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Submitted URL: https://go.levitate.ai/projects/80347-give-the-gift-of-mobility?t=1299dffa9d1142a89267e12da51bb3cf
Effective URL: https://pentaprosthetics.networkforgood.com/projects/80347-give-the-gift-of-mobility
Submission: On November 25 via manual from SG — Scanned from SG
Effective URL: https://pentaprosthetics.networkforgood.com/projects/80347-give-the-gift-of-mobility
Submission: On November 25 via manual from SG — Scanned from SG
Form analysis 1 forms found in the DOM
POST /projects/80347-give-the-gift-of-mobility/donations
<form class="simple_form new_donation_form" id="donation_form" novalidate="novalidate" data-donation-form="inline" action="/projects/80347-give-the-gift-of-mobility/donations" accept-charset="UTF-8" data-remote="true" method="post">
<div class="d-none hidden donation_form_step"><input value="2" class="hidden" autocomplete="off" type="hidden" name="donation_form[step]" id="donation_form_step"></div>
<div id="inline_donation_form">
<div data-additional-instructions-char-count="250"
data-canadian-provinces="["<option></option>", "<option value=\"AB\">Alberta</option>", "<option value=\"BC\">British Columbia</option>", "<option value=\"MB\">Manitoba</option>", "<option value=\"NB\">New Brunswick</option>", "<option value=\"NL\">Newfoundland and Labrador</option>", "<option value=\"NS\">Nova Scotia</option>", "<option value=\"NT\">Northwest Territories</option>", "<option value=\"NU\">Nunavut</option>", "<option value=\"ON\">Ontario</option>", "<option value=\"PE\">Prince Edward Island</option>", "<option value=\"QC\">Quebec</option>", "<option value=\"SK\">Saskatchewan</option>", "<option value=\"YT\">Yukon Territory</option>"]"
data-donor-note-char-count="150" data-toggle="donation-form-interactions" data-tribute-note-char-count="150"
data-us-states="["<option></option>", "<option value=\"AK\">Alaska</option>", "<option value=\"AL\">Alabama</option>", "<option value=\"AR\">Arkansas</option>", "<option value=\"AZ\">Arizona</option>", "<option value=\"CA\">California</option>", "<option value=\"CO\">Colorado</option>", "<option value=\"CT\">Connecticut</option>", "<option value=\"DC\">District of Columbia</option>", "<option value=\"DE\">Delaware</option>", "<option value=\"FL\">Florida</option>", "<option value=\"GA\">Georgia</option>", "<option value=\"HI\">Hawaii</option>", "<option value=\"IA\">Iowa</option>", "<option value=\"ID\">Idaho</option>", "<option value=\"IL\">Illinois</option>", "<option value=\"IN\">Indiana</option>", "<option value=\"KS\">Kansas</option>", "<option value=\"KY\">Kentucky</option>", "<option value=\"LA\">Louisiana</option>", "<option value=\"MA\">Massachusetts</option>", "<option value=\"MD\">Maryland</option>", "<option value=\"ME\">Maine</option>", "<option value=\"MI\">Michigan</option>", "<option value=\"MN\">Minnesota</option>", "<option value=\"MO\">Missouri</option>", "<option value=\"MS\">Mississippi</option>", "<option value=\"MT\">Montana</option>", "<option value=\"NC\">North Carolina</option>", "<option value=\"ND\">North Dakota</option>", "<option value=\"NE\">Nebraska</option>", "<option value=\"NH\">New Hampshire</option>", "<option value=\"NJ\">New Jersey</option>", "<option value=\"NM\">New Mexico</option>", "<option value=\"NV\">Nevada</option>", "<option value=\"NY\">New York</option>", "<option value=\"OH\">Ohio</option>", "<option value=\"OK\">Oklahoma</option>", "<option value=\"OR\">Oregon</option>", "<option value=\"PA\">Pennsylvania</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=\"VA\">Virginia</option>", "<option value=\"VT\">Vermont</option>", "<option value=\"WA\">Washington</option>", "<option value=\"WI\">Wisconsin</option>", "<option value=\"WV\">West Virginia</option>", "<option value=\"WY\">Wyoming</option>"]">
<label for="donation_donation_amount">Donation Amount</label>
<input autocomplete="off" type="hidden" name="donation[donation_amount]" id="donation_donation_amount">
<div class="row form-row mb-2" data-toggle="buttons" id="suggested-amts-wrapper">
<div class="col-6 col-md-4 mb-2">
<button class="donation_amount_lbl px-1 btn-lg btn btn-block d-flex align-items-start h-100 mb-0 btn-outline-secondary" for="_donation_donation_amount_25_0">
<span class="sr-only">Donate</span>
<input id="_donation_donation_amount_25_0" class="d-none" type="radio" value="25.0" name="donation[donation_amount]">
<div class="w-100">
<h2 class="h5 text-wrap text-break">$25</h2>
<p class="mt-1 mb-0 text-wrap text-break font-size-sm">shipping cost of 5 prosthetic feet</p>
</div>
</button>
</div>
<div class="col-6 col-md-4 mb-2">
<button class="donation_amount_lbl px-1 btn-lg btn btn-block d-flex align-items-start h-100 mb-0 btn-outline-secondary" for="_donation_donation_amount_50_0">
<span class="sr-only">Donate</span>
<input id="_donation_donation_amount_50_0" class="d-none" type="radio" value="50.0" name="donation[donation_amount]">
<div class="w-100">
<h2 class="h5 text-wrap text-break">$50</h2>
<p class="mt-1 mb-0 text-wrap text-break font-size-sm">warehouse supplies for 2 months</p>
</div>
</button>
</div>
<div class="col-6 col-md-4 mb-2">
<button class="donation_amount_lbl px-1 btn-lg btn btn-block d-flex align-items-start h-100 mb-0 btn-outline-secondary" for="_donation_donation_amount_100_0">
<span class="sr-only">Donate</span>
<input id="_donation_donation_amount_100_0" class="d-none" type="radio" value="100.0" name="donation[donation_amount]">
<div class="w-100">
<h2 class="h5 text-wrap text-break">$100</h2>
<p class="mt-1 mb-0 text-wrap text-break font-size-sm">shipping cost of 20 prosthetic feet</p>
</div>
</button>
</div>
<div class="col-6 col-md-4 mb-2">
<button class="donation_amount_lbl px-1 btn-lg btn btn-block d-flex align-items-start h-100 mb-0 btn-outline-secondary" for="_donation_donation_amount_250_0">
<span class="sr-only">Donate</span>
<input id="_donation_donation_amount_250_0" class="d-none" type="radio" value="250.0" name="donation[donation_amount]">
<div class="w-100">
<h2 class="h5 text-wrap text-break">$250</h2>
<p class="mt-1 mb-0 text-wrap text-break font-size-sm">1 person with regained mobility</p>
</div>
</button>
</div>
<div class="col-6 col-md-4 mb-2">
<button class="donation_amount_lbl px-1 btn-lg btn btn-block d-flex align-items-start h-100 mb-0 btn-outline-secondary" for="_donation_donation_amount_500_0">
<span class="sr-only">Donate</span>
<input id="_donation_donation_amount_500_0" class="d-none" type="radio" value="500.0" name="donation[donation_amount]">
<div class="w-100">
<h2 class="h5 text-wrap text-break">$500</h2>
<p class="mt-1 mb-0 text-wrap text-break font-size-sm">2 people with regained mobility</p>
</div>
</button>
</div>
<div class="col-6 col-md-4 mb-2" id="donation_custom_amount">
<div class="btn-outline-secondary px-2 btn btn-block d-flex align-items-start h-100 mb-0" id="donation_custom_amount_bootstrap_btn">
<div class="w-100">
<div class="media">
<div class="align-self-center mr-1">
<input id="_donation_donation_amount_-1" class="d-none" type="radio" value="-1" name="donation[donation_amount]">
<label for="_donation_donation_amount_-1" class="h5 mb-0">$ <span class="sr-only">Enter custom donation amount</span>
</label>
</div>
<div class="media-body"><input class="form-control" inputmode="numeric" pattern="[0-9]*" title="Custom Donation Amount" type="text" name="donation[donation_amount_custom_amount]" id="donation_donation_amount_custom_amount">
</div>
</div>
<p class="mt-1 mb-0 text-wrap text-break font-size-sm">Choose your own amount</p>
</div>
</div>
</div>
</div>
<input id="donation_form_targetable_type" autocomplete="off" type="hidden" value="Project" name="donation_form[targetable_type]">
<input id="donation_form_targetable_id" autocomplete="off" type="hidden" value="80347" name="donation_form[targetable_id]">
<div class="row form-row align-items-end" id="recurring_donation_block">
<div class="col-12 col-md-6" id="donation_recurring_donation_period">
<div class="form-group select required recurring_donation_period"><label class="select required control-label not-required" for="recurring_donation_period">Select Donation Frequency</label><select class="custom-select select required w-100"
id="recurring_donation_period" name="recurring_donation[period]">
<option selected="selected" value="one_time">One-time</option>
<option value="monthly">Monthly</option>
<option value="annually">Annually</option>
</select></div>
</div>
<div class="col-12 col-md-6 d-none" data-toggle="recurring-donation-end-date" id="donation_recurring_donation_end">
<div class="form-group string optional recurring_donation_end_date"><label class="string optional control-label" for="recurring_donation_end_date">Ending (Optional)</label><span class="Zebra_DatePicker_Icon_Wrapper"
style="display: block; position: relative; inset: auto;"><input class="form-control string optional" id="recurring_donation_end_date" data-toggle="datepicker" autocomplete="off" type="text" name="recurring_donation[end_date]"
style="position: relative; inset: auto;"><button type="button" class="Zebra_DatePicker_Icon Zebra_DatePicker_Icon_Inside" style="top: 12px; left: 81px;">Pick a date</button></span></div>
</div>
</div>
<!-- Donation Note -->
<div class="form-group">
<div class="form-group text optional donation_note mb-1"><label class="text optional control-label" for="donation_note">Your Note for the Donor Scroll</label><textarea class="form-control text optional" id="donation_note" rows="5"
placeholder="Write a public note about why you're choosing to give!" name="donation[note]"></textarea></div>
<p class="mb-0 form-text text-right text-muted font-size-sm"><span data-counter="donation-note" class="text-muted">0</span> / <span data-describe="max-length-for-donation-note-counter"> 150 </span>
</p>
</div>
<div class="row form-row">
<div class="col-12 col-md-6">
<div class="form-group">
<div class="form-group boolean optional donation_publish_my_donation_amount">
<div class="form-check "><input value="0" autocomplete="off" type="hidden" name="donation[publish_my_donation_amount]"><input id="donation_publish_my_donation_amount" class="form-check-input" type="checkbox" value="1" checked="checked"
name="donation[publish_my_donation_amount]"><label class="form-check-label" for="donation_publish_my_donation_amount">Post my donation amount</label></div>
</div>
</div>
</div>
<div class="col-12 col-md-6">
<div class="form-group">
<div class="form-group boolean optional donation_publish_my_name">
<div class="form-check "><input value="0" autocomplete="off" type="hidden" name="donation[publish_my_name]"><input id="donation_publish_my_name" class="form-check-input" type="checkbox" value="1" checked="checked"
name="donation[publish_my_name]"><label class="form-check-label" for="donation_publish_my_name">Post my name</label></div>
</div>
</div>
</div>
</div>
<div class="form-group select optional donation_honor_or_memorialize"><label class="select optional control-label" for="donation_honor_or_memorialize">Honor or remember someone with your gift?</label><select
class="custom-select select optional donation-honor-or-memorialize" id="donation_honor_or_memorialize" name="donation[honor_or_memorialize]">
<option selected="selected" value="No">No</option>
<option value="Honor">Honor</option>
<option value="Memorial">Memorial</option>
</select></div>
<div class="tribute-info d-none" data-toggle="tribute-info">
<div class="row form-row">
<div class="col-6">
<div class="form-group string required tribute_name"><label class="string required control-label" for="tribute_name">Whom do you want to recognize?</label><input class="form-control string required" id="tribute_name"
placeholder="Person or group name" type="text" name="tribute[name]"></div>
</div>
<div class="col-6">
<div class="form-group string optional tribute_relationship"><label class="string optional control-label" for="tribute_relationship">Your relationship to them:</label><input class="form-control string optional" id="tribute_relationship"
placeholder="E.g. Father" type="text" name="tribute[relationship]"></div>
</div>
</div>
<div class="modal-row modal-tribute-advanced d-none" data-toggle="tribute-notification">
<div class="form-group">
<h5 class="mb-2">Include a note to the recipient:</h5>
<div class="form-group text required tribute_note mb-1"><label class="text required control-label" for="tribute_note">What would you like the note to say?</label><textarea class="form-control text required" id="tribute_note" rows="5"
required="required" aria-required="true" name="tribute[note]"></textarea></div>
<p class="mb-0 form-text text-right text-muted font-size-sm"><span data-counter="tribute" id="tribtueNoteCounter" class="text-muted">0</span> / <span data-describe="max-length-for-notification-counter"> 150 </span>
</p>
</div>
<div id="notification_recipient">
<h5 class="mb-2">Where Should We Send the Notification?</h5>
<div class="row form-row">
<div class="col-6">
<div class="form-group string required person_first_name"><label class="string required control-label" for="person_first_name">First Name</label><input class="form-control string required" id="person_first_name" type="text"
name="person[first_name]"></div>
</div>
<div class="col-6">
<div class="form-group string required person_last_name"><label class="string required control-label" for="person_last_name">Last Name</label><input class="form-control string required" id="person_last_name" type="text"
name="person[last_name]"></div>
</div>
</div>
<div
data-canadian-provinces="["<option></option>", "<option value=\"AB\">Alberta</option>", "<option value=\"BC\">British Columbia</option>", "<option value=\"MB\">Manitoba</option>", "<option value=\"NB\">New Brunswick</option>", "<option value=\"NL\">Newfoundland and Labrador</option>", "<option value=\"NS\">Nova Scotia</option>", "<option value=\"NT\">Northwest Territories</option>", "<option value=\"NU\">Nunavut</option>", "<option value=\"ON\">Ontario</option>", "<option value=\"PE\">Prince Edward Island</option>", "<option value=\"QC\">Quebec</option>", "<option value=\"SK\">Saskatchewan</option>", "<option value=\"YT\">Yukon Territory</option>"]"
data-us-states="["<option></option>", "<option value=\"AK\">Alaska</option>", "<option value=\"AL\">Alabama</option>", "<option value=\"AR\">Arkansas</option>", "<option value=\"AZ\">Arizona</option>", "<option value=\"CA\">California</option>", "<option value=\"CO\">Colorado</option>", "<option value=\"CT\">Connecticut</option>", "<option value=\"DC\">District of Columbia</option>", "<option value=\"DE\">Delaware</option>", "<option value=\"FL\">Florida</option>", "<option value=\"GA\">Georgia</option>", "<option value=\"HI\">Hawaii</option>", "<option value=\"IA\">Iowa</option>", "<option value=\"ID\">Idaho</option>", "<option value=\"IL\">Illinois</option>", "<option value=\"IN\">Indiana</option>", "<option value=\"KS\">Kansas</option>", "<option value=\"KY\">Kentucky</option>", "<option value=\"LA\">Louisiana</option>", "<option value=\"MA\">Massachusetts</option>", "<option value=\"MD\">Maryland</option>", "<option value=\"ME\">Maine</option>", "<option value=\"MI\">Michigan</option>", "<option value=\"MN\">Minnesota</option>", "<option value=\"MO\">Missouri</option>", "<option value=\"MS\">Mississippi</option>", "<option value=\"MT\">Montana</option>", "<option value=\"NC\">North Carolina</option>", "<option value=\"ND\">North Dakota</option>", "<option value=\"NE\">Nebraska</option>", "<option value=\"NH\">New Hampshire</option>", "<option value=\"NJ\">New Jersey</option>", "<option value=\"NM\">New Mexico</option>", "<option value=\"NV\">Nevada</option>", "<option value=\"NY\">New York</option>", "<option value=\"OH\">Ohio</option>", "<option value=\"OK\">Oklahoma</option>", "<option value=\"OR\">Oregon</option>", "<option value=\"PA\">Pennsylvania</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=\"VA\">Virginia</option>", "<option value=\"VT\">Vermont</option>", "<option value=\"WA\">Washington</option>", "<option value=\"WI\">Wisconsin</option>", "<option value=\"WV\">West Virginia</option>", "<option value=\"WY\">Wyoming</option>"]"
id="address_block">
<div class="form-group string required person_street_address"><label class="string required control-label" for="person_street_address">Street Address</label><input class="form-control string required" id="person_street_address"
required="required" aria-required="true" type="text" name="person[street_address]"></div>
<div class="form-group string optional person_street_address2"><label class="string optional control-label" for="person_street_address2">Street Address 2</label><input class="form-control string optional" id="person_street_address2"
type="text" name="person[street_address2]">
<div class="form-text text-muted">Apartment, suite, etc. (optional)</div>
</div>
<div class="form-group string required person_city"><label class="string required control-label" for="person_city">City</label><input class="form-control string required w-lg-75" id="person_city" required="required" aria-required="true"
type="text" name="person[city]"></div>
<div class="row form-row">
<div class="col-12 col-md" id="state_field">
<div class="form-group"><label class="string optional control-label required" id="person_address_state_label" data-describe="state-label" for="person_state">State / Province</label>
<select class="custom-select w-100" data-country="US" id="person_state" name="person[state]">
<option value="" label=" "></option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="AE">Armed Forces Africa, Canada, Europe, Middle East</option>
<option value="AA">Armed Forces Americas (except Canada)</option>
<option value="AP">Armed Forces Pacific</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="MP">Northern Mariana Islands</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VI">Virgin Islands</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 class="form-group string optional person_state"><input class="form-control string optional d-none" id="person_address_state_text" name="" type="text"></div>
</div>
</div>
<div class="col-12 col-md-auto">
<div class="form-group string required person_zip_code"><label class="string required control-label" for="person_zip_code">Zip / Postal Code</label><input class="form-control string required w-auto" id="person_zip_code"
required="required" aria-required="true" type="text" name="person[zip_code]"></div>
</div>
</div>
<div class="form-group"><label class="country optional control-label required" for="person_country">Country</label>
<select class="custom-select" id="person_country" name="person[country]">
<option value="" label=" "></option>
<option selected="selected" value="US">United States</option>
<option value="CA">Canada</option>
<option disabled="disabled" value="---------------">---------------</option>
<option value="AF">Afghanistan</option>
<option value="AX">Åland Islands</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia</option>
<option value="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="CV">Cabo Verde</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</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="CI">Côte d'Ivoire</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curaçao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czechia</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="SZ">Eswatini</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island 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="KP">Korea, Democratic People's Republic of</option>
<option value="KR">Korea, Republic of</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</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="MK">North Macedonia</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="RE">Réunion</option>
<option value="RO">Romania</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda</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="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="US">United States</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela</option>
<option value="VN">Vietnam</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>
</select>
</div>
</div>
<div class="row form-row">
<div class="col-6">
<div class="form-group email optional person_email"><label class="email optional control-label" for="person_email">Email</label><input class="form-control string email optional" id="person_email" type="email" name="person[email]">
</div>
</div>
<div class="col-6">
<div class="form-group tel optional person_phone"><label class="tel optional control-label" for="person_phone">Phone</label><input class="form-control string tel optional" id="person_phone" type="tel" name="person[phone]"></div>
</div>
</div>
</div>
</div>
</div>
</div>
<button class="btn rounded-pill btn-lg btn-primary btn-block" data-describe="campaign-donate-button" data-disable-with="<i aria-hidden="true" class="fa fa-spinner fa-spin fa-fw"></i>" type="submit">Donate Once</button>
</div>
</form>Text Content
* Log In GIVE THE GIFT OF MOBILITY You can restore mobility to more people in need. Donation Amount Donate $25 shipping cost of 5 prosthetic feet Donate $50 warehouse supplies for 2 months Donate $100 shipping cost of 20 prosthetic feet Donate $250 1 person with regained mobility Donate $500 2 people with regained mobility $ Enter custom donation amount Choose your own amount Select Donation FrequencyOne-time Monthly Annually Ending (Optional)Pick a date Your Note for the Donor Scroll 0 / 150 Post my donation amount Post my name Honor or remember someone with your gift?No Honor Memorial Whom do you want to recognize? Your relationship to them: INCLUDE A NOTE TO THE RECIPIENT: What would you like the note to say? 0 / 150 WHERE SHOULD WE SEND THE NOTIFICATION? First Name Last Name Street Address Street Address 2 Apartment, suite, etc. (optional) City State / Province Alabama Alaska American Samoa Arizona Arkansas Armed Forces Africa, Canada, Europe, Middle East Armed Forces Americas (except Canada) Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip / Postal Code Country United States Canada --------------- Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czechia Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Email Phone Donate Once SHARE: GIVE TODAY AND CHANGE A LIFE Penta Medical Recycling has emerged as the only nonprofit repurposing prosthetic limbs on a global scale. And we're growing! Today, Penta works with over 50 health partners spanning 29 countries. Your gift will deliver access to needed prosthetics to more people all over the world: $25 = shipping cost of 5 prosthetic feet $50 = needed supplies in our warehouse for 2 months $250 = one person regaining mobility with prosthetics from Penta As a valued Penta donor, you will change more lives in the global amputee community for people like Resty (Uganda): -------------------------------------------------------------------------------- Resty lost her leg when a truck lost control and crashed into the house where she was staying. As a result, Resty lost her job due to her injuries. Today, Resty has a new leg with Penta prosthetics. She has found a new job as a special needs teacher and is even able to drive herself to work! -------------------------------------------------------------------------------- Please give today to maximize the impact of your donation. Together, we will continue to restore mobility to those who need it most around the world. With gratitude, The Penta Team OUR SUPPORTERS * DAVID BOGER $500 I donated in support of this campaign. 2 days ago * DAVENA WITCHER $100 I donated in support of this campaign. 2 days ago * ANONYMOUS I donated in support of this campaign. 30 days ago * MICHAEL LUNDQUIST $50 It's is great to see that you are doing so well. Looking forward to visiting your new site one of these days. 6 months ago * LANCE CHANTILES-WERTZ I donated in support of this campaign. 11 months ago * ANONYMOUS I donated in support of this campaign. 11 months ago * ANONYMOUS I donated in support of this campaign. 11 months ago * ANONYMOUS $100 Penta is a top-notch organization and I am lucky to have crossed paths with them. 11 months ago * ANONYMOUS $1,000 I donated in support of this campaign. 11 months ago * MICHAEL LUNDQUIST $50 You guys do great work. 12 months ago * ANONYMOUS MONTHLY $1,000 I donated in support of this campaign. 12 months ago * ANONYMOUS I donated in support of this campaign. 12 months ago * MR & MRS G KELLY MARTIN $500 Penta is amazing and the gift of mobility is life changing. 12 months ago * ANONYMOUS I donated in support of this campaign. 12 months ago * ANONYMOUS I donated in support of this campaign. 12 months ago * RALPH WHARTON, MD $500 Most important gift to quality of living and life about a year ago * JANET C. ROSS $1,000 I understand that the need keeps growing. With hope for a world where it does not. about a year ago * CHRISTOPHER RAINS MONTHLY $20 I donated in support of this campaign. about a year ago * TIM SWITZER $100 Anna and Mijamin, it was great to meet you at the .ORG Impact Awards and learn more about Penta. Kudos for all your are doing! about a year ago * SAUMIK BANERJI $100 I donated in support of this campaign. about a year ago * ANONYMOUS MONTHLY $1,000 I donated in support of this campaign. about a year ago * ANONYMOUS I donated in support of this campaign. about a year ago * CHRISTOPHER RAINS MONTHLY $20 I donated in support of this campaign. about a year ago * ANONYMOUS MONTHLY $1,000 I donated in support of this campaign. about a year ago * CHRISTOPHER RAINS MONTHLY $20 I donated in support of this campaign. about a year ago * PRANAV KAUL $10 I donated in support of this campaign. about a year ago * ANONYMOUS $50 I donated in support of this campaign. about a year ago * ANONYMOUS MONTHLY $1,000 I donated in support of this campaign. about a year ago * CHRISTOPHER RAINS MONTHLY $20 I donated in support of this campaign. about a year ago * ANONYMOUS MONTHLY $1,000 I donated in support of this campaign. about a year ago View All 182 Supporters Privacy Policy Send Bonterra feedback Powered by Bonterra «F, Y» MoTuWeThFrSaSuNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaNNaN falseClear date