veteranshonormonument.org
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66.206.28.11
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URL:
https://veteranshonormonument.org/
Submission: On July 14 via api from US — Scanned from CA
Submission: On July 14 via api from US — Scanned from CA
Form analysis 1 forms found in the DOM
Name: os_form — POST https://veteranshonormonument.org/index.php?option=com_jdonation&Itemid=
<form method="post" name="os_form" id="os_form" action="https://veteranshonormonument.org/index.php?option=com_jdonation&Itemid=" autocomplete="off" class="form form-horizontal row joomla4" enctype="multipart/form-data">
<div class="row form-group form-row">
<h4 class="jd-heading">Donor information</h4>
</div>
<div class="row form-group form-row campaign_0" id="field_first_name">
<label class="col-md-3 form-control-label " for="first_name" title="First Name">First Name<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="first_name" id="first_name" value="" class="input-large form-control validate[required]" placeholder="First Name">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_last_name">
<label class="col-md-3 form-control-label " for="last_name" title="Last Name">Last Name<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="last_name" id="last_name" value="" class="input-large form-control validate[required]" placeholder="Last Name">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_organization">
<label class="col-md-3 form-control-label " for="organization" title="Organization">Organization </label>
<div class="col-md-9" id="">
<input type="text" name="organization" id="organization" value="" class="input-large form-control" placeholder="Organization">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_address">
<label class="col-md-3 form-control-label " for="address" title="Address">Address<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="address" id="address" value="" class="input-large form-control validate[required]" placeholder="Address">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_address2">
<label class="col-md-3 form-control-label " for="address2" title="Address 2">Address 2 </label>
<div class="col-md-9" id="">
<input type="text" name="address2" id="address2" value="" class="input-large form-control" placeholder="Address 2">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_city">
<label class="col-md-3 form-control-label " for="city" title="City">City<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="city" id="city" value="" class="input-large form-control validate[required]" placeholder="City">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_zip">
<label class="col-md-3 form-control-label " for="zip" title="Zip">Zip<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="zip" id="zip" value="" class="input-large form-control validate[required]" placeholder="Zip">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_country">
<label class="col-md-3 form-control-label " for="country" title="Country">Country<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<select id="country" name="country" class=" form-control form-select input-large validate[required]" aria-label="Country">
<option value="">Select Country</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Canary Islands">Canary Islands</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="East Timor">East Timor</option>
<option value="East Timor">East Timor</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="France, Metropolitan">France, Metropolitan</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-bissau">Guinea-bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran (Islamic Republic of)">Iran (Islamic Republic of)</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macau">Macau</option>
<option value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Slovakia (Slovak Republic)">Slovakia (Slovak Republic)</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="St. Barthelemy">St. Barthelemy</option>
<option value="St. Eustatius">St. Eustatius</option>
<option value="St. Helena">St. Helena</option>
<option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="The Democratic Republic of Congo">The Democratic Republic of Congo</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States" selected="selected">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican City State (Holy See)">Vatican City State (Holy See)</option>
<option value="Venezuela">Venezuela</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (U.S.)">Virgin Islands (U.S.)</option>
<option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_state">
<label class="col-md-3 form-control-label " for="state" title="State">State<span class="required">*</span>
</label>
<div class="col-md-9" id="field_state_select">
<input type="text" name="state" id="state" value="CO" class="input-large form-control validate[required]" placeholder="State">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_phone">
<label class="col-md-3 form-control-label " for="phone" title="Phone">Phone<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="phone" id="phone" value="" class="input-large form-control validate[required]" placeholder="Phone">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_email">
<label class="col-md-3 form-control-label " for="email" title="Email">Email<span class="required">*</span>
</label>
<div class="col-md-9" id="">
<input type="text" name="email" id="email" value="" class="input-large form-control validate[required,custom[email]]" placeholder="Email">
</div>
</div>
<div class="row form-group form-row campaign_0" id="field_comment">
<label class="col-md-3 form-control-label " for="comment" title="Leave a comment if you like.">Leave a comment if you like. </label>
<div class="col-md-9" id="">
<textarea name="comment" id="comment" class="input-large" placeholder="Leave a comment if you like." rows="7"> </textarea>
</div>
</div>
<div class="row form-group form-row">
<label class="col-md-3 form-control-label hasTooltip hasTip" for="hide_me" title="Please tick this box if you wish your donation to be anonymous and your name will not be displayed in the donor list"> Anonymous donation </label>
<div class="col-md-9">
<input type="checkbox" name="hide_me" value="1" size="40">
</div>
</div>
<div class="row" id="dedicate_heading">
<div class="col-md-12">
<input type="checkbox" name="show_dedicate" id="show_dedicate" value="0" onclick="javascript:showDedicate();"> I would like this donation to be made in honor of someone
</div>
</div>
<div class="row nodisplay" id="honoreediv">
<div class="col-md-12">
<div class="row">
<div class="col-md-3">
<input type="radio" name="dedicate_type" value="1"> In honor of
</div>
<div class="col-md-3">
<input type="radio" name="dedicate_type" value="2"> In memory of
</div>
<div class="col-md-3">
<input type="radio" name="dedicate_type" value="3"> Dedicated to
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="row form-group form-row">
<label class="col-md-3 form-control-label" for="campaign_id"> Honoree's Name </label>
<div class="col-md-9">
<input type="text" class="form-control input-large" name="dedicate_name" value="">
</div>
</div>
<div class="row form-group form-row">
<label class="col-md-3 form-control-label" for="campaign_id"> Honoree's Email </label>
<div class="col-md-9">
<input type="text" class="form-control input-large" name="dedicate_email" value="">
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row form-group form-row">
<h4 class="jd-heading">Donation Information</h4>
</div>
<div class="row form-group form-row">
<label class="col-md-3 form-control-label"> Amount </label>
<div class="col-md-9" id="amount_container">
<div class="switch-amounts">
<input type="radio" name="rd_amount" id="pre_amount_0" value="10" onclick="clearTextbox();" class="" data-errormessage="Please choose from a pre-defined amount or enter your own donation amount">
<label for="pre_amount_0"> $10.00 </label>
<input type="radio" name="rd_amount" id="pre_amount_1" value="20" onclick="clearTextbox();" class="" data-errormessage="Please choose from a pre-defined amount or enter your own donation amount">
<label for="pre_amount_1"> $20.00 </label>
<input type="radio" name="rd_amount" id="pre_amount_2" value="50" onclick="clearTextbox();" class="" data-errormessage="Please choose from a pre-defined amount or enter your own donation amount">
<label for="pre_amount_2"> $50.00 </label>
<input type="radio" name="rd_amount" id="pre_amount_3" value="100" onclick="clearTextbox();" class="" data-errormessage="Please choose from a pre-defined amount or enter your own donation amount">
<label for="pre_amount_3"> $100.00 </label>
<input type="radio" name="rd_amount" id="pre_amount_4" value="500" onclick="clearTextbox();" class="" data-errormessage="Please choose from a pre-defined amount or enter your own donation amount">
<label for="pre_amount_4"> $500.00 </label>
</div>
<div class="input-group">
<span class="input-group-text">$</span>
<input type="number" size="10" placeholder="Other Amount" class="validate[required,custom[number],min[1],max[20000]] form-control input-small" name="amount" id="amount" value="" onchange="deSelectRadio();"
data-errormessage="Please choose from a pre-defined amount or enter your own donation amount" data-errormessage-range-underflow="Minimum donation amount allowed is 1"
data-errormessage-range-overflow="Maximum donation amount allowed is 20000">
</div>
</div>
</div>
<div class="row form-group form-row">
<label class="col-md-3 form-control-label"> </label>
<div class="col-md-9">
<div class="total_donated_amount" id="donatedAmount">
<input type="hidden" name="gross_amount" id="gross_amount" value="0">
</div>
</div>
</div>
<script type="text/javascript">
var selected_payment = "os_squarecard";
</script>
<div class="row form-group form-row">
<label class="col-md-3 form-control-label"> Payment method </label>
<div class="col-md-9"> Credit Card </div>
</div>
<div class="row form-group form-row payment_information" id="sq_field_zipcode" style="display:none">
<label class="col-md-3 form-control-label" for="sq_billing_zipcode"> Zipcode<span class="required">*</span>
</label>
<div class="col-md-9">
<div id="field_zip_input">
<input type="text" id="sq_billing_zipcode" name="sq_billing_zipcode" class="form-control input-large" value="">
</div>
</div>
</div>
<div class="row form-group form-row" id="tr_card_number" style="display:none">
<label class="col-md-3 form-control-label">Credit Card Number<span class="required">*</span></label>
<div class="col-md-9">
<div id="sq-card-number">
<input type="text" name="x_card_num" id="x_card_num" class="form-control input-large validate[required,creditCard]" value="" size="20" data-input-mask="0000 0000 0000 0000">
</div>
</div>
</div>
<div class="row form-group form-row" id="tr_exp_date" style="display:none">
<label class="col-md-3 form-control-label"> Expiration Date<span class="required">*</span>
</label>
<div class="col-md-9">
<div id="sq-expiration-date">
<select id="exp_month" name="exp_month" class="input-small form-select">
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select> / <select id="exp_year" name="exp_year" class="input-small form-select">
<option value="2024" selected="selected">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>
</select>
</div>
</div>
</div>
<div class="row form-group form-row" id="tr_cvv_code" style="display:none">
<label class="col-md-3 form-control-label"> Card (CVV) Code<span class="required">*</span>
</label>
<div class="col-md-9">
<div id="sq-cvv">
<input type="text" name="x_card_code" id="x_card_code" class="form-control input-large validate[required,custom[number]]" value="" size="20">
</div>
</div>
</div>
<div class="row form-group form-row" id="tr_card_type" style="display:none;">
<label class="col-md-3 form-control-label"> Card type<span class="required">*</span>
</label>
<div class="col-md-9">
<select id="card_type" name="card_type" class="inputbox">
<option value="Visa">Visa</option>
<option value="MasterCard">MasterCard</option>
<option value="Discover">Discover</option>
<option value="Amex">American Express</option>
</select>
</div>
</div>
<div class="row form-group form-row" id="tr_card_holder_name" style="display:none;">
<label class="col-md-3 form-control-label"> Card Holder Name<span class="required">*</span>
</label>
<div class="col-md-9">
<input type="text" name="card_holder_name" id="card_holder_name" class="form-control input-large validate[required]" value="" size="40">
</div>
</div>
<div class="row form-group form-row payment_information" id="square-card-form">
<div class="col-md-3 form-control-label"> Credit Card<span class="required">*</span>
</div>
<div class="col-md-9" id="square-card-element">
<div id="single-card-wrapper-62d0e678-40c9-230e-f181-950bb520dea2" class="sq-card-wrapper">
<div class="sq-card-iframe-container" style="height: 48px;"><iframe frameborder="0" height="48px" name="single-card-62d0e678-40c9-230e-f181-950bb520dea2" scrolling="no" src="https://web.squarecdn.com/1.60.0/single-card-element-iframe.html"
width="100%" class="sq-card-component"></iframe></div><span class="sq-card-message"></span>
</div>
</div>
</div>
<input type="hidden" name="square_card_token" value="">
<input type="hidden" name="square_card_verification_token" value="">
<div class="row form-group form-row jd_padding_top_10">
<label class="col-md-3 form-control-label"> Verification code<span class="required">*</span>
</label>
<div class="col-md-9">
<div id="dynamic_recaptcha_1" class="required g-recaptcha" data-sitekey="6LeU8QUqAAAAAKIMZzk2CigtjR9y4Jqs5BjjP10C" data-theme="light" data-size="normal" data-tabindex="0" data-callback="" data-expired-callback="" data-error-callback=""
data-recaptcha-widget-id="0">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-bsl9mtig9cqr" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LeU8QUqAAAAAKIMZzk2CigtjR9y4Jqs5BjjP10C&co=aHR0cHM6Ly92ZXRlcmFuc2hvbm9ybW9udW1lbnQub3JnOjQ0Mw..&hl=en-GB&v=-80zvSY9h4i8O-ocN2P5qTJk&theme=light&size=normal&cb=9st92samnay0"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
</div>
<div class="form-actions">
<input type="submit" class="btn btn-primary uk-button uk-button-primary" name="btnSubmit" id="btn-submit" value="Process donation">
</div>
<input type="hidden" name="payment_method" value="os_squarecard">
<input type="hidden" name="donation_type" value="onetime">
<input type="hidden" id="campaign_id" name="campaign_id" value="1">
<input type="hidden" name="validate_form_login" value="0">
<input type="hidden" name="receive_user_id" value="">
<input type="hidden" name="field_campaign" value="0">
<input type="hidden" name="amount_by_campaign" value="0">
<input type="hidden" name="enable_recurring" value="0">
<input type="hidden" name="count_method" value="1">
<input type="hidden" name="current_campaign" value="1">
<input type="hidden" name="donation_page_url" value="aHR0cHM6Ly92ZXRlcmFuc2hvbm9ybW9udW1lbnQub3JnLw==">
<input type="hidden" id="card-nonce" name="nonce">
<input type="hidden" name="task" value="donation.process">
<input type="hidden" name="smallinput" id="smallinput" value="form-control input-small">
<input type="hidden" name="activate_dedicate" id="activate_dedicate" value="1">
<input type="text" name="jd_my_own_website_name" value="" autocomplete="off" class="jd_invisible_to_visitors">
<input type="hidden" name="4e94d43a667f37048092cc884c6fa0bf" value="1720922722">
<input type="hidden" name="currency_code" id="currency_code" value="USD">
<!-- Version 5.6.13 -->
<input type="hidden" name="curr_1" id="curr_1" value="">
<input type="hidden" name="41ca2016bc304f209600b48401111f90" value="1">
<script type="text/javascript">
var amountInputCssClasses = 'validate[required,custom[number] ,min[1],max[20000] ] form-control input-small';
methods = new PaymentMethods();
method = new PaymentMethod('os_squarecard', 0, 0, 0, 0, 0);
methods.Add(method);
JD.jQuery(function($) {
$(document).ready(function() {
$("#os_form").validationEngine('attach', {
onValidationComplete: function(form, status) {
if (status == true) {
form.on('submit', function(e) {
e.preventDefault();
});
form.find('#btn-submit').prop('disabled', true);
if ($('input:radio[name^=payment_method]').length) {
var paymentMethod = $('input:radio[name^=payment_method]:checked').val();
} else {
var paymentMethod = $('input[name^=payment_method]').val();
}
if (typeof stripePublicKey !== 'undefined' && paymentMethod.indexOf('os_stripe') == 0 && $('#tr_card_number').is(':visible')) {
Stripe.card.createToken({
number: $('input[name^=x_card_num]').val(),
cvc: $('input[name^=x_card_code]').val(),
exp_month: $('select[name^=exp_month]').val(),
exp_year: $('select[name^=exp_year]').val(),
name: $('input[name^=card_holder_name]').val()
}, stripeResponseHandler);
return false;
}
// Stripe card element
if (typeof stripe !== 'undefined' && paymentMethod.indexOf('os_stripe') == 0 && $('#stripe-card-form').is(":visible")) {
stripe.createToken(card).then(function(result) {
if (result.error) {
// Inform the customer that there was an error.
//var errorElement = document.getElementById('card-errors');
//errorElement.textContent = result.error.message;
alert(result.error.message);
form.find('#btn-submit').prop('disabled', false);
} else {
// Send the token to your server.
stripeTokenHandler(result.token);
}
});
return false;
}
if (paymentMethod == 'os_squareup' && $('#tr_card_number').is(':visible')) {
sqPaymentForm.requestCardNonce();
return false;
}
if (paymentMethod.indexOf('os_squarecard') === 0 && $('#square-card-form').is(':visible')) {
squareCardCallBackHandle();
return false;
}
return true;
}
return false;
}
});
if (Joomla.getOptions('squareAppId')) {
createSquareCardElement();
}
if (typeof stripe !== 'undefined') {
var style = {
base: {
// Add your base input styles here. For example:
fontSize: '16px',
color: "#32325d",
}
};
// Create an instance of the card Element.
//card = elements.create('card', {hidePostalCode: true, style: style});
var card = elements.create('card', {
style: style
});
// Add an instance of the card Element into the `card-element` <div>.
card.mount('#stripe-card-element');
}
if ($("[name*='validate_form_login']").val() == 1) {
JDVALIDATEFORM("#jd-login-form");
}
})
});
</script>
</form>Text Content
Skip to main content * Donate * Donate 2ND ANNUAL VETERANS HONOR MONUMENT GOLF TOURNAMENT * 2nd Annual Veterans Honor Monument Golf Tournament MONDAY, AUGUST 12, 2024 MARIANA BUTTE, LOVELAND COLORADO 07:30 AM SHOTGUN CHECK-IN BEGINS: 06:30 AM TOURNAMENT FORMAT * Tournament is for fun with a Scramble Format. * Mulligans will be sold to help support this great cause, as well as make the event fun for golfers of all abilities. * Special awards will be given for the furthest drive (men & women), most centered drive, and closet to the pin. AWARDS, LUNCH & SILENT AUCTION Awards will be granted to the top finishers for each of the flights, including Men’s, Women’s & Mixed foursomes. Each participant will receive a lunch and be eligible for numerous donated prizes following play. There will also be a Silent Auction table with many terrific items to bid on. Proceeds will benefit the new Veterans Honor Monument. YOU CAN STILL ATTEND AND HAVE LUNCH OR SPONSOR A HOLE 1 Foursome Two Person Team Single Player Lunch Only (not playing) Hole Sponsor IF YOU CAN'T MAKE IT BUT WANT TO DONATE, SEE BELOW. ↓ BUILDING THE VETERANS HONOR MONUMENT AT LOVELAND SPORTS PARK Your generous donation will be used to fund the design and construction of the Veterans Honor Monument at Loveland Sports Park. The City of Loveland will now have a place for veterans, their families, and friends to find solace, reflect and heal. With our plans to honor all veterans involved in the many conflicts the United States has been involved in, the monument will be educational to anyone that visits. Thank you for your continued support. SAFELY DONATE ONLINE Please fill out form below to safely donate online. Read more DONATE BY MAIL Send contribution (no cash please) addressed to: Veterans Honor Monument at Loveland Sports Park 1917 River View Dr Berthoud, CO 80513 Memo line: Veterans Honor Monument Veterans Honor Monument at Loveland Sports Park is classified as a 501(c)(3) non-profit organization by the standards of the Internal Revenue Service (IRS). Therefore, the donation may be tax deductible to the extent allowed by law. Tax ID Number: 92-1146504 ONLINE DONATION DONOR INFORMATION First Name* Last Name* Organization Address* Address 2 City* Zip* Country* Select Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland 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 Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Barthelemy St. Eustatius St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand The Democratic Republic of Congo Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe State* Phone* Email* Leave a comment if you like. Anonymous donation I would like this donation to be made in honor of someone In honor of In memory of Dedicated to Honoree's Name Honoree's Email DONATION INFORMATION Amount $10.00 $20.00 $50.00 $100.00 $500.00 $ Payment method Credit Card Zipcode* Credit Card Number* Expiration Date* 01 02 03 04 05 06 07 08 09 10 11 12 / 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 Card (CVV) Code* Card type* Visa MasterCard Discover American Express Card Holder Name* Credit Card* Verification code* --Select-- Daily Weekly Monthly Quarterly Semi-Annually $10.00 $20.00 $50.00 $100.00 $500.00 $ PRIVACY POLICY We will not share or sell your email; we may use it to contact you. Veterans Honor Monument at Loveland Sports Park 1917 Riverview Dr. Berthoud, CO 80513 © 2024 All Rights Reserved Site design & Development, Full Circle Creative