www.jvs-socal.org
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Submitted URL: https://www.jvs-socal.org/woman-to-woman-conference-2021/#registration-WLN-21
Effective URL: https://www.jvs-socal.org/woman-to-woman-conference-2021/
Submission: On November 05 via manual from US — Scanned from DE
Effective URL: https://www.jvs-socal.org/woman-to-woman-conference-2021/
Submission: On November 05 via manual from US — Scanned from DE
Form analysis 3 forms found in the DOM
GET https://www.jvs-socal.org/
<form role="search" method="get" class="et-search-form" action="https://www.jvs-socal.org/">
<label class="da11y-screen-reader-text" for="et_pb_search_module_input_0">Search for...</label><input type="search" class="et-search-field" placeholder="Search …" value="" name="s" title="Search for:" id="et_pb_search_module_input_0"><button
type="submit" class="da11y-screen-reader-text">Search</button>
</form>Name: mc-embedded-subscribe-form — POST https://jvs-socal.us12.list-manage.com/subscribe/post?u=4729ee54e2e9ecdc29752c009&id=2ffb5952cc
<form action="https://jvs-socal.us12.list-manage.com/subscribe/post?u=4729ee54e2e9ecdc29752c009&id=2ffb5952cc" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate="">
<div id="mc_embed_signup_scroll">
<div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
<div class="mc-field-group">
<label for="mce-EMAIL">Email Address <span class="asterisk">*</span>
</label>
<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
</div>
<div class="mc-field-group">
<label for="mce-FNAME">First Name </label>
<input type="text" value="" name="FNAME" class="" id="mce-FNAME">
</div>
<div class="mc-field-group">
<label for="mce-LNAME">Last Name </label>
<input type="text" value="" name="LNAME" class="" id="mce-LNAME">
</div>
<div id="mce-responses" class="clear">
<div class="response" id="mce-error-response" style="display:none"></div>
<div class="response" id="mce-success-response" style="display:none"></div>
</div> <!-- real people should not fill this in and expect good things - do not remove this or risk form bot signups-->
<div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_4729ee54e2e9ecdc29752c009_2ffb5952cc" tabindex="-1" value=""></div>
<div class="clear"><input type="submit" value="Register" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
</div>
</form><form id="mongo-form">
<div id="bboxevent_BBEmbeddedForm" class="BBFormContainer" data-bbox-part-id="9cc774b1-a018-4f57-a097-6537b4eac98e">
<div id="bboxevent_divForm">
<div id="divClientError" class="BBFormErrorBlock" style="display: none"></div>
<div id="bboxevent_divTestMessage"></div>
<div id="BBPanelHeading" data-panel="heading">
<div class="BBFormSection BBFormSectionPriceSelect">
<fieldset>
<legend>
<div class="BBFormTitle">
<label id="bboxevent_lblEventName" class="BBFormEventName">9th Annual Woman to Woman Conference</label>
</div>
<div class="BBFormSubTitle">
<label id="bboxevent_lblEventDate" class="BBFormEventDate">Donnerstag, 18. November 2021</label>
</div>
<div class="BBFormSubTitle">
<label id="bboxevent_lblEventTime" class="BBFormEventTime">09:00</label>
</div>
</legend>
</fieldset>
</div>
</div>
<div id="BBPanelPrices" data-panel="prices" style="display:;">
<div class="BBFormSection BBFormSectionPriceSelect">
<fieldset>
<legend class="BBFormSectionHeadingRegistration">
<div class="BBFormSectionHeading">
<label id="bboxevent_priceselect_lblHeadingPrices" class="BBFormFieldLabelEdit">Registration</label>
</div>
</legend>
<div class="BBFormTable BBFormPricingTable">
<div class="BBFormTableHeader">
<div class="BBFormTableHeaderCell BBFormColPriceName"> </div>
<div id="bboxevent_priceselect_divColPriceHeader" class="BBFormTableHeaderCell BBFormColPriceAmt">Price</div>
<div class="BBFormTableHeaderCell BBFormColQty">Quantity</div>
<div id="bboxevent_priceselect_divColTotalHeader" class="BBFormTableHeaderCell BBFormColTotal">Total</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl00_priceItemRow" class="BBFormTableRow" data-price-id="439" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl00_lblPriceName">Presenting Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl00_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl00_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl00_lblPriceAmt">$50,000</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl00_ddQty" id="bboxevent_priceselect_ctl00_lblQty" class="BBAccessibilityOnly">Presenting Sponsor, 1 registrant allowed, price $50,000</label>
<select name="bboxevent$priceselect$ctl00$ddQty" id="bboxevent_priceselect_ctl00_ddQty" data-price="50000.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl00_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl00_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl01_priceItemRow" class="BBFormTableRow" data-price-id="440" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl01_lblPriceName">Empowerment Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl01_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl01_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl01_lblPriceAmt">$35,000</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl01_ddQty" id="bboxevent_priceselect_ctl01_lblQty" class="BBAccessibilityOnly">Empowerment Sponsor, 1 registrant allowed, price $35,000</label>
<select name="bboxevent$priceselect$ctl01$ddQty" id="bboxevent_priceselect_ctl01_ddQty" data-price="35000.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl01_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl01_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl02_priceItemRow" class="BBFormTableRow" data-price-id="446" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl02_lblPriceName">Encouragement Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl02_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl02_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl02_lblPriceAmt">$25,000</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl02_ddQty" id="bboxevent_priceselect_ctl02_lblQty" class="BBAccessibilityOnly">Encouragement Sponsor, 1 registrant allowed, price $25,000</label>
<select name="bboxevent$priceselect$ctl02$ddQty" id="bboxevent_priceselect_ctl02_ddQty" data-price="25000.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl02_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl02_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl03_priceItemRow" class="BBFormTableRow" data-price-id="441" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl03_lblPriceName">Inspiration Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl03_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl03_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl03_lblPriceAmt">$12,500</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl03_ddQty" id="bboxevent_priceselect_ctl03_lblQty" class="BBAccessibilityOnly">Inspiration Sponsor, 1 registrant allowed, price $12,500</label>
<select name="bboxevent$priceselect$ctl03$ddQty" id="bboxevent_priceselect_ctl03_ddQty" data-price="12500.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl03_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl03_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl04_priceItemRow" class="BBFormTableRow" data-price-id="442" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl04_lblPriceName">Impact Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl04_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl04_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl04_lblPriceAmt">$6,000</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl04_ddQty" id="bboxevent_priceselect_ctl04_lblQty" class="BBAccessibilityOnly">Impact Sponsor, 1 registrant allowed, price $6,000</label>
<select name="bboxevent$priceselect$ctl04$ddQty" id="bboxevent_priceselect_ctl04_ddQty" data-price="6000.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl04_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl04_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl05_priceItemRow" class="BBFormTableRow" data-price-id="443" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl05_lblPriceName">Essential Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl05_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl05_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl05_lblPriceAmt">$3,000</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl05_ddQty" id="bboxevent_priceselect_ctl05_lblQty" class="BBAccessibilityOnly">Essential Sponsor, 1 registrant allowed, price $3,000</label>
<select name="bboxevent$priceselect$ctl05$ddQty" id="bboxevent_priceselect_ctl05_ddQty" data-price="3000.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl05_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl05_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl06_priceItemRow" class="BBFormTableRow" data-price-id="444" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl06_lblPriceName">Vital Sponsor</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl06_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl06_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl06_lblPriceAmt">$1,000</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl06_ddQty" id="bboxevent_priceselect_ctl06_lblQty" class="BBAccessibilityOnly">Vital Sponsor, 1 registrant allowed, price $1,000</label>
<select name="bboxevent$priceselect$ctl06$ddQty" id="bboxevent_priceselect_ctl06_ddQty" data-price="1000.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl06_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl06_lblPriceItemDescription">please refer to our registration form for further details on sponsorship benefits</span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_ctl07_priceItemRow" class="BBFormTableRow" data-price-id="445" data-price-qty="1">
<div class="BBFormTableRowCell BBFormColPriceName">
<div class="BBFormPriceName">
<span id="bboxevent_priceselect_ctl07_lblPriceName">Donation</span>
</div>
<div class="BBTableRowCellFinePrint">
<span id="bboxevent_priceselect_ctl07_lblPriceRegCount">(1 registrant)</span>
</div>
</div>
<div id="bboxevent_priceselect_ctl07_divColPrice" class="BBFormTableRowCell BBFormColPriceAmt BBFormPriceAmt">
<span id="bboxevent_priceselect_ctl07_lblPriceAmt">$0</span>
</div>
<div class="BBFormTableRowCell BBFormColQty">
<label for="bboxevent_priceselect_ctl07_ddQty" id="bboxevent_priceselect_ctl07_lblQty" class="BBAccessibilityOnly">Donation, 1 registrant allowed, price $0</label>
<select name="bboxevent$priceselect$ctl07$ddQty" id="bboxevent_priceselect_ctl07_ddQty" data-price="0.0000" class="BBFormSelectList BBFormSelectQuantity">
<option value="0"></option>
<option value="1">1</option>
</select>
</div>
<div id="bboxevent_priceselect_ctl07_PriceItemTotal" class="BBFormTableRowCell BBFormColTotal BBFormTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
<div class="BBFormTableRowCell BBFormPriceDescription">
<span id="bboxevent_priceselect_ctl07_lblPriceItemDescription"></span>
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_divAddedDonation" class="BBFormAddedDonation" style="display:;">
<div class="BBFormTableRowCell BBFormColAddedDonationLabel">
<label for="txtAddedDonation" id="bboxevent_priceselect_lblAddedDonation" class="BBFormFieldLabelEdit">Enter your DONATION ONLY amount here:</label>
</div>
<div class="BBFormTableRowCell BBFormColAddedDonation">
<input name="bboxevent$priceselect$txtAddedDonation" type="tel" id="txtAddedDonation" data-amt="0" class="BBFormTextbox BBFormCurrency" placeholder="optional" data-culture="en-US">
</div>
<div style="clear: both"></div>
</div>
<div id="bboxevent_priceselect_divFooterRow" class="BBFormTableFooter">
<div class="BBFormTableFooterCell BBFormTableFooterLabel" style="display: none;">Total due:</div>
<div id="bboxevent_priceselect_GrandTotal" class="BBFormTableFooterCell BBFormTableFooterTotal" data-culture="en-US"> </div>
<div style="clear: both"></div>
</div>
</div>
</fieldset>
</div>
<div class="BBFormButtonRow BBFormButtonRowNext" id="BBFormButtonRowNext" style="display: none;">
<input class="BBFormNextbutton BBFormSubmitbuttonEdit" id="BBbtnNext" type="submit" value="Next">
</div>
<input name="bboxevent$priceselect$hdnJsonRegistrants" type="hidden" id="bboxevent_priceselect_hdnJsonRegistrants" class="hdnJsonRegistrants">
</div>
<div id="BBPanelPayment" data-panel="payment" style="display:none;">
<div id="bboxevent_fldOrgReg" class="BBFormFieldContainer">
<input name="bboxevent$chkOrgReg" type="checkbox" id="bboxevent_chkOrgReg" data-reg-field="orgreg">
<label for="bboxevent_chkOrgReg" id="bboxevent_lblOrgReg" class="BBFormFieldLabel BBFormCheckbox BBFormCheckboxLabel BBFormFieldLabelEdit">Register as an organization</label>
</div>
<div id="bboxevent_billing_divBillingSection" class="BBFormSection BBDFormSectionBillingInfo BBFormAddressBlock" data-section="Billing">
<fieldset>
<legend>
<div id="bboxevent_billing_divBillingHeader" class="BBFormSectionHeading">
<label id="bboxevent_billing_lblHeadingContact" class="BBFormFieldLabelEdit">Billing Address</label>
</div>
</legend>
<div id="fldOrgInfo" class="BBFormOrgFields" style="display: none;">
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_billing_txtOrgName" id="bboxevent_billing_lblOrgName" class="BBFormFieldLabel BBFormFieldLabelEdit ">Organization name:</label>
<input name="bboxevent$billing$txtOrgName" type="text" id="bboxevent_billing_txtOrgName" class="BBFormTextbox" required="required" data-billing-field="orgname" maxlength="60">
</div>
</div>
<div id="fldIndivInfo" class="BBFormIndivFields">
<div id="divName" class="BBFormFieldContainer BBFormFieldContainerRequired BBTwoFields">
<span id="bboxevent_billing_lblFullName" class="BBFormFieldLabel BBFormFieldLabelEdit">Name:</span>
<label for="bboxevent_billing_ddTitle" id="bboxevent_billing_lblTitle" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Title:</label>
<label for="bboxevent_billing_txtFirstName" id="bboxevent_billing_lblFirstName" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">First name:</label>
<input name="bboxevent$billing$txtFirstName" type="text" id="bboxevent_billing_txtFirstName" class="BBFormTextbox" data-billing-field="firstname" maxlength="50" required="required" placeholder="first name">
<label for="bboxevent_billing_txtLastName" id="bboxevent_billing_lblLastName" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Last name:</label>
<input name="bboxevent$billing$txtLastName" type="text" id="bboxevent_billing_txtLastName" class="BBFormTextbox" data-billing-field="lastname" maxlength="100" required="required" placeholder="last name">
</div>
</div>
<div id="bboxevent_billing_divEmail" class="BBFormFieldContainer BBFormFieldContainerRequired BBFormBillingEmail">
<label for="bboxevent_billing_txtEmail" id="bboxevent_billing_lblEmail" class="BBFormFieldLabel BBFormFieldLabelEdit">Email:</label>
<input name="bboxevent$billing$txtEmail" type="email" id="bboxevent_billing_txtEmail" class="BBFormTextbox" data-billing-field="email" required="required">
</div>
<div id="bboxevent_billing_divPhone" class="BBFormFieldContainer BBFormBillingPhone BBFormFieldContainerRequired">
<label for="bboxevent_billing_txtPhone" id="bboxevent_billing_lblPhone" class="BBFormFieldLabel BBFormFieldLabelEdit">Phone:</label>
<input name="bboxevent$billing$txtPhone" type="tel" id="bboxevent_billing_txtPhone" class="BBFormTextbox" data-billing-field="phone" required="required">
</div>
<div class="BBFormAddress">
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_billing_billingAddress_ddCountry" id="bboxevent_billing_billingAddress_lblCountry" class="BBFormFieldLabel BBFormFieldLabelEdit">Country:</label>
<select name="bboxevent$billing$billingAddress$ddCountry" id="bboxevent_billing_billingAddress_ddCountry" class="BBFormSelectList BBFormCountryDropDown" required="required">
<option selected="selected" value="United States" data-country-format="1" data-short-text="US">United States</option>
<option value="Canada" data-country-format="3" data-short-text="CA">Canada</option>
<option value="United Kingdom" data-country-format="2" data-short-text="GB">United Kingdom</option>
<option value="Australia" data-country-format="4" data-short-text="AU">Australia</option>
<option value="New Zealand" data-country-format="5" data-short-text="NZ">New Zealand</option>
</select>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_billing_billingAddress_txtAddress" id="bboxevent_billing_billingAddress_lblAddress" class="BBFormFieldLabel BBFormFieldLabelEdit">Address:</label>
<textarea name="bboxevent$billing$billingAddress$txtAddress" id="bboxevent_billing_billingAddress_txtAddress" class="BBFormTextArea" rows="2" cols="30" required="required" data-country-field="address" maxlength="150"></textarea>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="1">
<label for="bboxevent_billing_billingAddress_txtCity" id="bboxevent_billing_billingAddress_lblCity" class="BBFormFieldLabel BBFormFieldLabelEdit">City:</label>
<input name="bboxevent$billing$billingAddress$txtCity" type="text" id="bboxevent_billing_billingAddress_txtCity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50">
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="1">
<label for="bboxevent_billing_billingAddress_ddState" id="bboxevent_billing_billingAddress_lblStateZip" class="BBFormFieldLabel BBFormFieldLabelEdit">State & zip:</label>
<label for="bboxevent_billing_billingAddress_ddState" id="bboxevent_billing_billingAddress_lblState" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">State:</label>
<select name="bboxevent$billing$billingAddress$ddState" id="bboxevent_billing_billingAddress_ddState" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
<option selected="selected" value="" default="default">state</option>
<option value="AA">AA</option>
<option value="AB">AB</option>
<option value="AE">AE</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AP">AP</option>
<option value="AR">AR</option>
<option value="AS">AS</option>
<option value="AZ">AZ</option>
<option value="BC">BC</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="CZ">CZ</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="FM">FM</option>
<option value="GA">GA</option>
<option value="GU">GU</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MB">MB</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MH">MH</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MP">MP</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NB">NB</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NL">NL</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NS">NS</option>
<option value="NT">NT</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="ON">ON</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="PE">PE</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="QC">QC</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="SK">SK</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VI">VI</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="YT">YT</option>
<option value="NU">NU</option>
</select>
<label for="bboxevent_billing_billingAddress_txtZip" id="bboxevent_billing_billingAddress_lblZip" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Zip:</label>
<input name="bboxevent$billing$billingAddress$txtZip" type="tel" id="bboxevent_billing_billingAddress_txtZip" class="BBFormTextbox" data-country-field="postcode" data-country-sync="1" required="required" maxlength="12"
placeholder="zip">
</div>
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="2" style="display: none;">
<label for="bboxevent_billing_billingAddress_txtUKCity" id="bboxevent_billing_billingAddress_lblUKCityCounty" class="BBFormFieldLabel BBFormFieldLabelEdit">City & county:</label>
<label for="bboxevent_billing_billingAddress_txtUKCity" id="bboxevent_billing_billingAddress_lblUKCity" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">City:</label>
<input name="bboxevent$billing$billingAddress$txtUKCity" type="text" id="bboxevent_billing_billingAddress_txtUKCity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50"
placeholder="city">
<label for="bboxevent_billing_billingAddress_ddUKCounty" id="bboxevent_billing_billingAddress_lblUKCounty" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">County:</label>
<select name="bboxevent$billing$billingAddress$ddUKCounty" id="bboxevent_billing_billingAddress_ddUKCounty" class="BBFormSelectList GhostText" data-country-field="county">
<option selected="selected" value="" default="default">county (optional)</option>
<option value="Ada">Ada</option>
<option value="Alameda">Alameda</option>
<option value="Albemarle">Albemarle</option>
<option value="Allegheny">Allegheny</option>
<option value="Bergen">Bergen</option>
<option value="Berks">Berks</option>
<option value="Bexar">Bexar</option>
<option value="Blaine">Blaine</option>
<option value="Boulder">Boulder</option>
<option value="Bristol">Bristol</option>
<option value="Broward">Broward</option>
<option value="Buncombe">Buncombe</option>
<option value="Camden">Camden</option>
<option value="Cheshire">Cheshire</option>
<option value="Chester">Chester</option>
<option value="Clark">Clark</option>
<option value="Cochise">Cochise</option>
<option value="Collier">Collier</option>
<option value="Contra Costa">Contra Costa</option>
<option value="Cook">Cook</option>
<option value="Cuyahoga">Cuyahoga</option>
<option value="Dallas">Dallas</option>
<option value="Dauphin">Dauphin</option>
<option value="Dekalb">Dekalb</option>
<option value="Delaware">Delaware</option>
<option value="District Of Columbia">District Of Columbia</option>
<option value="Douglas">Douglas</option>
<option value="Dupage">Dupage</option>
<option value="Eagle">Eagle</option>
<option value="East Baton Rouge">East Baton Rouge</option>
<option value="El Paso">El Paso</option>
<option value="Erie">Erie</option>
<option value="Essex">Essex</option>
<option value="Fairfax">Fairfax</option>
<option value="Fairfield">Fairfield</option>
<option value="Franklin">Franklin</option>
<option value="Fresno">Fresno</option>
<option value="Fulton">Fulton</option>
<option value="Hampden">Hampden</option>
<option value="Harris">Harris</option>
<option value="Hennepin">Hennepin</option>
<option value="Howard">Howard</option>
<option value="Jefferson">Jefferson</option>
<option value="King">King</option>
<option value="Kings">Kings</option>
<option value="Knox">Knox</option>
<option value="Lafayette">Lafayette</option>
<option value="Lake">Lake</option>
<option value="Litchfield">Litchfield</option>
<option value="Los Angeles">Los Angeles</option>
<option value="Lucas">Lucas</option>
<option value="Maricopa">Maricopa</option>
<option value="Marin">Marin</option>
<option value="Marion">Marion</option>
<option value="Marshall">Marshall</option>
<option value="Mchenry">Mchenry</option>
<option value="Mecklenburg">Mecklenburg</option>
<option value="Miami-dade">Miami-dade</option>
<option value="Middlesex">Middlesex</option>
<option value="Milwaukee">Milwaukee</option>
<option value="Montgomery">Montgomery</option>
<option value="Nassau">Nassau</option>
<option value="Nevada">Nevada</option>
<option value="New Haven">New Haven</option>
<option value="New York">New York</option>
<option value="Norfolk">Norfolk</option>
<option value="Norfolk City">Norfolk City</option>
<option value="Oakland">Oakland</option>
<option value="Oldham">Oldham</option>
<option value="Orange">Orange</option>
<option value="Orleans">Orleans</option>
<option value="Palm Beach">Palm Beach</option>
<option value="Philadelphia">Philadelphia</option>
<option value="Pima">Pima</option>
<option value="Placer">Placer</option>
<option value="Queens">Queens</option>
<option value="Riverside">Riverside</option>
<option value="Sacramento">Sacramento</option>
<option value="Saint Louis">Saint Louis</option>
<option value="Saint Louis City">Saint Louis City</option>
<option value="San Bernardino">San Bernardino</option>
<option value="San Diego">San Diego</option>
<option value="San Francisco">San Francisco</option>
<option value="San Joaquin">San Joaquin</option>
<option value="San Luis Obispo">San Luis Obispo</option>
<option value="San Mateo">San Mateo</option>
<option value="Santa Barbara">Santa Barbara</option>
<option value="Santa Clara">Santa Clara</option>
<option value="Santa Fe">Santa Fe</option>
<option value="Shelby">Shelby</option>
<option value="Somerset">Somerset</option>
<option value="Sonoma">Sonoma</option>
<option value="Suffolk">Suffolk</option>
<option value="Tarrant">Tarrant</option>
<option value="Travis">Travis</option>
<option value="Tulsa">Tulsa</option>
<option value="Vanderburgh">Vanderburgh</option>
<option value="Ventura">Ventura</option>
<option value="Washington">Washington</option>
<option value="Westchester">Westchester</option>
<option value="Yolo">Yolo</option>
<option value="England">England</option>
</select>
</div>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="2" style="display: none;">
<label for="bboxevent_billing_billingAddress_txtUKPostCode" id="bboxevent_billing_billingAddress_lblUKPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">Postcode:</label>
<input name="bboxevent$billing$billingAddress$txtUKPostCode" type="text" id="bboxevent_billing_billingAddress_txtUKPostCode" class="BBFormTextbox" data-country-field="postcode" data-country-sync="1" required="required" maxlength="12">
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="3" style="display: none;">
<label for="bboxevent_billing_billingAddress_txtCACity" id="bboxevent_billing_billingAddress_lblCACity" class="BBFormFieldLabel BBFormFieldLabelEdit">City:</label>
<input name="bboxevent$billing$billingAddress$txtCACity" type="text" id="bboxevent_billing_billingAddress_txtCACity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50">
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="3" style="display: none;">
<label for="bboxevent_billing_billingAddress_ddCAProvince" id="bboxevent_billing_billingAddress_lblCAProvincePostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">Province & postal:</label>
<label for="bboxevent_billing_billingAddress_ddCAProvince" id="bboxevent_billing_billingAddress_lblCAProvince" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Province:</label>
<select name="bboxevent$billing$billingAddress$ddCAProvince" id="bboxevent_billing_billingAddress_ddCAProvince" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
<option selected="selected" value="" default="default">province</option>
<option value="AA">AA</option>
<option value="AB">AB</option>
<option value="AE">AE</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AP">AP</option>
<option value="AR">AR</option>
<option value="AS">AS</option>
<option value="AZ">AZ</option>
<option value="BC">BC</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="CZ">CZ</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="FM">FM</option>
<option value="GA">GA</option>
<option value="GU">GU</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MB">MB</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MH">MH</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MP">MP</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NB">NB</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NL">NL</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NS">NS</option>
<option value="NT">NT</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="ON">ON</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="PE">PE</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="QC">QC</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="SK">SK</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VI">VI</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="YT">YT</option>
<option value="NU">NU</option>
</select>
<label for="bboxevent_billing_billingAddress_txtCAPostCode" id="bboxevent_billing_billingAddress_lblCAPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Postal:</label>
<input name="bboxevent$billing$billingAddress$txtCAPostCode" type="text" id="bboxevent_billing_billingAddress_txtCAPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode"
maxlength="12" placeholder="postal">
</div>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="4" style="display: none;">
<label for="bboxevent_billing_billingAddress_txtAUCity" id="bboxevent_billing_billingAddress_lblAUCity" class="BBFormFieldLabel BBFormFieldLabelEdit">Suburb:</label>
<input name="bboxevent$billing$billingAddress$txtAUCity" type="text" id="bboxevent_billing_billingAddress_txtAUCity" class="BBFormTextbox" data-country-sync="1" data-country-field="city" required="required" maxlength="50">
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="4" style="display: none;">
<label for="bboxevent_billing_billingAddress_ddAUState" id="bboxevent_billing_billingAddress_lblAUStatePostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">State & postcode:</label>
<label for="bboxevent_billing_billingAddress_ddAUState" id="bboxevent_billing_billingAddress_lblAUState" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">State:</label>
<select name="bboxevent$billing$billingAddress$ddAUState" id="bboxevent_billing_billingAddress_ddAUState" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
<option selected="selected" value="" default="default">state</option>
<option value="AA">AA</option>
<option value="AB">AB</option>
<option value="AE">AE</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AP">AP</option>
<option value="AR">AR</option>
<option value="AS">AS</option>
<option value="AZ">AZ</option>
<option value="BC">BC</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="CZ">CZ</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="FM">FM</option>
<option value="GA">GA</option>
<option value="GU">GU</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MB">MB</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MH">MH</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MP">MP</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NB">NB</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NL">NL</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NS">NS</option>
<option value="NT">NT</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="ON">ON</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="PE">PE</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="QC">QC</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="SK">SK</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VI">VI</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="YT">YT</option>
<option value="NU">NU</option>
</select>
<label for="bboxevent_billing_billingAddress_txtAUPostCode" id="bboxevent_billing_billingAddress_lblAUPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Postcode:</label>
<input name="bboxevent$billing$billingAddress$txtAUPostCode" type="tel" id="bboxevent_billing_billingAddress_txtAUPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode" maxlength="12"
placeholder="postcode">
</div>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="5" style="display: none;">
<label for="bboxevent_billing_billingAddress_ddNZSuburb" id="bboxevent_billing_billingAddress_lblNZSuburb" class="BBFormFieldLabel BBFormFieldLabelEdit">Suburb:</label>
<select name="bboxevent$billing$billingAddress$ddNZSuburb" id="bboxevent_billing_billingAddress_ddNZSuburb" class="BBFormSelectList GhostText" required="required" data-country-field="nzsuburb">
<option selected="selected" value="" default="default">suburb</option>
</select>
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="5" style="display: none;">
<label for="bboxevent_billing_billingAddress_ddNZCity" id="bboxevent_billing_billingAddress_lblNZCityPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">City & post code:</label>
<label for="bboxevent_billing_billingAddress_ddNZCity" id="bboxevent_billing_billingAddress_lblNZCity" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">City:</label>
<select name="bboxevent$billing$billingAddress$ddNZCity" id="bboxevent_billing_billingAddress_ddNZCity" class="BBFormSelectList GhostText" required="required" data-country-field="nzcity">
<option selected="selected" value="" default="default">city</option>
</select>
<label for="bboxevent_billing_billingAddress_txtNZPostCode" id="bboxevent_billing_billingAddress_lblNZPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Post code:</label>
<input name="bboxevent$billing$billingAddress$txtNZPostCode" type="tel" id="bboxevent_billing_billingAddress_txtNZPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode" maxlength="12"
placeholder="post code">
</div>
</div>
</div>
</fieldset>
</div>
<div id="bboxevent_orginfo_divBillingSection" class="BBFormSection BBDFormSectionBillingInfo BBFormAddressBlock" data-section="OrgInfo">
<fieldset>
<legend>
<div id="bboxevent_orginfo_divBillingHeader" class="BBFormSectionHeading">
<label id="bboxevent_orginfo_lblHeadingContact" class="BBFormFieldLabelEdit">Organization information</label>
</div>
</legend>
<div id="fldOrgInfo" class="BBFormOrgFields">
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_orginfo_txtOrgName" id="bboxevent_orginfo_lblOrgName" class="BBFormFieldLabel BBFormFieldLabelEdit ">Organization:</label>
<input name="bboxevent$orginfo$txtOrgName" type="text" id="bboxevent_orginfo_txtOrgName" class="BBFormTextbox" required="required" data-billing-field="orgname" maxlength="60">
</div>
</div>
<div id="fldIndivInfo" class="BBFormIndivFields">
<div id="divName" class="BBFormFieldContainer BBFormFieldContainerRequired BBTwoFields">
<span id="bboxevent_orginfo_lblFullName" class="BBFormFieldLabel BBFormFieldLabelEdit">Name:</span>
<label for="bboxevent_orginfo_ddTitle" id="bboxevent_orginfo_lblTitle" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Title:</label>
<label for="bboxevent_orginfo_txtFirstName" id="bboxevent_orginfo_lblFirstName" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">First name:</label>
<input name="bboxevent$orginfo$txtFirstName" type="text" id="bboxevent_orginfo_txtFirstName" class="BBFormTextbox" data-billing-field="firstname" maxlength="50" required="required" placeholder="first name">
<label for="bboxevent_orginfo_txtLastName" id="bboxevent_orginfo_lblLastName" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Last name:</label>
<input name="bboxevent$orginfo$txtLastName" type="text" id="bboxevent_orginfo_txtLastName" class="BBFormTextbox" data-billing-field="lastname" maxlength="100" required="required" placeholder="last name">
</div>
</div>
<div id="bboxevent_orginfo_divEmail" class="BBFormFieldContainer BBFormFieldContainerRequired BBFormBillingEmail">
<label for="bboxevent_orginfo_txtEmail" id="bboxevent_orginfo_lblEmail" class="BBFormFieldLabel BBFormFieldLabelEdit">Email:</label>
<input name="bboxevent$orginfo$txtEmail" type="email" id="bboxevent_orginfo_txtEmail" class="BBFormTextbox" data-billing-field="email" required="required">
</div>
<div id="bboxevent_orginfo_divPhone" class="BBFormFieldContainer BBFormBillingPhone BBFormFieldContainerRequired">
<label for="bboxevent_orginfo_txtPhone" id="bboxevent_orginfo_lblPhone" class="BBFormFieldLabel BBFormFieldLabelEdit">Phone:</label>
<input name="bboxevent$orginfo$txtPhone" type="tel" id="bboxevent_orginfo_txtPhone" class="BBFormTextbox" data-billing-field="phone" required="required">
</div>
<div class="BBFormAddress">
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_orginfo_billingAddress_ddCountry" id="bboxevent_orginfo_billingAddress_lblCountry" class="BBFormFieldLabel BBFormFieldLabelEdit">Country:</label>
<select name="bboxevent$orginfo$billingAddress$ddCountry" id="bboxevent_orginfo_billingAddress_ddCountry" class="BBFormSelectList BBFormCountryDropDown" required="required">
<option selected="selected" value="United States" data-country-format="1" data-short-text="US">United States</option>
<option value="Canada" data-country-format="3" data-short-text="CA">Canada</option>
<option value="United Kingdom" data-country-format="2" data-short-text="GB">United Kingdom</option>
<option value="Australia" data-country-format="4" data-short-text="AU">Australia</option>
<option value="New Zealand" data-country-format="5" data-short-text="NZ">New Zealand</option>
</select>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_orginfo_billingAddress_txtAddress" id="bboxevent_orginfo_billingAddress_lblAddress" class="BBFormFieldLabel BBFormFieldLabelEdit">Address:</label>
<textarea name="bboxevent$orginfo$billingAddress$txtAddress" id="bboxevent_orginfo_billingAddress_txtAddress" class="BBFormTextArea" rows="2" cols="30" required="required" data-country-field="address" maxlength="150"></textarea>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="1">
<label for="bboxevent_orginfo_billingAddress_txtCity" id="bboxevent_orginfo_billingAddress_lblCity" class="BBFormFieldLabel BBFormFieldLabelEdit">City:</label>
<input name="bboxevent$orginfo$billingAddress$txtCity" type="text" id="bboxevent_orginfo_billingAddress_txtCity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50">
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="1">
<label for="bboxevent_orginfo_billingAddress_ddState" id="bboxevent_orginfo_billingAddress_lblStateZip" class="BBFormFieldLabel BBFormFieldLabelEdit">State & zip:</label>
<label for="bboxevent_orginfo_billingAddress_ddState" id="bboxevent_orginfo_billingAddress_lblState" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">State:</label>
<select name="bboxevent$orginfo$billingAddress$ddState" id="bboxevent_orginfo_billingAddress_ddState" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
<option selected="selected" value="" default="default">state</option>
<option value="AA">AA</option>
<option value="AB">AB</option>
<option value="AE">AE</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AP">AP</option>
<option value="AR">AR</option>
<option value="AS">AS</option>
<option value="AZ">AZ</option>
<option value="BC">BC</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="CZ">CZ</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="FM">FM</option>
<option value="GA">GA</option>
<option value="GU">GU</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MB">MB</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MH">MH</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MP">MP</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NB">NB</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NL">NL</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NS">NS</option>
<option value="NT">NT</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="ON">ON</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="PE">PE</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="QC">QC</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="SK">SK</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VI">VI</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="YT">YT</option>
<option value="NU">NU</option>
</select>
<label for="bboxevent_orginfo_billingAddress_txtZip" id="bboxevent_orginfo_billingAddress_lblZip" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Zip:</label>
<input name="bboxevent$orginfo$billingAddress$txtZip" type="tel" id="bboxevent_orginfo_billingAddress_txtZip" class="BBFormTextbox" data-country-field="postcode" data-country-sync="1" required="required" maxlength="12"
placeholder="zip">
</div>
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="2" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_txtUKCity" id="bboxevent_orginfo_billingAddress_lblUKCityCounty" class="BBFormFieldLabel BBFormFieldLabelEdit">City & county:</label>
<label for="bboxevent_orginfo_billingAddress_txtUKCity" id="bboxevent_orginfo_billingAddress_lblUKCity" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">City:</label>
<input name="bboxevent$orginfo$billingAddress$txtUKCity" type="text" id="bboxevent_orginfo_billingAddress_txtUKCity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50"
placeholder="city">
<label for="bboxevent_orginfo_billingAddress_ddUKCounty" id="bboxevent_orginfo_billingAddress_lblUKCounty" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">County:</label>
<select name="bboxevent$orginfo$billingAddress$ddUKCounty" id="bboxevent_orginfo_billingAddress_ddUKCounty" class="BBFormSelectList GhostText" data-country-field="county">
<option selected="selected" value="" default="default">county (optional)</option>
<option value="Ada">Ada</option>
<option value="Alameda">Alameda</option>
<option value="Albemarle">Albemarle</option>
<option value="Allegheny">Allegheny</option>
<option value="Bergen">Bergen</option>
<option value="Berks">Berks</option>
<option value="Bexar">Bexar</option>
<option value="Blaine">Blaine</option>
<option value="Boulder">Boulder</option>
<option value="Bristol">Bristol</option>
<option value="Broward">Broward</option>
<option value="Buncombe">Buncombe</option>
<option value="Camden">Camden</option>
<option value="Cheshire">Cheshire</option>
<option value="Chester">Chester</option>
<option value="Clark">Clark</option>
<option value="Cochise">Cochise</option>
<option value="Collier">Collier</option>
<option value="Contra Costa">Contra Costa</option>
<option value="Cook">Cook</option>
<option value="Cuyahoga">Cuyahoga</option>
<option value="Dallas">Dallas</option>
<option value="Dauphin">Dauphin</option>
<option value="Dekalb">Dekalb</option>
<option value="Delaware">Delaware</option>
<option value="District Of Columbia">District Of Columbia</option>
<option value="Douglas">Douglas</option>
<option value="Dupage">Dupage</option>
<option value="Eagle">Eagle</option>
<option value="East Baton Rouge">East Baton Rouge</option>
<option value="El Paso">El Paso</option>
<option value="Erie">Erie</option>
<option value="Essex">Essex</option>
<option value="Fairfax">Fairfax</option>
<option value="Fairfield">Fairfield</option>
<option value="Franklin">Franklin</option>
<option value="Fresno">Fresno</option>
<option value="Fulton">Fulton</option>
<option value="Hampden">Hampden</option>
<option value="Harris">Harris</option>
<option value="Hennepin">Hennepin</option>
<option value="Howard">Howard</option>
<option value="Jefferson">Jefferson</option>
<option value="King">King</option>
<option value="Kings">Kings</option>
<option value="Knox">Knox</option>
<option value="Lafayette">Lafayette</option>
<option value="Lake">Lake</option>
<option value="Litchfield">Litchfield</option>
<option value="Los Angeles">Los Angeles</option>
<option value="Lucas">Lucas</option>
<option value="Maricopa">Maricopa</option>
<option value="Marin">Marin</option>
<option value="Marion">Marion</option>
<option value="Marshall">Marshall</option>
<option value="Mchenry">Mchenry</option>
<option value="Mecklenburg">Mecklenburg</option>
<option value="Miami-dade">Miami-dade</option>
<option value="Middlesex">Middlesex</option>
<option value="Milwaukee">Milwaukee</option>
<option value="Montgomery">Montgomery</option>
<option value="Nassau">Nassau</option>
<option value="Nevada">Nevada</option>
<option value="New Haven">New Haven</option>
<option value="New York">New York</option>
<option value="Norfolk">Norfolk</option>
<option value="Norfolk City">Norfolk City</option>
<option value="Oakland">Oakland</option>
<option value="Oldham">Oldham</option>
<option value="Orange">Orange</option>
<option value="Orleans">Orleans</option>
<option value="Palm Beach">Palm Beach</option>
<option value="Philadelphia">Philadelphia</option>
<option value="Pima">Pima</option>
<option value="Placer">Placer</option>
<option value="Queens">Queens</option>
<option value="Riverside">Riverside</option>
<option value="Sacramento">Sacramento</option>
<option value="Saint Louis">Saint Louis</option>
<option value="Saint Louis City">Saint Louis City</option>
<option value="San Bernardino">San Bernardino</option>
<option value="San Diego">San Diego</option>
<option value="San Francisco">San Francisco</option>
<option value="San Joaquin">San Joaquin</option>
<option value="San Luis Obispo">San Luis Obispo</option>
<option value="San Mateo">San Mateo</option>
<option value="Santa Barbara">Santa Barbara</option>
<option value="Santa Clara">Santa Clara</option>
<option value="Santa Fe">Santa Fe</option>
<option value="Shelby">Shelby</option>
<option value="Somerset">Somerset</option>
<option value="Sonoma">Sonoma</option>
<option value="Suffolk">Suffolk</option>
<option value="Tarrant">Tarrant</option>
<option value="Travis">Travis</option>
<option value="Tulsa">Tulsa</option>
<option value="Vanderburgh">Vanderburgh</option>
<option value="Ventura">Ventura</option>
<option value="Washington">Washington</option>
<option value="Westchester">Westchester</option>
<option value="Yolo">Yolo</option>
<option value="England">England</option>
</select>
</div>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="2" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_txtUKPostCode" id="bboxevent_orginfo_billingAddress_lblUKPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">Postcode:</label>
<input name="bboxevent$orginfo$billingAddress$txtUKPostCode" type="text" id="bboxevent_orginfo_billingAddress_txtUKPostCode" class="BBFormTextbox" data-country-field="postcode" data-country-sync="1" required="required" maxlength="12">
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="3" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_txtCACity" id="bboxevent_orginfo_billingAddress_lblCACity" class="BBFormFieldLabel BBFormFieldLabelEdit">City:</label>
<input name="bboxevent$orginfo$billingAddress$txtCACity" type="text" id="bboxevent_orginfo_billingAddress_txtCACity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50">
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="3" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_ddCAProvince" id="bboxevent_orginfo_billingAddress_lblCAProvincePostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">Province & postal:</label>
<label for="bboxevent_orginfo_billingAddress_ddCAProvince" id="bboxevent_orginfo_billingAddress_lblCAProvince" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Province:</label>
<select name="bboxevent$orginfo$billingAddress$ddCAProvince" id="bboxevent_orginfo_billingAddress_ddCAProvince" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
<option selected="selected" value="" default="default">province</option>
<option value="AA">AA</option>
<option value="AB">AB</option>
<option value="AE">AE</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AP">AP</option>
<option value="AR">AR</option>
<option value="AS">AS</option>
<option value="AZ">AZ</option>
<option value="BC">BC</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="CZ">CZ</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="FM">FM</option>
<option value="GA">GA</option>
<option value="GU">GU</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MB">MB</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MH">MH</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MP">MP</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NB">NB</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NL">NL</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NS">NS</option>
<option value="NT">NT</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="ON">ON</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="PE">PE</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="QC">QC</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="SK">SK</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VI">VI</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="YT">YT</option>
<option value="NU">NU</option>
</select>
<label for="bboxevent_orginfo_billingAddress_txtCAPostCode" id="bboxevent_orginfo_billingAddress_lblCAPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Postal:</label>
<input name="bboxevent$orginfo$billingAddress$txtCAPostCode" type="text" id="bboxevent_orginfo_billingAddress_txtCAPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode"
maxlength="12" placeholder="postal">
</div>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="4" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_txtAUCity" id="bboxevent_orginfo_billingAddress_lblAUCity" class="BBFormFieldLabel BBFormFieldLabelEdit">Suburb:</label>
<input name="bboxevent$orginfo$billingAddress$txtAUCity" type="text" id="bboxevent_orginfo_billingAddress_txtAUCity" class="BBFormTextbox" data-country-sync="1" data-country-field="city" required="required" maxlength="50">
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="4" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_ddAUState" id="bboxevent_orginfo_billingAddress_lblAUStatePostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">State & postcode:</label>
<label for="bboxevent_orginfo_billingAddress_ddAUState" id="bboxevent_orginfo_billingAddress_lblAUState" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">State:</label>
<select name="bboxevent$orginfo$billingAddress$ddAUState" id="bboxevent_orginfo_billingAddress_ddAUState" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
<option selected="selected" value="" default="default">state</option>
<option value="AA">AA</option>
<option value="AB">AB</option>
<option value="AE">AE</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AP">AP</option>
<option value="AR">AR</option>
<option value="AS">AS</option>
<option value="AZ">AZ</option>
<option value="BC">BC</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="CZ">CZ</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="FM">FM</option>
<option value="GA">GA</option>
<option value="GU">GU</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MB">MB</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MH">MH</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MP">MP</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NB">NB</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NL">NL</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NS">NS</option>
<option value="NT">NT</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="ON">ON</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="PE">PE</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="QC">QC</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="SK">SK</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VI">VI</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="YT">YT</option>
<option value="NU">NU</option>
</select>
<label for="bboxevent_orginfo_billingAddress_txtAUPostCode" id="bboxevent_orginfo_billingAddress_lblAUPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Postcode:</label>
<input name="bboxevent$orginfo$billingAddress$txtAUPostCode" type="tel" id="bboxevent_orginfo_billingAddress_txtAUPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode" maxlength="12"
placeholder="postcode">
</div>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="5" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_ddNZSuburb" id="bboxevent_orginfo_billingAddress_lblNZSuburb" class="BBFormFieldLabel BBFormFieldLabelEdit">Suburb:</label>
<select name="bboxevent$orginfo$billingAddress$ddNZSuburb" id="bboxevent_orginfo_billingAddress_ddNZSuburb" class="BBFormSelectList GhostText" required="required" data-country-field="nzsuburb">
<option selected="selected" value="" default="default">suburb</option>
</select>
</div>
<div class="BBTwoFields BBFieldBillingStateZip">
<div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="5" style="display: none;">
<label for="bboxevent_orginfo_billingAddress_ddNZCity" id="bboxevent_orginfo_billingAddress_lblNZCityPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">City & post code:</label>
<label for="bboxevent_orginfo_billingAddress_ddNZCity" id="bboxevent_orginfo_billingAddress_lblNZCity" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">City:</label>
<select name="bboxevent$orginfo$billingAddress$ddNZCity" id="bboxevent_orginfo_billingAddress_ddNZCity" class="BBFormSelectList GhostText" required="required" data-country-field="nzcity">
<option selected="selected" value="" default="default">city</option>
</select>
<label for="bboxevent_orginfo_billingAddress_txtNZPostCode" id="bboxevent_orginfo_billingAddress_lblNZPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Post code:</label>
<input name="bboxevent$orginfo$billingAddress$txtNZPostCode" type="tel" id="bboxevent_orginfo_billingAddress_txtNZPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode" maxlength="12"
placeholder="post code">
</div>
</div>
</div>
</fieldset>
</div>
<div class="BBFormSection BBDFormSectionPaymentInfo">
<fieldset>
<legend>
<div id="bboxevent_payment_divHeadingPayment" class="BBFormSectionHeading">
<label id="bboxevent_payment_lblHeadingPayment" class="BBFormFieldLabelEdit">Payment details</label>
</div>
</legend>
<div id="bboxevent_payment_PaymentChoices" class="BBFormPaymentChoice">
<div class="BBFormFieldContainer">
<span id="bboxevent_payment_lblPaymentMethod" class="BBFormFieldLabel BBFormFieldLabelEdit">Payment method:</span>
<div class="BBFormFieldContainerPaymentMethods">
<div id="bboxevent_payment_divPaymentChoiceCreditCard" class="BBFormFieldContainer BBFormPaymentRadioOptions">
<input value="0" name="bboxevent$payment$BBFormPaymentChoice" type="radio" id="bboxevent_payment_BBFormPaymentChoiceCredit" data-pmtchoice="1" checked="checked">
<label for="bboxevent_payment_BBFormPaymentChoiceCredit" id="bboxevent_payment_lblChoiceCredit" class="BBFormFieldLabelEdit BBFormRadioPaymentSelected">Credit card</label>
</div>
<div id="bboxevent_payment_divPaymentChoiceBillMeLater" class="BBFormFieldContainer BBFormPaymentRadioOptions">
<input value="1" name="bboxevent$payment$BBFormPaymentChoice" type="radio" id="bboxevent_payment_BBFormPaymentChoiceBillMeLater" data-pmtchoice="1">
<label for="bboxevent_payment_BBFormPaymentChoiceBillMeLater" id="bboxevent_payment_lblChoiceBillMeLater" class="BBFormFieldLabelEdit BBFormRadioPaymentNotSelected">Bill me later</label>
</div>
</div>
</div>
</div>
<div id="bboxevent_payment_BBFormCCDetails" class="BBFormCreditCardDetails">
<div id="bboxevent_payment_divProcessedByBlackbaud" class="BBFormFieldContainer ">
<a id="bboxsecure" class="BBLinkSecureInfo hasTooltip" href="#bbsecure" rel="https://bbox.blackbaudhosting.com/webforms/components/custom.ashx?handler=blackbaud.appfx.mongo.parts.getcontenthandler&c=secure&callback=?" title="Learn more about how your credit card information will be protected by Blackbaud" tabindex="0" style="text-decoration: none; border-bottom: 1px dashed;">Payment Processed by Blackbaud</a>
</div>
<div class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_payment_txtCardholder" id="bboxevent_payment_lblCardHoldersName" class="BBFormFieldLabel BBFormFieldLabelEdit ">Cardholder name:</label>
<input name="bboxevent$payment$txtCardholder" type="text" id="bboxevent_payment_txtCardholder" class="BBFormTextbox" maxlength="60" required="required">
</div>
<div id="DCCreditNumber" class="BBFormFieldContainer BBFormFieldContainerRequired">
<label for="bboxevent_payment_txtCardNumber" id="bboxevent_payment_lblCCNumber" class="BBFormFieldLabel BBFormFieldLabelEdit ">Card number:</label>
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Select Page
* For Job Seekers
* Start Your Job Search Here
* America’s Job Center of California
* Antelope Valley
* WeHoWorks
* Disability and Assessment
* GAIN / GROW / REAS
* Career Development
* JVSWorks: No Cost Career Training
* ApartmentWorks
* BankWork$
* CareerWork$ Medical
* HealthWorks
* Mentoring For Women
* Networking for Women
* Jewish Community Programs
* Career Focus
* Ezra Network for Job Seekers
* Scholarship Program
* For Students
* Youth Programs
* JVS Scholarship
* Scholarship Donors
* 2020 Virtual Scholarship Award Ceremony
* For Veterans
* Veteran Services
* Women Veterans
* Veterans AJCC
* Veterans First
* Veterans Tech Academy
* About Us
* Blog
* Women’s Leadership Network
* Management
* Diversity, Equity and Inclusion
* Jobs at JVS SoCal
* Publications
* For Employers
* Locations
* Ways To Support Us
* Ways To Support Us
* Fundraise on Behalf of JVS SoCal
* Plan My Gift
* Donate
* Scholarship Donors
* Corporate Giving
* Generation Impact
* JVS Women’s Leadership Network
* Events
* Annual Walk – 2021
* WLN Conference – 2021
* The Way Forward Event: Changing Lives Together
Search for...Search
9TH ANNUAL WOMAN TO WOMAN CONFERENCE
Presented by JVS SoCal Women’s Leadership Network
THURSDAY, NOVEMBER 18, 2021 | 9AM-10:30AM
SPEAKERS
REGISTRATION
OUR SPONSORS
ABOUT THIS YEAR’S VIRTUAL CONFERENCE
Join a livestreamed celebration of women leaders in our community. Be inspired
by their stories of challenges, triumphs, personal insights and more. Learn
about the Women’s Leadership Network and the work we do to support women through
career crisis and transition. Find out how you can help make a difference in
women’s lives.
THIS YEAR’S DISTINGUISHED HOST
GISELLE FERNANDEZ
Giselle Fernandez is known for her cutting-edge reporting in hot spots
throughout the world and interviewing prominent global and local leaders. Today,
this veteran anchor is on Your Morning on Spectrum News 1, helping Southern
Californians get all the information they need to start their day, and on the
Emmy Award-winning weekly series L.A. Stories with Giselle Fernandez,
highlighting people who shape lives and create an impact throughout the
community.
FEATURED SPEAKERS
GEORGIA BERKOVICH
Georgia Berkovich is a community leader and inspirational speaker, who currently
serves as the Director of Public Affairs for The Midnight Mission. Her work
provides hope to people in the Skid Row community, many of whom struggle with
barriers such as addiction. In recovery herself, Georgia brings a unique
perspective to her position and serves and an example of overcoming personal
challenges and giving back to her community.
JOY CHEN
Joy Chen is a world-renowned leadership coach whom the Wall Street Journal calls
“a Lean-In Guru” and the Los Angeles Times refers to simply as “The Networker.”
She formerly served as a Deputy Mayor of Los Angeles and a Fortune 500 executive
search consultant. Her firm, JOYOUS, provides leadership development for Asian
Americans.
AJA BROWN
Aja Brown is an economic development expert and community activist, having most
recently served two terms as Mayor of Compton, the youngest person ever to hold
the position. Her “New Vision for Compton” led to unprecedented socioeconomic
growth in her city, as well as a historic decrease in violence. Aja’s leadership
and her work with mothers brings a fresh perspective that inspires women around
Los Angeles and nationally.
OUR 2021
ROSALINE L. ZUKERMAN
WLN EMPOWERMENT AWARD HONOREE
DIANE SHADER SMITH
Diane Shader Smith has been a writer, speaker, publicist and fundraiser for 30
years. For the past two years, Diane has traveled the country offering
inspiration to those who have experienced great loss or are dealing with crisis.
She speaks on behalf of her late daughter Mallory, whose memoir was published
posthumously. Mallory’s work, Salt in My Soul: An Unfinished Life, has been
called life-changing.
OUR IMPACT
Over the past year, thousands of women have been driven out of the workforce as
a direct result of the pandemic. An estimated 9.9 million jobs were lost in the
U.S. within the past year, with women being disproportionately affected. As we
move forward toward hopeful recovery, the Women’s Leadership Network is proud to
assist women experiencing career crisis and transition. Through the JVS SoCal
programs we support, we are uniquely positioned to help women through this time
and get them on the road to recovery.
Since its founding in 2008, the WLN has raised over $3 million dollars to
provide free mentoring career training and job placement support to over 2,500
women participating in JVS SoCal program across Los Angeles and Southern
California. We are able to do this with the support of our members and sponsors
of our annual Woman to Woman Conference, and through the WLN Empowerment Fund.
GET INVOLVED
You can help support the WLN by subscribing to our mailing list, making a
donation, registering for our conference or becoming a volunteer with our
WoMentoring programs. Learn more.
REGISTER TODAY
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Email Address *
First Name
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SPONSORSHIP PACKAGES
9th Annual Woman to Woman Conference
Donnerstag, 18. November 2021
09:00
Registration
Price
Quantity
Total
Presenting Sponsor
(1 registrant)
$50,000
Presenting Sponsor, 1 registrant allowed, price $50,000 1
please refer to our registration form for further details on sponsorship
benefits
Empowerment Sponsor
(1 registrant)
$35,000
Empowerment Sponsor, 1 registrant allowed, price $35,000 1
please refer to our registration form for further details on sponsorship
benefits
Encouragement Sponsor
(1 registrant)
$25,000
Encouragement Sponsor, 1 registrant allowed, price $25,000 1
please refer to our registration form for further details on sponsorship
benefits
Inspiration Sponsor
(1 registrant)
$12,500
Inspiration Sponsor, 1 registrant allowed, price $12,500 1
please refer to our registration form for further details on sponsorship
benefits
Impact Sponsor
(1 registrant)
$6,000
Impact Sponsor, 1 registrant allowed, price $6,000 1
please refer to our registration form for further details on sponsorship
benefits
Essential Sponsor
(1 registrant)
$3,000
Essential Sponsor, 1 registrant allowed, price $3,000 1
please refer to our registration form for further details on sponsorship
benefits
Vital Sponsor
(1 registrant)
$1,000
Vital Sponsor, 1 registrant allowed, price $1,000 1
please refer to our registration form for further details on sponsorship
benefits
Donation
(1 registrant)
$0
Donation, 1 registrant allowed, price $0 1
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State & zip: State: state AA AB AE AK AL AP AR AS AZ BC CA CO CT CZ DC DE FL FM
GA GU HI IA ID IL IN KS KY LA MA MB MD ME MH MI MN MO MP MS MT NB NC ND NE NL NH
NJ NM NS NT NV NY OH OK ON OR PA PE PR PW QC RI SC SD SK TN TX UT VA VI VT WA WI
WV WY YT NU Zip:
City & county: City: County: county (optional) Ada Alameda Albemarle Allegheny
Bergen Berks Bexar Blaine Boulder Bristol Broward Buncombe Camden Cheshire
Chester Clark Cochise Collier Contra Costa Cook Cuyahoga Dallas Dauphin Dekalb
Delaware District Of Columbia Douglas Dupage Eagle East Baton Rouge El Paso Erie
Essex Fairfax Fairfield Franklin Fresno Fulton Hampden Harris Hennepin Howard
Jefferson King Kings Knox Lafayette Lake Litchfield Los Angeles Lucas Maricopa
Marin Marion Marshall Mchenry Mecklenburg Miami-dade Middlesex Milwaukee
Montgomery Nassau Nevada New Haven New York Norfolk Norfolk City Oakland Oldham
Orange Orleans Palm Beach Philadelphia Pima Placer Queens Riverside Sacramento
Saint Louis Saint Louis City San Bernardino San Diego San Francisco San Joaquin
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Yolo England
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OUR GENEROUS SPONSORS
PRESENTING SPONSORS
Terri and Jerry Kohl
Susan W. Robertson
*OF BLESSED MEMORY
EMPOWERMENT SPONSORS
ENCOURAGEMENT SPONSORS
Susan and Fred Kunik
Don Levin Trust
Debbie and Rick Powell
INSPIRATION SPONSORS
Allen and Anita Kohl Charitable Foundation
Herbert McLaughlin Children’s Trust
Barbara and Tom Leanse
Leslie and Bobby Spivak
Harriet Nichols
IMPACT SPONSORS
Linda Brown
Tina Elowitt
Deborah and Alan Levey
Joyce Powell
Nancy and Jeff Cherry
Bonnie Fein
Carol Muchin
Kathy Suto
Jane Z. Cohen
Pamela Hirsh
Eleanor Padnick
Robbi and Tom Schiff
Don and Eileen Coskey Fracchia
Lauren Kurzweil
Nancy and Jeff Paul
ESSENTIAL SPONSORS
Joan August
Lynn Bider
Brooke and Micah Dekofsky
Eileen Goodis
Karen Kaplan Berger
Joni and Jeff Marine
Shana Passman
Deb Schwarz
Trinka Stotsky Soloway
Anne Barnett
Joanie Black
Lynne and Jimmy DeWitt
Salli Harris
Laurie Konheim and Corrine Sands
Teresa Nathanson
Robert Pearman
Annette and Leonard Shapiro
Bonnie and Ronny Bensimon
Sue Brucker
Rusty Feldman
Linda and Jim Hausberg
Wendy Levin
Susan Neisloss
Dr. Michelle Israel and
Robbie Shipp
Jamie and Joel Berman
Alexandra Carter
Linda Essakow
Deborah Kallick
Virginia Maas
Connie and David Oliver
Judy Rosenberg
Jill and Harris Smith
Enterprise Holdings Foundation
VITAL SPONSORS
Eva Aaronson
Harriet Bernstein
Nancy Eisenstadt
Sharon Glaser
Barbara Herman
Debra Loggia
Marlene and Sandy Loucheim
Marylouise Oates
Susan Meltzer
Ellen Sandler
Susan Sugarman
Arnon & Camille Adar
Lynn Behar
Sari Eshman
Nan Goodman
Jackie Gottlieb
Sue Hochberg
Laura Maslon
Adrian Miller
Bonnie Nash
D’Angela Proctor
Charlene & Victor Sands
Sunnye Tuch
Carol Moss Foundation | Mary Aguado
Sophie Alpert
Elisha and David Bolour
Nancy Epstein
Vicki Gold
Adrienne Horwitch
Pamela Kluft
Michaela Mendelsohn
Aliza and David Nikayin
Diane Shader Smith
Renee Remeny
Toby Waldorf
Dr. Adrienne Youdim
Jill Black
Linda Davis
Judy Felsenthal
Pat Gage
Nancy Grant
Janice kamenir Reznik
Neal Mendelsohn
Nancy Noori
Donna Rosen
Andrea Sonnenberg
Janet Wells Kahane
Rosaline L. Zukerman
LAST YEAR’S EVENT
2020 WOMAN TO WOMAN CONFERENCE
ADDITIONAL INFORMATION
If you have questions regarding this annual Conference or the Women’s Leadership
Network, contact lthomas@jvs-socal.org*protected email*
Your Sponsorship and participation will empower women to achieve dignity and
economic independence through sustainable employment.
JVS SoCal is a 501(c)(3) charitable organization
Our Tax ID is 95-1691012
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JVS SoCal
6505 Wilshire Blvd.
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Los Angeles, CA 90048
(323) 761-8888
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JVS SoCal is a 501(c)(3) non-profit organization. EIN number: 95-1691012