www.kennedy24.com
Open in
urlscan Pro
2606:4700:7::a29f:802d
Public Scan
Submitted URL: http://paracom.paramountcommunication.com/ct/62721774:WVMPDwiMN:m:1:2685199000:0B0CFBD7B600CB084C1D33BE999F7D37:r
Effective URL: https://www.kennedy24.com/donate?amount=24&utm_campaign=path_to_victory&utm_medium=email1&utm_source=joinkennedy
Submission: On January 24 via api from US — Scanned from DE
Effective URL: https://www.kennedy24.com/donate?amount=24&utm_campaign=path_to_victory&utm_medium=email1&utm_source=joinkennedy
Submission: On January 24 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
POST /forms/donations
<form id="donate_page_new_donation_form" class="donation_form" method="POST" action="/forms/donations" data-gtm-form-interact-id="0"><input name="authenticity_token" type="hidden" value="JGBPJtqg0N/39pbAuOqKkjVBcKOGU8stF/cR/B3FdRE="><input
name="page_id" type="hidden" value="4840"><input name="return_to" type="hidden" value="https://www.kennedy24.com/donate">
<div class="email_address_form" style="display:none;" aria-hidden="true">
<p><label for="email_address">Optional email code</label><br><input name="email_address" type="text" class="text" id="email_address" autocomplete="off"></p>
</div>
<div class="form">
<div class="form-errors"></div>
<fieldset>
<legend class="donate-legend-header">Donate</legend>
<div class="form-row">
<div class="form-group col">
<div class="donation-v2-amounts">
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_5" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="5">
<label for="donation_amount_5" class="custom-control-label radio">$5</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_25" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="25">
<label for="donation_amount_25" class="custom-control-label radio">$25</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_75" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="75">
<label for="donation_amount_75" class="custom-control-label radio">$75</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_100" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="100">
<label for="donation_amount_100" class="custom-control-label radio">$100</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_240" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="240">
<label for="donation_amount_240" class="custom-control-label radio">$240</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_1000" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="1000">
<label for="donation_amount_1000" class="custom-control-label radio">$1,000</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_3300" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="3300">
<label for="donation_amount_3300" class="custom-control-label radio">$3,300</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_other" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="" data-gtm-form-interact-field-id="0">
<label for="donation_amount_other" class="custom-control-label radio">Other</label>
</div>
<div class="input-group donation-other-input-container">
<div class="input-group-prepend">
<span class="input-group-text currency-symbol">$</span>
</div>
<input id="donation_amount_other_input" type="text" name="donation[amount]" class="form-control text nb_donation_v2_amount" placeholder="Enter Amount" min="1" max="6600" required="required">
<div id="validation_donation_amount_other_input" class="invalid-feedback"> Please enter an amount between $1 and $6,600 </div>
</div>
</div>
</div>
</div>
<div class="form-row align-items-center donation-v2-options ">
</div>
<div class="form-group col-md-6 d-none">
<div class="donation-v2-occurence-radio radio-inline clearfix">
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_donation_occurrence_one_time" type="radio" name="donation[donation_occurrence]" class="custom-control-input donation_amount_option" value="one-time" checked="checked">
<label class="custom-control-label radio" for="donation_donation_occurrence_one_time"> One-time </label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_donation_occurrence_monthly" type="radio" name="donation[donation_occurrence]" class="custom-control-input donation_amount_option" value="monthly">
<label class="custom-control-label radio" for="donation_donation_occurrence_monthly"> Monthly </label>
</div>
</div>
</div>
<div class="custom-control custom-checkbox make-it-monthly-checkbox my-3">
<input class="custom-control-input checkbox" id="make_it_monthly" name="make_it_monthly" type="checkbox" value="0">
<label class="custom-control-label checkbox text-nowrap" for="make_it_monthly">Make it Monthly</label>
<i class="fa-solid fa-circle-info" data-toggle="tooltip" data-placement="top" title="" aria-hidden="true" data-original-title="If checked, payments will automatically be made every 30 days until cancelled."></i><span class="sr-only">If
checked, payments will automatically be made every 30 days until cancelled.</span>
</div>
<div class="custom-control custom-checkbox my-3">
<input class="custom-control-input checkbox" id="donation_donor_covers_fees" name="donation_donor_covers_fees" type="checkbox" value="1">
<label class="custom-control-label checkbox" for="donation_donor_covers_fees">I'll cover the processing fee - add it to my donation.</label>
</div>
</fieldset>
<hr>
<!-- BEGIN EPO CODE - #payments-methods div starts the new button options for Apple/Gpay or credit card -->
<div id="payment-methods" class="payment-options-section" style="display: block;">
<legend class="donate-legend-header">Pay With</legend>
<div class="row">
<div class="form-group col-md-12">
<div id="donation-v2-payment-request" class="StripeElement">
<div class="__PrivateStripeElement" style="margin: 0px !important; padding: 0px !important; border: none !important; display: block !important; background: transparent !important; position: relative !important; opacity: 1 !important;">
<iframe name="__privateStripeFrame46713" frameborder="0" allowtransparency="true" scrolling="no" role="presentation" allow="payment *"
src="https://js.stripe.com/v3/elements-inner-payment-request-826937446387873540409d20f5b074f5.html#locale=auto&wait=false&mids[guid]=NA&mids[muid]=NA&mids[sid]=NA&style[paymentRequestButton][theme]=dark&rtl=false&componentName=paymentRequestButton&keyMode=live&apiKey=pk_live_1TjMHnI0fp51k3hKVhJEpm6D&referrer=https%3A%2F%2Fwww.kennedy24.com%2Fdonate%3Famount%3D24%26utm_campaign%3Dpath_to_victory%26utm_medium%3Demail1%26utm_source%3Djoinkennedy&controllerId=__privateStripeController4671"
title="Secure payment button frame"
style="border: none !important; margin: 0px !important; padding: 0px !important; width: 1px !important; min-width: 100% !important; overflow: hidden !important; display: block !important; user-select: none !important; transform: translate(0px) !important; color-scheme: light only !important; height: 40px; min-height: auto;"></iframe><input
class="__PrivateStripeElement-input" aria-hidden="true" aria-label=" " autocomplete="false" maxlength="1"
style="border: none !important; display: block !important; position: absolute !important; height: 1px !important; top: -1px !important; left: 0px !important; padding: 0px !important; margin: 0px !important; width: 100% !important; opacity: 0 !important; background: transparent !important; pointer-events: none !important; font-size: 16px !important;">
</div>
</div>
</div>
<div class="form-group col-md-12">
<div id="cc-request-button" class="">
<button type="button" class="btn btn-payment-options"><i class="fa-regular fa-credit-card" aria-hidden="true"></i>Credit Card</button>
</div>
</div>
<div class="form-group col-md-6">
<a class="btn btn-payment-options" href="donate-check"><i class="fa-solid fa-money-check-dollar" aria-hidden="true"></i>Check</a>
</div>
<div class="form-group col-md-6">
<a href="https://checkout.opennode.com/p/d05e70a0-a317-4e30-b81d-1ae3e5575d2c" class="btn btn-payment-options" target="_blank"><i class="fa-brands fa-bitcoin" aria-hidden="true"></i>Bitcoin</a>
</div>
</div>
<div id="apple-pay-notice">
<p class="descriptor-text">If you use Apple Pay, your confirmation prompt may refer to our processor, "NationBuilder."</p>
</div>
</div>
<div id="selected-payment-method" class="row" style="display: none;">
<div class="padtop">
<i id="payment-method-icon"></i><a href="#" class="change-payment-method">Change payment method</a>
</div>
<p>You're almost done! Submit donation below.</p>
</div>
<p id="cc-change-payment-method" class="padtop text-center" style="display:none;"> Pay with Credit Card below or<br>
<a href="#" class="change-payment-method">Click to change payment method</a>
</p>
<div id="your-info">
<fieldset>
<legend class="donate-legend-header mb-2">Personal Information</legend>
<p class="text-primary" style="font-size:1rem;">US law requires that we collect all the information on this page when making a political donation.</p>
<div class="">
<div class="">
<p id="demographics-read-only" style="display: none;">
<span id="demographics-name"></span><a href="#" id="edit-demographics">Edit</a><br>
<span id="demographics-email"></span><br>
<span id="demographics-phone"></span>
</p>
</div>
<div id="demographics-info">
<div class="form-row">
<div class="form-group col-md-6">
<div class="float-label">
<label for="donation_first_name">First Name</label>
<input required="required" class="form-control" id="donation_first_name" name="donation[first_name]" type="text">
<div id="validation_donation_first_name" class="invalid-feedback"> Please provide a first name </div>
</div>
</div>
<div class="form-group col-md-6">
<div class="float-label">
<label for="donation_last_name">Last Name</label>
<input required="required" class="form-control" id="donation_last_name" name="donation[last_name]" type="text">
<div id="validation_donation_last_name" class="invalid-feedback"> Please provide a last name </div>
</div>
</div>
<div class="form-group col-md-6">
<div class="float-label">
<label for="donation_email">Email</label>
<input required="required" class="form-control" id="donation_email" name="donation[email]" type="email">
<div id="validation_donation_email" class="invalid-feedback"> Please provide an email </div>
</div>
</div>
<div class="form-group col-md-6">
<div class="float-label">
<label for="donation_billing_address_phone_number">Phone</label>
<input required="required" class="form-control" id="donation_billing_address_phone_number" name="donation[billing_address_attributes][phone_number]" type="tel">
<div id="validation_donation_phone" class="invalid-feedback"> Please provide a phone number </div>
</div>
</div>
</div>
</div>
<div class="">
<div class="">
<p id="address-read-only" style="display: none;">
<span class="address-line">
<span id="address-line1"></span><a href="#" id="edit-address">Edit</a>
</span>
<span class="address-line">
<span id="address-line2"></span>
</span>
<span class="address-line">
<span id="address-city"></span>, <span id="address-state"></span> <span id="address-zip"></span>
</span>
<span class="address-line">
<span id="address-country"></span>
</span>
</p>
</div>
</div>
<div id="address-info">
<div class="form-row">
<div class="form-group col-md-8">
<div class="float-label">
<label for="donation_billing_address_address1">Billing Address</label>
<input required="required" class="form-control" id="donation_billing_address_address1" name="donation[billing_address_attributes][address1]" type="text">
<div id="validation_donation_billing_line1" class="invalid-feedback"> Please provide a billing address </div>
</div>
</div>
<div class="form-group col-md-4">
<div class="float-label">
<label for="donation_billing_address_address2">Unit No. (optional)</label>
<input class="form-control text" id="donation_billing_address_address2" name="donation[billing_address_attributes][address2]" type="text">
</div>
</div>
<div class="form-group col-md-3">
<div class="float-label">
<label for="donation_billing_address_city">City</label>
<input required="required" class="form-control" id="donation_billing_address_city" name="donation[billing_address_attributes][city]" type="text">
<div id="validation_donation_billing_city" class="invalid-feedback"> Please provide a city </div>
</div>
</div>
<div class="form-group col-md-3 us-or-canada us-only hide" style="display: block;">
<div class="float-label">
<label for="donation_state">State</label>
<select id="donation_billing_address_state" name="donation[billing_address_attributes][state]" class="form-control">
<option value="" selected="selected"></option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="AA">Armed Forces Americas</option>
<option value="AE">Armed Forces Europe</option>
<option value="AP">Armed Forces Pacific</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FM">Federated States of Micronesia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MH">Marshall Islands</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PW">Palau</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VI">Virgin Island</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<div id="validation_donation_billing_us_state" class="invalid-feedback"> Please select a state </div>
</div>
</div>
<div class="form-group col-md-3 us-or-canada canada-only hide" style="display: none;">
<div class="float-label">
<label for="donation_billing_address_state">State</label>
<input required="required" class="form-control" id="donation_billing_address_state" name="donation[billing_address_attributes][state]" type="text" disabled="disabled">
<div id="validation_donation_billing_state" class="invalid-feedback"> Please provide a state </div>
</div>
</div>
<div class="form-group col-md-3">
<div class="float-label">
<label for="donation_billing_address_zip">Postal code</label>
<input required="required" class="form-control" id="donation_billing_address_zip" name="donation[billing_address_attributes][zip]" type="text">
<div id="validation_donation_billing_line1" class="invalid-feedback"> Please provide a postal code </div>
</div>
</div>
<div class="form-group col-md-3">
<div class="float-label float-label-active">
<label for="donation_billing_address_country_code">Country</label>
<select id="donation_billing_address_country_code" name="donation[billing_address_attributes][country_code]" class="form-control">
<option value="AF">Afghanistan</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia</option>
<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet Island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</option>
<option value="CV">Cape Verde</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CG">Congo</option>
<option value="CD">Congo, the Democratic Republic of the</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curaçao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="CI">Côte d'Ivoire</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran, Islamic Republic of</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IM">Isle of Man</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JE">Jersey</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macao</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="KP">North Korea</option>
<option value="MK">North Macedonia, Republic of</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestine, State of</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="RO">Romania</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda</option>
<option value="RE">Réunion</option>
<option value="BL">Saint Barthélemy</option>
<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="MF">Saint Martin (French part)</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SX">Sint Maarten (Dutch part)</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="KR">South Korea</option>
<option value="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SZ">Swaziland</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US" selected="selected">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam</option>
<option value="VG">Virgin Islands, British</option>
<option value="VI">Virgin Islands, U.S.</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
<option value="AX">Åland Islands</option>
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<div class="out-of-us-requirement" style="display:none;">
<hr>
<legend class="donate-legend-header">Passport Information</legend>
<div class="form-row">
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<div class="form-group col-md-6">
<div class="float-label">
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</div>
</div>
<div class="form-group col-md-12 mb-0">
<p class="descriptor-text">For donors currently outside United States territory, we are required to record your US Passport number and expiration date.</p>
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</div>
<hr>
<legend class="donate-legend-header">Employer Information (Required)</legend>
<div class="form-row">
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<input class="custom-control-input checkbox" id="retired_not_working" name="retired_not_working" type="checkbox" value="0">
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<div class="form-group col-md-6 employer_details">
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<input required="required" class="form-control" id="donation_occupation" name="donation[occupation]" type="text">
<div id="validation_donation_occupation" class="invalid-feedback"> Please provide your occupation </div>
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</div>
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<div class="form-group">
<p class="descriptor-text">Law requires we ask for your employer and occupation. If you don't have an employer or are retired, check the box above, and if you are self-employed put "self-employed" in employer and describe your occupation.
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<div id="cc-info" class="">
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<legend class="donate-legend-header">Credit Card</legend>
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<div class="card-error-container"></div>
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<input name="donation[is_confirmed]" type="hidden" value="1">
<input name="donation[email_opt_in]" type="hidden" value="1">
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<div class="form-group">
<div class="submit-container">
<div class="donation-v2-amount d-flex align-items-center my-4 justify-content-center">
<span class="pt-1 align-self-start">$</span>
<span class="nb_donation_v2_amount h2 mb-0 mr-1">24.00</span>
<span id="paid_monthly_text"></span>
<div class="text-muted nb_donation_v2_interval pt-1" data-placeholder="paid monthly"></div>
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