miquelon St Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands - British Virgin Islands - US Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Billing ZIP Code* Billing City Billing State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces the Americas California Colorado Connecticut Delaware District of Columbia Fed. States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Is. Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Honor / Memory Acknowledgement Information Tribute Type In Honor of In Memory of Tribute's Name Mail an acknowledgement of my donation. Mail acknowledgement to: Recipient First Name Recipient Last Name Recipient Address Line 1 Recipient Address Line 2(Not Required) Recipient Country United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Islands Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Island Costa Rica Cote Divoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Egypt El Salvador Equador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Macdonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia (Rep. of Fmr Yugoslav) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Metropolitan France Mexico Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S. Georgia and S. Sandwich Islands Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St Helena St Kitts and Nevis St Lucia St Pierre and Miquelon St Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands - British Virgin Islands - US Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Recipient ZIP Code Recipient City Recipient State Armed Forces the Americas Armed Forces Europe Alaska Alabama Armed Forces Pacific Arkansas American Samoa Arizona California Colorado Connecticut District of Columbia Delaware Florida Fed. States of Micronesia Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Marshall Islands Michigan Minnesota Missouri Northern Mariana Islands Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Northern Mariana Is. Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Palau Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming Additional Options to Honor You can receive a card that you can give to the honoree. Click to Enlarge Note: Your email confirmation will also contain a link to a page where you can download and print a card. Please send me a card that I can give to my honoree. Select the number of cards below. I would like to order Number of cards to order 012345 mail cards, to be sent to the mailing address shown above. * You can get one card for every $10 donated. * Cards take 2 - 3 weeks to arrive. Send Me a Card PayPal Button Section -------------------------------------------------------------------------------- By clicking donate, your gift will be processed. A donation receipt will be emailed to the email address you provided. PROCESSING Please wait while we finish processing your transaction... * Donate by Phone: 855.448.3997 * Donate by Mail: Download Form -------------------------------------------------------------------------------- Wounded Warrior Project ® is a tax-exempt 501(C)(3) nonprofit organization. -------------------------------------------------------------------------------- ©2022 Wounded Warrior Project | Privacy Policy | Terms of Use | State Notices | Frequently Asked Questions | Live Chat Powered by PreviousNext