www2.jdrf.org Open in urlscan Pro
74.123.154.222  Public Scan

Form analysis
2 forms found in the DOM

<form class="ng-pristine ng-valid">
  <div class="spirit-form__field-group spirit-form__input spirit-form__input--with-icon" role="combobox" aria-expanded="false" aria-haspopup="listbox" aria-labelledby="downshift-0-label"><label for="jdrf-global-header-search"
      class="spirit-form__label spirit-form__label-accessible-text">Search</label>
    <div class="spirit-form__input-icon-wrap -left"><svg xmlns="http://www.w3.org/2000/svg" class="spirit-icon spirit-form__input-icon" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke-width="2" stroke-linecap="round"
        stroke-linejoin="round">
        <circle cx="11" cy="11" r="8"></circle>
        <line x1="21" y1="21" x2="16.65" y2="16.65"></line>
      </svg></div><input aria-autocomplete="list" aria-labelledby="downshift-0-label" autocomplete="off" class="spirit-form__input-field" id="jdrf-global-header-search" placeholder="Search"> <input type="submit"
      class="spirit-form__label-accessible-text" value="Submit">
  </div>
</form>

Name: secureCheckoutForm — POST

<form id="secureCheckoutForm" name="secureCheckoutForm" method="post" class="ng-pristine ng-valid">
  <input type="hidden" id="secure_checkout_js_request_timeout" value="60000" autocomplete="off">
  <input type="hidden" name="donationFormUrl" id="donationFormUrl"
    value="https://www2.jdrf.org/site/Donation2?2376.donation=form1&amp;df_id=2376&amp;mfc_pref=T&amp;s_src=monthlyGiving&amp;_gl=1*n7svp0*_gcl_aw*R0NMLjE2OTU2NjM4NDUuQ2p3S0NBanczOFNvQmhCNkVpd0E4RVFWTHRhZkoyVGUwRjI5U3lLXzRjaWJ3QWt4QUg4cUpyd3JLMzExOTZtLVhJUDdqYTZ0am1tTEx4b0M2aWtRQXZEX0J3RQ..*_gcl_au*OTAwOTE2MjQ0LjE2OTU2NjM4NDU.&amp;_ga=2.198372463.1581473403.1702908735-1506882820.1695663845&amp;utm_source=newsletter&amp;utm_medium=email&amp;utm_campaign=20240131_TakeTheSurvey_E2&amp;utm_content=Marketable_Footer&amp;s_src=bsd_newsletter_email&amp;s_subsrc=20240131_TakeTheSurvey_E2_Marketable_Footer"
    autocomplete="off">
  <input type="hidden" name="submitUrl" id="submitUrl" value="https://www2.jdrf.org/site/CRDonationAPI" autocomplete="off">
  <input type="hidden" name="attempt-count" id="attempt-count" value="0" autocomplete="off">
  <input type="hidden" id="maxAttemptCount" value="3" autocomplete="off">
  <input type="hidden" id="maxDonationAmount" value="0" autocomplete="off">
  <input type="hidden" id="attemptCount" value="0" autocomplete="off">
  <input type="hidden" class="submit-field" name="method" value="securePayToForm" autocomplete="off">
  <input type="hidden" class="submit-field" name="api_key" value="gj3ot" autocomplete="off">
  <input type="hidden" class="submit-field" name="v" value="1.0" autocomplete="off">
  <input type="hidden" class="submit-field" name="response_format" value="json" autocomplete="off">
  <input type="hidden" class="submit-field" name="form_id" id="form_id" value="2376" autocomplete="off">
  <input type="hidden" class="submit-field" name="donor.cons_id" id="donor_id" value="0" autocomplete="off">
  <input type="hidden" class="submit-field" name="donor.email_opt_in" value="true" autocomplete="off">
  <input type="hidden" class="submit-field" id="achPaymentAllowed" name="allow_ach" value="true" autocomplete="off">
  <input type="hidden" class="submit-field" id="bbcForLODonFormAllowed" name="allow_bbc_for_don_form" value="false" autocomplete="off">
  <input type="hidden" class="submit-field" name="paymentThroughLO" id="paymentThroughLO" value="false" autocomplete="off">
  <input type="hidden" class="submit-field" id="allowDonorCover" name="allow_donor_cover" value="false" autocomplete="off">
  <input type="hidden" class="submit-field" name="donor.postal_opt_in" value="true" autocomplete="off">
  <input type="hidden" class="submit-field" name="source" value="bsd_newsletter_email" autocomplete="off">
  <input type="hidden" class="submit-field" name="sub_source" value="20240131_TakeTheSurvey_E2_Marketable_Footer" autocomplete="off">
  <input type="hidden" class="submit-field" name="sustaining.frequency" id="sustaining.frequency" value="one-time" autocomplete="off">
  <input type="hidden" class="submit-field" name="sustaining.duration" id="sustaining.duration" value="0" autocomplete="off">
  <input type="hidden" class="submit-field" name="fr_id" value="0" autocomplete="off">
  <input type="hidden" class="submit-field" name="soft_credit_type" value="" autocomplete="off">
  <input type="hidden" class="submit-field" name="soft_credit_id" value="0" autocomplete="off">
  <div class="donation-form-container responsive">
    <div id="message">
      <div id="secure_checkout_loading_timeout" class="error">
        <span class="error-message-header"> This page isn't working right now. </span>
        <span class="error-message-text"> We'll redirect you to another page in <span id="redirect_time">10</span> seconds. </span>
      </div>
      <div id="capture_error" class="error">
        <span class="error-message-header"> Your donation wasn't processed. </span>
        <span class="error-message-text"> Something went wrong. Can we try that again? </span>
      </div>
      <div id="gift_success_message" class="success">
        <span id="gift_success_message" class="success-message-header"> Thank you for your {0} donation! </span>
      </div>
      <div id="tr_success_message" class="success">
        <span class="success-message-header"> Thank you for your {0} donation to {1}! </span>
      </div>
      <div id="recurring_gift_success_message" class="success">
        <span id="recurring_gift_success_message" class="success-message-header"> Thank you for your {0} recurring donation! </span>
      </div>
    </div>
    <div class="donation-form-content" style="">
      <div class="don-standard-levels form-row">
        <input type="hidden" id="currencyLocale" value="en_US" autocomplete="off">
        <input type="hidden" id="defaultDonationLevelId" value="0" autocomplete="off">
        <input type="hidden" id="giftAmountError" value="Gift amount is required." autocomplete="off">
        <input type="hidden" id="giftAmountLessThanMinAllowedError" value="Gift amount is lower than minimum allowed." autocomplete="off">
        <input type="hidden" id="giftAmountGreaterThanMaxAllowedError" value="Gift amount is more than maximum allowed." autocomplete="off">
        <input type="hidden" id="frequencyError" value="Please select frequency when making a sustaining donation." autocomplete="off">
        <input type="hidden" id="durationError" value="Please select duration when making a sustaining donation." autocomplete="off">
        <div id="level_standard_row" class="form-row form-donation-level">
          <div class="ErrorMessage" style="display:none;">
            <span class="field-error-indicator"></span>
            <span id="level-error" class="error field-error-text" style="display: inline;"> Gift amount is required. </span>
          </div>
          <div class="form-content">
            <span id="gift_amount_header" class="FormLabelText hidden" style="display: inline;"> Your Gift Amount </span>
            <span id="recurring_gift_amount_header" class="FormLabelText hidden" style="display: none;"> Your Recurring Gift Amount </span>
            <div class="gift-type-container">
              <div class="gift-type-button" id="one_time">
                <label class="gift-type-label spirit-button spirit-button--toggle selected" for="one_time"><input type="radio" class="spirit-button__input spirit-button__radio" name="custom_gift_type_label_radio">
                  <div class="spirit-button__inner"><span class="spirit-form__radio-label-new">One-Time Gift</span></div>
                </label>
              </div>
              <div class="gift-type-button" id="sustaining">
                <label class="gift-type-label spirit-button spirit-button--toggle" for="sustaining"><input type="radio" class="spirit-button__input spirit-button__radio" name="custom_gift_type_label_radio">
                  <div class="spirit-button__inner"><span class="spirit-form__radio-label-new">Monthly Gift</span></div>
                </label>
              </div>
            </div>
            <div class="sustaining-frequency-container form-selectlist form-row form-input hidden" style="display: none;">
              <div class="ErrorMessage" style="display:none;">
                <span class="field-error-indicator"></span>
                <span id="frequency-level-error" class="error field-error-text" style="display: inline;">
                </span>
              </div>
              <div class="form-content">
                <span class="field-required"></span>
                <label class="FormLabel" for="frequeency-list">Frequency</label>
                <select id="frequency-list" onchange="setSustainingFrequency()">
                  <option value="">Select a frequency</option>
                  <option value="monthly">Monthly</option>
                </select>
              </div>
            </div>
            <div class="sustaining-duration-container form-input hidden" style="display: none;">
              <div class="ErrorMessage" style="display:none;">
                <span class="field-error-indicator"></span>
                <span id="duration-level-error" class="error field-error-text" style="display: inline;">
                </span>
              </div>
              <div class="spirit-form__field-group"><label class="spirit-form__label"><span>Donation Duration</span> <span class="spirit-form__label-required-indicator" title="This field is required." aria-hidden="true">*</span><span
                    class="spirit-form__label-accessible-text">Required Field.</span></label>
                <div class="spirit-form__select"><select id="monthly-durations" class="hidden spirit-form__select-input" onchange="setSustainingDuration()" style="display: none;">
                    <option value="" class="spirit-form__select-option">Select a gift duration</option>
                    <option value="0" class="spirit-form__select-option">Ongoing</option>
                    <option value="2" class="spirit-form__select-option">2</option>
                    <option value="3" class="spirit-form__select-option">3</option>
                    <option value="4" class="spirit-form__select-option">4</option>
                    <option value="5" class="spirit-form__select-option">5</option>
                    <option value="6" class="spirit-form__select-option">6</option>
                    <option value="7" class="spirit-form__select-option">7</option>
                    <option value="8" class="spirit-form__select-option">8</option>
                    <option value="9" class="spirit-form__select-option">9</option>
                    <option value="10" class="spirit-form__select-option">10</option>
                    <option value="11" class="spirit-form__select-option">11</option>
                    <option value="12" class="spirit-form__select-option">12</option>
                  </select>
                  <div class="spirit-form__select-inner"></div><span class="spirit-form__select-open-indicator"><svg class="spirit-icon spirit-form__select-open-icon" aria-hidden="true">
                      <use xlink:href="../jdrf-framework/dist/spirit/icons/spirit.svg#chevron-down"></use>
                    </svg></span>
                </div>
              </div>
            </div>
            <div id="donation-levels" class="donation-levels" style="">
              <div class="donation-level-container">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level66835_amount" name="donation_level66835_amount" value="1000" autocomplete="off">
                    <input type="hidden" id="donation_level66835_minimum_amount" name="donation_level66835_minimum_amount" value="1000" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level66835" name="level_id" value="66835">
                    </div>
                    <label for="donation_level66835" class="donation-level-selector">
                      <div class="donation-level-label-container"> $1,000 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level66836_amount" name="donation_level66836_amount" value="500" autocomplete="off">
                    <input type="hidden" id="donation_level66836_minimum_amount" name="donation_level66836_minimum_amount" value="500" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level66836" name="level_id" value="66836">
                    </div>
                    <label for="donation_level66836" class="donation-level-selector">
                      <div class="donation-level-label-container"> $500 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level66837_amount" name="donation_level66837_amount" value="250" autocomplete="off">
                    <input type="hidden" id="donation_level66837_minimum_amount" name="donation_level66837_minimum_amount" value="250" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level66837" name="level_id" value="66837">
                    </div>
                    <label for="donation_level66837" class="donation-level-selector">
                      <div class="donation-level-label-container"> $250 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level66838_amount" name="donation_level66838_amount" value="120" autocomplete="off">
                    <input type="hidden" id="donation_level66838_minimum_amount" name="donation_level66838_minimum_amount" value="120" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level66838" name="level_id" value="66838">
                    </div>
                    <label for="donation_level66838" class="donation-level-selector">
                      <div class="donation-level-label-container"> $120 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level66839_amount" name="donation_level66839_amount" value="60" autocomplete="off">
                    <input type="hidden" id="donation_level66839_minimum_amount" name="donation_level66839_minimum_amount" value="60" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level66839" name="level_id" value="66839">
                    </div>
                    <label for="donation_level66839" class="donation-level-selector">
                      <div class="donation-level-label-container"> $60 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level66840_amount" name="donation_level66840_amount" value="30" autocomplete="off">
                    <input type="hidden" id="donation_level66840_minimum_amount" name="donation_level66840_minimum_amount" value="30" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level66840" name="level_id" value="66840">
                    </div>
                    <label for="donation_level66840" class="donation-level-selector">
                      <div class="donation-level-label-container"> $30 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container donation-level-container--other">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="userSpecified">
                    <input type="hidden" id="donation_level6315_amount" name="donation_level6315_amount" value="5" autocomplete="off">
                    <input type="hidden" id="donation_level6315_minimum_amount" name="donation_level6315_minimum_amount" value="5" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level6315" name="level_id" value="6315">
                    </div>
                    <label for="donation_level6315" class="donation-level-selector">
                      <div class="donation-level-label-container">Other amount</div>
                    </label>
                    <div class="donation-level-user-entered">
                      <label for="other_amount" class="userCurrency">
                        <p id="dollarSign">$</p>
                      </label>
                      <input type="text" name="other_amount" id="other_amount" value="" size="12" aria-required="true" aria-invalid="true" aria-describedby="donation_level6315amount-error">
                      <a class="otherClose" href="#"><img alt="Close" src="../images/closeButton.gif"></a>
                    </div>
                  </div>
                </div>
              </div>
              <div class="donation-level-container" style="display: none;">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level99763_amount" name="donation_level99763_amount" value="100" autocomplete="off">
                    <input type="hidden" id="donation_level99763_minimum_amount" name="donation_level99763_minimum_amount" value="100" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level99763" name="level_id" value="99763">
                    </div>
                    <label for="donation_level99763" class="donation-level-selector">
                      <div class="donation-level-label-container"> $100 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container" style="display: none;">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level99764_amount" name="donation_level99764_amount" value="50" autocomplete="off">
                    <input type="hidden" id="donation_level99764_minimum_amount" name="donation_level99764_minimum_amount" value="50" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level99764" name="level_id" value="99764">
                    </div>
                    <label for="donation_level99764" class="donation-level-selector">
                      <div class="donation-level-label-container"> $50 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container" style="display: none;">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level99765_amount" name="donation_level99765_amount" value="30" autocomplete="off">
                    <input type="hidden" id="donation_level99765_minimum_amount" name="donation_level99765_minimum_amount" value="30" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level99765" name="level_id" value="99765">
                    </div>
                    <label for="donation_level99765" class="donation-level-selector">
                      <div class="donation-level-label-container"> $30 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container" style="display: none;">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level99766_amount" name="donation_level99766_amount" value="25" autocomplete="off">
                    <input type="hidden" id="donation_level99766_minimum_amount" name="donation_level99766_minimum_amount" value="25" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level99766" name="level_id" value="99766">
                    </div>
                    <label for="donation_level99766" class="donation-level-selector">
                      <div class="donation-level-label-container"> $25 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container" style="display: none;">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level99767_amount" name="donation_level99767_amount" value="20" autocomplete="off">
                    <input type="hidden" id="donation_level99767_minimum_amount" name="donation_level99767_minimum_amount" value="20" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level99767" name="level_id" value="99767">
                    </div>
                    <label for="donation_level99767" class="donation-level-selector">
                      <div class="donation-level-label-container"> $20 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="donation-level-container" style="display: none;">
                <div id="form-content" class="form-content">
                  <div id="donation-level-input-container" class="donation-level-input-container form-input" type="preset">
                    <input type="hidden" id="donation_level99768_amount" name="donation_level99768_amount" value="10" autocomplete="off">
                    <input type="hidden" id="donation_level99768_minimum_amount" name="donation_level99768_minimum_amount" value="10" autocomplete="off">
                    <div class="donation-level-label-input-container">
                      <input type="radio" id="donation_level99768" name="level_id" value="99768">
                    </div>
                    <label for="donation_level99768" class="donation-level-selector">
                      <div class="donation-level-label-container"> $10 </div>
                    </label>
                  </div>
                </div>
              </div>
              <div class="clearfix"></div>
            </div>
            <div class="sustaining-gift-message hidden">
            </div>
          </div>
        </div>
      </div>
      <div class="form-row" id="cover-processing-fee-checkout">
        <p class="error hidden" id="cover-fee-error" style="color: red;">Please choose a gift amount.</p><label class="spirit-form__checkbox"><input type="checkbox" class="spirit-form__checkbox-input checkmark-input" id="donation-cover-fee"
            name="donation-cover-fee"><span class="spirit-form__checkbox-inner"><span class="spirit-form__checkbox-visual"><svg class="spirit-icon spirit-form__checkbox-checked-icon" aria-hidden="true">
                <use xlink:href="../jdrf-framework/dist/spirit/icons/spirit.svg#check"></use>
              </svg></span><span class="spirit-form__checkbox-label">I would like to cover the <span class="fee-amt"></span> processing fee for this donation so more can go to the cause!</span></span></label>
      </div>
      <script type="text/javascript">
        function supportsSustainingGiving() {
          return true;
        }

        function supportsOneTimeGift() {
          return true;
        }
      </script>
      <script type="text/javascript" src="../js/don2/secure_checkout/donation_levels.js"></script>
      <div class="honoreeDetailFields" style="display: none;">
      </div>
      <script type="text/javascript" src="../js/don2/secure_checkout/bbsp_secure_checkout.js"></script>
      <input type="hidden" id="merchantAccountId" value="d5dbc70c-5482-498a-b22c-18fc29484dd2" autocomplete="off">
      <input type="hidden" id="secureCheckoutKey" value="bf2508d8-a472-435b-9ce2-fbcb58e45a22" autocomplete="off">
      <input type="hidden" class="submit-field" name="transactiontoken" id="transactiontoken" value="" autocomplete="off">
      <input type="hidden" id="clientName" value="Luminate" autocomplete="off">
      <input type="hidden" id="secureCheckoutPaneLoadingTimeout" value="10000" autocomplete="off">
      <input type="hidden" id="bbspClientHostURI" value="https://payments.blackbaud.com" autocomplete="off">
      <input type="hidden" id="cardToken" value="6eaad150-d790-4e62-af51-5624e494c60a" autocomplete="off">
      <input type="hidden" id="accountToken" value="e6ac7ec1-ff71-44a3-8992-60e0ff42be0b" autocomplete="off">
      <input type="hidden" id="isNameRequired" value="true" autocomplete="off">
      <div class="button-container clearfix">
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FUEL THE FIGHT AGAINST T1D

Your generous tax-deductible gift to the JUVENILE DIABETES RESEARCH FOUNDATION
INTERNATIONAL® (JDRF) today will help us continue our work to bring
life-changing treatments and therapies to the millions of people living with
type 1 diabetes (T1D) until we find a cure.

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