secure3.convio.net Open in urlscan Pro
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1 forms found in the DOM

Name: process — POST https://secure3.convio.net/otthf/site/Donation2

<form name="process" id="ProcessForm" action="https://secure3.convio.net/otthf/site/Donation2" method="post" onsubmit="return checkDoubleClick();">
  <div class="donation-form-container responsive">
    <script type="text/javascript">
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        xmlHttp.open('POST', 'AjaxHelper;jsessionid=00000000.app30130a?NONCE_TOKEN=A550F5BBFF9BB41AD157EE619157E310', true);
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    <div class="donation-form-content">
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      <input type="hidden" name="currency_locale" id="currency_locale" value="en_CA">
      <div class="form-progress-bar">
        <div class="progress-bar-step-container progress-bar-step-current">
          <div class="progress-bar-step-number-container">1</div>
          <div class="progress-bar-step-text-container">Gift Selection</div>
        </div>
        <div class="progress-bar-step-container ">
          <div class="progress-bar-step-number-container">2</div>
          <div class="progress-bar-step-text-container">Donor Information</div>
        </div>
        <div class="progress-bar-step-container ">
          <div class="progress-bar-step-number-container">3</div>
          <div class="progress-bar-step-text-container">Payment Information</div>
        </div>
      </div>
      <div class="form-row">
        <div class="html-caption-container">
          <h1>Help us transform care</h1>
          <p>Your support makes an incredible difference for patients like Erin. Your generosity ensures means our medical teams have cutting-edge equipment to save lives like hers, even when it’s a case unlike any ever documented in the world. </p>
          <hr>
          <p class="required-fields-label">Required fields <span>*</span></p>
        </div>
      </div>
      <h2 class="section-header-container"> Gift Information </h2>
      <div id="level_standard_row">
        <div class="don-standard-levels form-row">
          <div class="levels-label">
          </div>
          <div id="level_standard_row" class="form-row form-donation-level">
            <div class="form-content">
              <span class="field-required"></span> <span class="aural-only">Field Is Required</span>
              <span class="FormLabelText">Donation Amount</span>
              <div class="donation-level-general-ask">
              </div>
              <div class="donation-levels">
                <div class="donation-level-container">
                  <div class="form-content">
                    <div class="donation-level-input-container form-input">
                      <div class="donation-level-label-input-container">
                        <input type="radio" name="level_standardexpanded" id="level_standardexpanded5179" value="5179" onclick="evalMatchingGift('$75.00');
updateDonorCoverAmount('$75.00');">
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                      <label for="level_standardexpanded5179" onclick="">
                        <div class="donation-level-amount-container" tabindex="0">$ 75 </div>
                        <div class="donation-level-label-container"> $75 </div>
                      </label>
                    </div>
                    <input type="hidden" name="level_standardexpandedsubmit" id="level_standard_5179expandedsubmit" value="true">
                  </div>
                </div>
                <div class="donation-level-container">
                  <div class="form-content">
                    <div class="donation-level-input-container form-input">
                      <div class="donation-level-label-input-container">
                        <input type="radio" name="level_standardexpanded" id="level_standardexpanded5180" value="5180" checked="checked" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');">
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                      <label for="level_standardexpanded5180" onclick="">
                        <div class="donation-level-amount-container selected" tabindex="0">$ 100 </div>
                        <div class="donation-level-label-container"> $100 </div>
                      </label>
                    </div>
                    <input type="hidden" name="level_standardexpandedsubmit" id="level_standard_5180expandedsubmit" value="true">
                  </div>
                </div>
                <div class="donation-level-container">
                  <div class="form-content">
                    <div class="donation-level-input-container form-input">
                      <div class="donation-level-label-input-container">
                        <input type="radio" name="level_standardexpanded" id="level_standardexpanded5470" value="5470" onclick="evalMatchingGift('$250.00');
updateDonorCoverAmount('$250.00');">
                      </div>
                      <label for="level_standardexpanded5470" onclick="">
                        <div class="donation-level-amount-container" tabindex="0">$ 250 </div>
                        <div class="donation-level-label-container"> $250 </div>
                      </label>
                    </div>
                    <input type="hidden" name="level_standardexpandedsubmit" id="level_standard_5470expandedsubmit" value="true">
                  </div>
                </div>
                <div class="donation-level-container">
                  <div class="form-content">
                    <div class="donation-level-input-container form-input">
                      <div class="donation-level-label-input-container">
                        <input type="radio" name="level_standardexpanded" id="level_standardexpanded5183" value="5183" onclick="evalMatchingGift('$500.00');
updateDonorCoverAmount('$500.00');">
                      </div>
                      <label for="level_standardexpanded5183" onclick="">
                        <div class="donation-level-amount-container" tabindex="0">$ 500 </div>
                        <div class="donation-level-label-container"> $500 </div>
                      </label>
                    </div>
                    <input type="hidden" name="level_standardexpandedsubmit" id="level_standard_5183expandedsubmit" value="true">
                  </div>
                </div>
                <div class="donation-level-container">
                  <div class="form-content">
                    <div class="donation-level-input-container form-input">
                      <div class="donation-level-label-input-container">
                        <input type="radio" name="level_standardexpanded" id="level_standardexpanded5469" value="5469" onclick="evalMatchingGift('$1,000.00');
updateDonorCoverAmount('$1,000.00');">
                      </div>
                      <label for="level_standardexpanded5469" onclick="">
                        <div class="donation-level-amount-container" tabindex="0">$ 1,000 </div>
                        <div class="donation-level-label-container"> $1,000 </div>
                      </label>
                    </div>
                    <input type="hidden" name="level_standardexpandedsubmit" id="level_standard_5469expandedsubmit" value="true">
                  </div>
                </div>
                <div class="donation-level-container">
                  <div class="form-content">
                    <div class="donation-level-input-container form-input">
                      <div class="donation-level-label-input-container">
                        <input type="radio" name="level_standardexpanded" id="level_standardexpanded5184" value="5184" onclick="evalMatchingGift(document.getElementById('level_standardexpanded5184amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded5184amount').value);">
                      </div>
                      <label for="level_standardexpanded5184" onclick="">
                        <div class="donation-level-label-container"> Other </div>
                      </label>
                      <div class="donation-level-user-entered">
                        <label for="level_standardexpanded5184amount"><span class="aural-only">Enter amount</span></label>
                        <input type="text" name="level_standardexpanded5184amount" id="level_standardexpanded5184amount" value="" size="12" maxlength="50"
                          onfocus="var el = document.getElementById ('level_standardexpanded5184');if (el) el.click(); fire_obs_comp_event('level_standardexpanded5184amount', this, event);evalMatchingGift(value); "
                          onchange="fire_obs_comp_event('level_standardexpanded5184amount', this, event);evalMatchingGift(value);" onkeyup="fire_obs_comp_event('level_standardexpanded5184amount', this, event);evalMatchingGift(value);"
                          onblur="fire_obs_comp_event('level_standardexpanded5184amount', this);updateDonorCoverAmount(value);" placeholder="Other amount">
                      </div>
                    </div>
                    <input type="hidden" name="level_standardexpandedsubmit" id="level_standard_5184expandedsubmit" value="true">
                  </div>
                </div>
              </div>
            </div>
            <script type="text/javascript">
              Y.use("jquery-ui", function(Y) {
                jQuery(function() {
                  // subscribe observables
                  jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
                    var syncAction = function(obj) {
                      if (obj.is(':checked')) {
                        obj.closest('div.donation-level-container').addClass('selected');
                      } else {
                        obj.closest('div.donation-level-container').removeClass('selected');
                      };
                      return arguments.callee;
                    }(jQuery(this));
                    jQuery(this).click(function() {
                      jQuery('div.donation-level-container').removeClass('selected');
                      syncAction(jQuery(this));
                    });
                  });
                });
              });
            </script><noscript> </noscript>
          </div>
          <div class="levels-gift-aid">
          </div>
          <input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true">
          <script type="text/javascript">
            function updateDonorCoverAmount(gift) {
              if (typeof updateAmount !== "undefined") {
                updateAmount(gift);
              }
            };

            function evalMatchingGift(gift) {}
          </script><noscript> </noscript>
        </div>
        <script type="text/javascript">
          // subscribe listeners to make an ajax call to the server to calculate the total amount
          Y.use('jquery-noconflict', function() {
            var fetchAmountFunc = function() {
              // find all the select, textarea, input, etc... and format them into key=val pairs.
              var params = jQuery('#level_standard_row :input').serialize();
              // parse the path and append the key/value pairs above to the url
              var url = 'https://secure3.convio.net/otthf/site/Donation2?2967.donation=form1&idb=1389848086&level_standardajaxfetch=true&df_id=2967&mfc_pref=T&level_standardtotalcalculateBtn=true';
              var index = url.indexOf("?");
              var path = url.substring(0, index);
              var args = url.substring(index + 1, url.length);
              args += '&' + params;
              var recurringGiftTermsContainer = jQuery('#recurring_gift_terms_acceptance_message_container');
              if (recurringGiftTermsContainer && recurringGiftTermsContainer.length > 0) {
                jQuery.ajax(path, {
                  data: args,
                  success: function(data) {
                    jQuery('#recurring_gift_terms_acceptance_message_container').trigger("recurringTermsChange");
                  }
                });
              }
            };
            jQuery('#level_standard_row :input[type=text]').blur(function() {
              fetchAmountFunc();
            });
            jQuery('#level_standard_row input:checkbox, #level_standard_row input:radio').click(function() {
              fetchAmountFunc();
            });
            jQuery('#level_standard_row select').change(function() {
              fetchAmountFunc();
            });
            // call it on page load
            fetchAmountFunc();
          });
        </script><noscript> </noscript>
      </div>
      <div id="anonymous_donation_row" class="form-row form-checkbox">
        <div class="form-content">
          <input type="checkbox" name="anonymous_donationname" id="anonymous_donationname" onclick="fire_obs_comp_event('anonymous_donation', this);">
          <label for="anonymous_donationname">Yes, I would like to make this donation anonymously</label>
          <input type="hidden" name="anonymous_donationsubmit" id="anonymous_donationsubmit" value="true">
          <script type="text/javascript">
            var comp = new ObservableComponent('anonymous_donation', 'name');
            comp.hide = function(_hidden) {
              var _display = _hidden ? 'none' : '';
              set_display('anonymous_donation_row', _display);
              this.disable_submit_flag(_hidden);
            }
            comp.set = function(_value) {
              if (document.getElementById('anonymous_donationname')) {
                document.getElementById('anonymous_donationname').checked = _value;
                this.fireEvent();
              }
            }
            comp.get = function() {
              if (document.getElementById('anonymous_donationname')) {
                return document.getElementById('anonymous_donationname').checked;
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            }
            comp.clear = function() {
              this.set(false);
            }
          </script><noscript> </noscript>
        </div>
      </div>
      <div id="single_designee_row" class="form-row form-designee">
        <div class="form-content">
          <fieldset>
            <legend>
              <span class="field-required"></span> <span class="aural-only">Field Is Required</span> Please direct my gift to:
            </legend>
            <div class="form-input">
              <div class="unrestricted-option">
                <input type="radio" name="single_designee_radio" id="single_designee_unrestricted" value="unrestricted" onclick="single_designee_disable_list(this.checked);" checked="checked">
                <label for="single_designee_unrestricted">Use my gift where it is needed most.</label>
              </div>
              <div class="designated-option">
                <input type="radio" name="single_designee_radio" id="single_designee_designated" value="designated" onclick="single_designee_enable_list(this.checked);">
                <label for="single_designee_designated"></label>
                <select name="single_designee" id="single_designee" size="1" disabled="">
                  <option selected="selected" value="0">Select a program</option>
                  <option value="1383">Cancer Research</option>
                  <option value="1386">Equipment, Technology and Innovation</option>
                  <option value="1381">Our New Hospital</option>
                  <option value="1384">Research to Improve Patient Care</option>
                  <option value="1385">Stem Cell Research</option>
                </select>
                <script type="text/javascript">
                  <!--
                  var comp = new ObservableComponent('single_designee', '');
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                  //
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                </script>
                <noscript><br>Required</noscript>
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            </div>
          </fieldset>
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        <input type="hidden" name="single_designeesubmit" id="single_designeesubmit" value="true">
        <script type="text/javascript">
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            var e = _evt ? _evt : event; // IE vs. Mozilla event model
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              var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
              fire_obs_comp_event('single_designee', src);
            }
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          var el = document.getElementById('single_designee');
          if (el) {
            Utils.addEvent(el, 'change', single_designee_listChanged);
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        </script><noscript> </noscript>
      </div>
      <div class="custom-field-container form-row ">
        <div class="form-content">
          <div class="form-input-label-block">
            <label for="inspiration_input">What inspired you to donate:</label>
          </div>
          <input type="text" name="inspiration_input" id="inspiration_input" value="" maxlength="255">
          <input type="hidden" name="inspirationsubmit" id="inspirationsubmit" value="true">
        </div>
      </div>
      <div class="button-container clearfix">
        <div class="button-sub-container">
          <button class="step-button next-step" type="submit" id="pstep_next" name="pstep_next" value="Next">Next<i class="fas fa-caret-right" aria-hidden="true"></i></button>
          <button class="step-button cancel-step" type="submit" id="pstep_cancel" name="pstep_cancel" value="Cancel" title="Cancel">Cancel</button>
        </div>
      </div>
      <input type="hidden" name="idb" id="idb" value="1389848086">
      <input type="hidden" name="df_id" id="df_id" value="2967">
      <input type="hidden" name="mfc_pref" id="mfc_pref" value="T">
    </div>
    <input type="hidden" name="2967.donation" id="2967.donation" value="form1">
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  </script><noscript> </noscript>
</form>

Text Content

Why Give? FR

 * One-time gift
 * Monthly gift

1
Gift Selection
2
Donor Information
3
Payment Information


HELP US TRANSFORM CARE

Your support makes an incredible difference for patients like Erin. Your
generosity ensures means our medical teams have cutting-edge equipment to save
lives like hers, even when it’s a case unlike any ever documented in the world.

--------------------------------------------------------------------------------

Required fields *


GIFT INFORMATION

Field Is Required Donation Amount

$ 75
$75
$ 100
$100
$ 250
$250
$ 500
$500
$ 1,000
$1,000
Other
Enter amount
 

 
 
Yes, I would like to make this donation anonymously  
Field Is Required Please direct my gift to:
Use my gift where it is needed most.
Select a program Cancer Research Equipment, Technology and Innovation Our New
Hospital Research to Improve Patient Care Stem Cell Research
Required
 
What inspired you to donate:
Next Cancel
 


CONTACT US

The Ottawa Hospital Foundation
737 Parkdale Avenue, 1st Floor, Box 610,
Ottawa, ON K1Y 1J8

Tel 613-761-4295

Fax 613-761-5014

© 2024 The Ottawa Hospital Foundation

 * 
 * 
 * 
 * 
 * 


WHY GIVE?

Thanks to support from people like you, our hospital has been able to push the
boundaries of research and healthcare to provide new hope to patients. Your
support today will fuel more groundbreaking discoveries, treatment, and patient
care — providing greater hope for us all.

Continue to Donate


CREDIT CARD VERIFICATION CODE

The Verification Code is imprinted on credit cards to help merchants verify
transactions when the actual card is not present, such as Internet purchases or
donations. The merchant uses this number as part of the authorization process
with the card issuer.

Please use the images below to locate the verification code for your card type.


VISA & MASTERCARD

The verification code for Visa or Mastercard is a 3-digit number printed on the
back of your card. It appears after the account number or last 4-digits of your
account number, in the signature panel.


AMERICAN EXPRESS

The American Express verification code is a 4-digit number printed on the front
of your card. It appears above and to the right of the embossed account number.