help.rescue.org Open in urlscan Pro
151.101.194.130  Public Scan

Submitted URL: http://help.rescue.org/donate/syria-earthquake
Effective URL: https://help.rescue.org/donate/syria-earthquake
Submission: On February 08 via manual from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST /donate/syria-earthquake

<form class="webform-client-form form-layouts one-column fundraiser-donation-form submit-valid-processed submit-progress-processed jquery-once-12-processed" enctype="multipart/form-data" action="/donate/syria-earthquake" method="post"
  id="webform-client-form-9858" accept-charset="UTF-8" novalidate="novalidate">
  <div class="step-group fieldset-step active" id="step-1"><label for="edit-submitted-donation-amount" aria-selected="false" role="tab" class="step-label">Select your donation </label>
    <fieldset class="webform-component-fieldset form-wrapper" id="webform-component-donation">
      <legend><span class="fieldset-legend">Donation</span></legend>
      <div class="fieldset-wrapper">
        <div class="form-item webform-component webform-component-radios control-group" id="webform-component-donation--recurs-monthly" tabindex="0" role="tablist" aria-label="One-Time Donation / Monthly Donation">
          <div id="edit-submitted-donation-recurs-monthly">
            <div class="form-item form-type-radio form-item-submitted-donation-recurs-monthly control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurs-monthly-1" name="submitted[donation][recurs_monthly]" value="NO_RECURR" checked="checked" role="radio"> <label class="option" for="edit-submitted-donation-recurs-monthly-1"
                aria-selected="false" role="tab">Give once </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-recurs-monthly control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurs-monthly-2" name="submitted[donation][recurs_monthly]" value="recurs" role="radio"> <label class="option" for="edit-submitted-donation-recurs-monthly-2" aria-selected="false"
                role="tab">Give monthly </label>
            </div>
          </div>
        </div>
        <div class="form-item webform-component webform-component-radios control-group" id="webform-component-donation--amount">
          <div id="edit-submitted-donation-amount">
            <div class="form-item form-type-radio form-item-submitted-donation-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-amount-1" name="submitted[donation][amount]" value="60" role="radio"> <label class="option" for="edit-submitted-donation-amount-1" aria-selected="false" role="tab">$60 </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-amount-2" name="submitted[donation][amount]" value="80" role="radio"> <label class="option" for="edit-submitted-donation-amount-2" aria-selected="false" role="tab">$80 </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-amount control-group selected" tabindex="0">
              <input type="radio" id="edit-submitted-donation-amount-3" name="submitted[donation][amount]" value="108" checked="checked" role="radio"> <label class="option" for="edit-submitted-donation-amount-3" aria-selected="false" role="tab">$108
              </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-amount-4" name="submitted[donation][amount]" value="190" role="radio"> <label class="option" for="edit-submitted-donation-amount-4" aria-selected="false" role="tab">$190 </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-amount-5" name="submitted[donation][amount]" value="500" role="radio"> <label class="option" for="edit-submitted-donation-amount-5" aria-selected="false" role="tab">$500 </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-amount-6" name="submitted[donation][amount]" value="other" role="radio"> <label class="option" for="edit-submitted-donation-amount-6" aria-selected="false" role="tab">Other </label>
            </div>
          </div>
        </div>
        <div class="form-item webform-component webform-component-radios control-group" id="webform-component-donation--recurring-amount" style="display: none;">
          <div id="edit-submitted-donation-recurring-amount">
            <div class="form-item form-type-radio form-item-submitted-donation-recurring-amount control-group selected" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurring-amount-1" name="submitted[donation][recurring_amount]" value="36" checked="checked" role="radio"> <label class="option" for="edit-submitted-donation-recurring-amount-1"
                aria-selected="false" role="tab">$36 per month </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-recurring-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurring-amount-2" name="submitted[donation][recurring_amount]" value="60" role="radio"> <label class="option" for="edit-submitted-donation-recurring-amount-2" aria-selected="false"
                role="tab">$60 per month </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-recurring-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurring-amount-3" name="submitted[donation][recurring_amount]" value="108" role="radio"> <label class="option" for="edit-submitted-donation-recurring-amount-3" aria-selected="false"
                role="tab">$108 per month </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-recurring-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurring-amount-4" name="submitted[donation][recurring_amount]" value="190" role="radio"> <label class="option" for="edit-submitted-donation-recurring-amount-4" aria-selected="false"
                role="tab">$190 per month </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-recurring-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurring-amount-5" name="submitted[donation][recurring_amount]" value="500" role="radio"> <label class="option" for="edit-submitted-donation-recurring-amount-5" aria-selected="false"
                role="tab">$500 per month </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-donation-recurring-amount control-group" tabindex="0">
              <input type="radio" id="edit-submitted-donation-recurring-amount-6" name="submitted[donation][recurring_amount]" value="other" role="radio"> <label class="option" for="edit-submitted-donation-recurring-amount-6" aria-selected="false"
                role="tab">Other per month </label>
            </div>
          </div>
        </div>
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-donation--other-amount">
          <label for="edit-submitted-donation-other-amount" aria-selected="false" role="tab">Other </label>
          <div class="field-prefix">$</div><input class="input-medium form-text" type="number" id="edit-submitted-donation-other-amount" name="submitted[donation][other_amount]" value="" size="10" maxlength="128" inputmode="numeric"
            placeholder="Other Amount" tabindex="-1">
          <div class="description">Minimum payment $10.00.</div>
        </div>
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-donation--recurring-other-amount" style="display: none;">
          <label for="edit-submitted-donation-recurring-other-amount" aria-selected="false" role="tab">Other </label>
          <div class="field-prefix">$</div><input class="input-medium form-text" type="number" id="edit-submitted-donation-recurring-other-amount" name="submitted[donation][recurring_other_amount]" value="" size="10" maxlength="128"
            inputmode="numeric" placeholder="Other Amount" tabindex="-1">
          <div class="description">Minimum payment $10.00.</div>
        </div>
      </div>
    </fieldset>
    <div class="progress-buttons"><span class="step continue" data-step-current="step-1" data-step-next="step-2" tabindex="0">Payment Information</span></div>
  </div>
  <input type="hidden" name="submitted[ms]" value="">
  <input type="hidden" name="submitted[cid]" value="70167000001AtkyAAC">
  <div class="step-group fieldset-step" id="step-2">
    <fieldset class="webform-component-fieldset form-wrapper donor-message-processed" id="webform-component-payment-information">
      <div class="donation-message">Your <span style="font-weight: 700" class="donation-frequency">one-time</span> donation of <span class="donation-message-amount">$108</span> <strong>USD</strong> will be processed securely. Every gift counts, thank
        you!</div>
      <legend><span class="fieldset-legend">Payment Information</span></legend>
      <div class="fieldset-wrapper">
        <div class="form-item webform-component webform-component-radios control-group" id="webform-component-payment-information--payment-method">
          <label for="edit-submitted-payment-information-payment-method" aria-selected="false" role="tab">Payment Method <span class="form-required" title="This field is required.">*</span></label>
          <div id="edit-submitted-payment-information-payment-method">
            <div class="form-item form-type-radio form-item-submitted-payment-information-payment-method control-group credit" tabindex="0">
              <input class="fundraiser-payment-methods" type="radio" id="edit-submitted-payment-information-payment-method-1" name="submitted[payment_information][payment_method]" value="credit" checked="checked" role="radio"> <label class="option"
                for="edit-submitted-payment-information-payment-method-1" aria-selected="false" role="tab">Credit Card </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-payment-information-payment-method control-group paypal" tabindex="0">
              <input class="fundraiser-payment-methods" type="radio" id="edit-submitted-payment-information-payment-method-3" name="submitted[payment_information][payment_method]" value="paypal" role="radio"> <label class="option"
                for="edit-submitted-payment-information-payment-method-3" aria-selected="false" role="tab">Paypal </label>
            </div>
            <div class="form-item form-type-radio form-item-submitted-payment-information-payment-method control-group bank-account" tabindex="0">
              <input class="fundraiser-payment-methods" type="radio" id="edit-submitted-payment-information-payment-method-4" name="submitted[payment_information][payment_method]" value="bank account" role="radio"> <label class="option"
                for="edit-submitted-payment-information-payment-method-4" aria-selected="false" role="tab">Bank Account </label>
            </div>
          </div>
        </div>
        <div class="webform-component-fieldset form-wrapper" id="webform-component-payment-information--payment-fields">
          <fieldset class="fundraiser-payment-fields form-wrapper" id="edit-submitted-payment-information-payment-fields-credit">
            <div class="fieldset-wrapper">
              <div class="form-item form-type-textfield form-item-submitted-payment-information-payment-fields-credit-card-number control-group">
                <label for="edit-submitted-payment-information-payment-fields-credit-card-number" aria-selected="false" role="tab">Credit card number <span class="form-required">*</span></label>
                <input class="input-large form-text" type="text" id="edit-submitted-payment-information-payment-fields-credit-card-number" name="submitted[payment_information][payment_fields][credit][card_number]" value="" size="20" maxlength="128"
                  autocomplete="off" role="textbox" inputmode="numeric" pattern="[0-9]*">
              </div>
              <div class="expiration-date-wrapper clear-block">
                <div class="form-item form-type-select form-item-submitted-payment-information-payment-fields-credit-expiration-date-card-expiration-month control-group">
                  <label for="edit-submitted-payment-information-payment-fields-credit-expiration-date-card-expiration-month" aria-selected="false" role="tab">Expiration date <span class="form-required">*</span></label>
                  <div class="select-wrapper"><select class="input-small form-select" id="edit-submitted-payment-information-payment-fields-credit-expiration-date-card-expiration-month"
                      name="submitted[payment_information][payment_fields][credit][expiration_date][card_expiration_month]" aria-selected="true" tabindex="0" role="listbox" aria-expanded="false">
                      <option value="1" aria-label="January" id="January" role="option">January</option>
                      <option value="2" selected="selected" aria-label="February" id="February" role="option">February</option>
                      <option value="3" aria-label="March" id="March" role="option">March</option>
                      <option value="4" aria-label="April" id="April" role="option">April</option>
                      <option value="5" aria-label="May" id="May" role="option">May</option>
                      <option value="6" aria-label="June" id="June" role="option">June</option>
                      <option value="7" aria-label="July" id="July" role="option">July</option>
                      <option value="8" aria-label="August" id="August" role="option">August</option>
                      <option value="9" aria-label="September" id="September" role="option">September</option>
                      <option value="10" aria-label="October" id="October" role="option">October</option>
                      <option value="11" aria-label="November" id="November" role="option">November</option>
                      <option value="12" aria-label="December" id="December" role="option">December</option>
                    </select></div>
                  <div class="select-wrapper"><select class="input-small form-select" id="edit-submitted-payment-information-payment-fields-credit-expiration-date-card-expiration-year"
                      name="submitted[payment_information][payment_fields][credit][expiration_date][card_expiration_year]" aria-selected="true" tabindex="0" role="listbox" aria-expanded="false">
                      <option value="2023" selected="selected" aria-label="2023" id="2023" role="option">2023</option>
                      <option value="2024" aria-label="2024" id="2024" role="option">2024</option>
                      <option value="2025" aria-label="2025" id="2025" role="option">2025</option>
                      <option value="2026" aria-label="2026" id="2026" role="option">2026</option>
                      <option value="2027" aria-label="2027" id="2027" role="option">2027</option>
                      <option value="2028" aria-label="2028" id="2028" role="option">2028</option>
                      <option value="2029" aria-label="2029" id="2029" role="option">2029</option>
                      <option value="2030" aria-label="2030" id="2030" role="option">2030</option>
                      <option value="2031" aria-label="2031" id="2031" role="option">2031</option>
                      <option value="2032" aria-label="2032" id="2032" role="option">2032</option>
                      <option value="2033" aria-label="2033" id="2033" role="option">2033</option>
                      <option value="2034" aria-label="2034" id="2034" role="option">2034</option>
                      <option value="2035" aria-label="2035" id="2035" role="option">2035</option>
                      <option value="2036" aria-label="2036" id="2036" role="option">2036</option>
                      <option value="2037" aria-label="2037" id="2037" role="option">2037</option>
                      <option value="2038" aria-label="2038" id="2038" role="option">2038</option>
                    </select></div>
                </div>
              </div>
              <div class="form-item form-type-textfield form-item-submitted-payment-information-payment-fields-credit-card-cvv control-group">
                <label for="edit-submitted-payment-information-payment-fields-credit-card-cvv" aria-selected="false" role="tab">CVV <span class="form-required">*</span></label>
                <input class="input-small form-text" type="text" id="edit-submitted-payment-information-payment-fields-credit-card-cvv" name="submitted[payment_information][payment_fields][credit][card_cvv]" value="" size="6" maxlength="128"
                  autocomplete="off" role="textbox" inputmode="numeric" pattern="[0-9]*">
              </div><input type="hidden" name="submitted[payment_information][payment_fields][credit][card_type]" value="">
              <div class="metrix-container">
                <div style="background:url(https://h.online-metrix.net/fp/clear.png?org_id=1gqehjqy&amp;session_id=rescu-960253179910&amp;m=1)"></div><img
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                  <param name="wmode" value="transparent">
                  <div></div>
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              </div><input type="hidden" name="submitted[payment_information][payment_fields][credit][session_id]" value="rescu-960253179910">
            </div>
          </fieldset>
          <fieldset class="fundraiser-payment-fields form-wrapper" id="edit-submitted-payment-information-payment-fields-applepay" style="display: none;">
            <div class="fieldset-wrapper">
              <div id="payment-details" class="form-wrapper">
                <div id="braintree-payment-form-outer">
                  <div class="braintree-payment-form form-wrapper" id="edit-submitted-payment-information-payment-fields-applepay-braintree-new"><input type="hidden" name="payment_method_nonce" value="">
                  </div>
                </div>
              </div><input type="hidden" name="braintree[errors]" value="">
              <input type="hidden" name="payment_method_nonce" value="">
              <input type="hidden" name="submitted[payment_information][payment_fields][applepay][braintree_card_type]" value="">
              <input type="hidden" name="submitted[payment_information][payment_fields][applepay][braintree_last4]" value="">
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          <fieldset class="fundraiser-payment-fields form-wrapper" id="edit-submitted-payment-information-payment-fields-paypal" style="display: none;">
            <div class="fieldset-wrapper">
              <div id="paypal-container" class="form-wrapper">
                <div id="braintree-paypal-loggedin" class="form-wrapper"><span id="bt-pp-name">PayPal</span><span id="bt-pp-email"></span><button id="bt-pp-cancel">Cancel</button></div>
              </div><input type="hidden" name="payment_method_nonce" value="">
              <input type="hidden" name="submitted[payment_information][payment_fields][paypal][braintree_card_type]" value="">
              <input type="hidden" name="submitted[payment_information][payment_fields][paypal][braintree_last4]" value="">
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          </fieldset>
          <fieldset class="fundraiser-payment-fields form-wrapper" id="edit-submitted-payment-information-payment-fields-bank-account" style="display: none;">
            <div class="fieldset-wrapper">
              <div class="form-item form-type-select form-item-submitted-payment-information-payment-fields-bank account-accType control-group">
                <label for="edit-submitted-payment-information-payment-fields-bank-account-acctype" class="hidden" aria-selected="false" role="tab">Account type </label>
                <div class="select-wrapper"><select id="edit-submitted-payment-information-payment-fields-bank-account-acctype" name="submitted[payment_information][payment_fields][bank account][accType]" class="form-select" aria-selected="true"
                    tabindex="0" role="listbox" aria-expanded="false">
                    <option value="Checking" aria-label="Checking" id="Checking" role="option">Checking</option>
                    <option value="Savings" aria-label="Savings" id="Savings" role="option">Savings</option>
                    <option value="Corporate" aria-label="Corporate" id="Corporate" role="option">Corporate</option>
                    <option value="Corp Savings" aria-label="Corp Savings" id="Corp Savings" role="option">Corp Savings</option>
                  </select></div>
              </div>
              <div class="form-item form-type-textfield form-item-submitted-payment-information-payment-fields-bank account-routingNum control-group">
                <label for="edit-submitted-payment-information-payment-fields-bank-account-routingnum" aria-selected="false" role="tab">Routing number </label>
                <input autocomplete="off" type="text" id="edit-submitted-payment-information-payment-fields-bank-account-routingnum" name="submitted[payment_information][payment_fields][bank account][routingNum]" value="" size="20" maxlength="128"
                  class="form-text" role="textbox">
              </div>
              <div class="form-item form-type-textfield form-item-submitted-payment-information-payment-fields-bank account-accNum control-group">
                <label for="edit-submitted-payment-information-payment-fields-bank-account-accnum" aria-selected="false" role="tab">Account number </label>
                <input autocomplete="off" type="text" id="edit-submitted-payment-information-payment-fields-bank-account-accnum" name="submitted[payment_information][payment_fields][bank account][accNum]" value="" size="30" maxlength="128"
                  class="form-text" role="textbox">
              </div>
              <div class="form-item form-type-textfield form-item-submitted-payment-information-payment-fields-bank account-phone control-group">
                <label for="edit-submitted-payment-information-payment-fields-bank-account-phone" aria-selected="false" role="tab">Phone number </label>
                <input type="tel" id="edit-submitted-payment-information-payment-fields-bank-account-phone" name="submitted[payment_information][payment_fields][bank account][phone]" value="" size="30" maxlength="12" class="form-text" role="textbox"
                  pattern="[0-9]{3}[0-9]{3}[0-9]{4}">
                <div class="description">Your phone number is used to validate your transaction and will not be retained for marketing purposes.</div>
              </div>
              <div class="metrix-container">
                <div style="background:url(https://h.online-metrix.net/fp/clear.png?org_id=1gqehjqy&amp;session_id=rescu-960253179910&amp;m=1)"></div><img
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        </div>
        <div class="form-item webform-component webform-component-checkboxes control-group" id="webform-component-payment-information--processing-fee" style="display: block;">
          <label for="edit-submitted-payment-information-processing-fee" aria-selected="false" role="tab">Processing fee </label>
          <div id="edit-submitted-payment-information-processing-fee">
            <div class="form-item form-type-checkbox form-item-submitted-payment-information-processing-fee-1 control-group"
              aria-label="Checkbox option: I want to help the IRC’s mission even more by covering the processing fees and other costs associated with my donation." tabindex="0">
              <input type="checkbox" id="edit-submitted-payment-information-processing-fee-1" name="submitted[payment_information][processing_fee][1]" value="1" class="form-checkbox" tabindex="-1" role="checkbox"> <label class="option"
                for="edit-submitted-payment-information-processing-fee-1" aria-selected="false" role="tab">I want to help the IRC’s mission even more by covering the processing fees and other costs associated with my donation.</label>
            </div>
          </div>
        </div><input type="hidden" name="submitted[payment_information][processing_fee_amount]" value="">
      </div>
    </fieldset>
    <div class="progress-buttons"><span class="step continue" data-step-current="step-2" data-step-next="step-3" tabindex="0">Your Information</span><span id="compact-submit" class="step submit" style="display: none;">Make a one-time donation &gt;
      </span></div>
    <div class="fundraiser_submit_message compact-disclaimer" style="display: none;"><img typeof="foaf:Image" src="https://help.rescue.org/sites/all/modules/springboard/fundraiser/modules/fundraiser_webform/images/padlock.png" alt="">Here is my gift
      to the IRC to provide support where it is needed most</div>
  </div>
  <div class="step-group fieldset-step" id="step-3">
    <fieldset class="webform-component-fieldset form-wrapper donor-message-processed" id="webform-component-donor-information">
      <div class="donation-message">Your <span style="font-weight: 700" class="donation-frequency">one-time</span> donation of <span class="donation-message-amount">$108</span> <strong>USD</strong> will be processed securely. Every gift counts, thank
        you!</div>
      <legend><span class="fieldset-legend">Your Information</span></legend>
      <div class="fieldset-wrapper">
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-donor-information--first-name">
          <label for="edit-submitted-donor-information-first-name" aria-selected="false" role="tab">First Name <span class="form-required" title="This field is required.">*</span></label>
          <input type="text" id="edit-submitted-donor-information-first-name" name="submitted[donor_information][first_name]" value="" size="60" maxlength="128" class="form-text required" role="textbox">
        </div>
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-donor-information--last-name">
          <label for="edit-submitted-donor-information-last-name" aria-selected="false" role="tab">Last Name <span class="form-required" title="This field is required.">*</span></label>
          <input type="text" id="edit-submitted-donor-information-last-name" name="submitted[donor_information][last_name]" value="" size="60" maxlength="128" class="form-text required" role="textbox">
        </div>
        <div class="form-item webform-component webform-component-email control-group" id="webform-component-donor-information--mail">
          <label for="edit-submitted-donor-information-mail" aria-selected="false" role="tab">E-mail address <span class="form-required" title="This field is required.">*</span></label>
          <input class="email form-text form-email required" type="email" id="edit-submitted-donor-information-mail" name="submitted[donor_information][mail]" size="60">
        </div>
      </div>
    </fieldset>
    <fieldset class="webform-component-fieldset form-wrapper" id="webform-component-email-optin">
      <div class="fieldset-wrapper">
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-email-optin--telephone">
          <label for="edit-submitted-email-optin-telephone" aria-selected="false" role="tab">Phone Number (Optional) </label>
          <input type="tel" id="edit-submitted-email-optin-telephone" name="submitted[email_optin][telephone]" value="" size="60" maxlength="12" class="form-text" pattern="[0-9]{3}[0-9]{3}[0-9]{4}" role="textbox">
        </div>
        <div class="form-item webform-component webform-component-markup control-group" id="webform-component-email-optin--phone-disclaimer">
          <p><em data-renderer-mark="true">By providing my phone number, I consent to receiving periodic calls and text messages about the IRC’s life-changing programs around the world. Message and data rates may apply.</em></p>
        </div>
      </div>
    </fieldset>
    <fieldset class="webform-component-fieldset form-wrapper" id="webform-component-billing-information">
      <div class="fieldset-wrapper">
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-billing-information--address">
          <label for="edit-submitted-billing-information-address" aria-selected="false" role="tab">Address <span class="form-required" title="This field is required.">*</span></label>
          <input type="text" id="edit-submitted-billing-information-address" name="submitted[billing_information][address]" value="" size="60" maxlength="128" class="form-text required" role="textbox">
        </div>
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-billing-information--address-line-2">
          <label for="edit-submitted-billing-information-address-line-2" aria-selected="false" role="tab">Address Line 2 </label>
          <input type="text" id="edit-submitted-billing-information-address-line-2" name="submitted[billing_information][address_line_2]" value="" size="60" maxlength="128" class="form-text" role="textbox">
        </div>
        <div class="form-item webform-component webform-component-textfield control-group" id="webform-component-billing-information--city">
          <label for="edit-submitted-billing-information-city" aria-selected="false" role="tab">City <span class="form-required" title="This field is required.">*</span></label>
          <input type="text" id="edit-submitted-billing-information-city" name="submitted[billing_information][city]" value="" size="60" maxlength="128" class="form-text required" role="textbox">
        </div>
        <div class="form-item webform-component webform-component-select control-group" id="webform-component-billing-information--country">
          <label for="edit-submitted-billing-information-country" aria-selected="false" role="tab" class="hidden">Country <span class="form-required" title="This field is required.">*</span></label>
          <div class="select-wrapper"><select id="edit-submitted-billing-information-country" name="submitted[billing_information][country]" class="form-select required ajax-processed" aria-selected="true" tabindex="0" role="listbox"
              aria-expanded="false">
              <option value="AF" aria-label="Afghanistan" id="Afghanistan" role="option">Afghanistan</option>
              <option value="AX" aria-label="Aland Islands" id="Aland Islands" role="option">Aland Islands</option>
              <option value="AL" aria-label="Albania" id="Albania" role="option">Albania</option>
              <option value="DZ" aria-label="Algeria" id="Algeria" role="option">Algeria</option>
              <option value="AS" aria-label="American Samoa" id="American Samoa" role="option">American Samoa</option>
              <option value="AD" aria-label="Andorra" id="Andorra" role="option">Andorra</option>
              <option value="AO" aria-label="Angola" id="Angola" role="option">Angola</option>
              <option value="AI" aria-label="Anguilla" id="Anguilla" role="option">Anguilla</option>
              <option value="AQ" aria-label="Antarctica" id="Antarctica" role="option">Antarctica</option>
              <option value="AG" aria-label="Antigua and Barbuda" id="Antigua and Barbuda" role="option">Antigua and Barbuda</option>
              <option value="AR" aria-label="Argentina" id="Argentina" role="option">Argentina</option>
              <option value="AM" aria-label="Armenia" id="Armenia" role="option">Armenia</option>
              <option value="AW" aria-label="Aruba" id="Aruba" role="option">Aruba</option>
              <option value="AU" aria-label="Australia" id="Australia" role="option">Australia</option>
              <option value="AT" aria-label="Austria" id="Austria" role="option">Austria</option>
              <option value="AZ" aria-label="Azerbaijan" id="Azerbaijan" role="option">Azerbaijan</option>
              <option value="BS" aria-label="Bahamas" id="Bahamas" role="option">Bahamas</option>
              <option value="BH" aria-label="Bahrain" id="Bahrain" role="option">Bahrain</option>
              <option value="BD" aria-label="Bangladesh" id="Bangladesh" role="option">Bangladesh</option>
              <option value="BB" aria-label="Barbados" id="Barbados" role="option">Barbados</option>
              <option value="BY" aria-label="Belarus" id="Belarus" role="option">Belarus</option>
              <option value="BE" aria-label="Belgium" id="Belgium" role="option">Belgium</option>
              <option value="BZ" aria-label="Belize" id="Belize" role="option">Belize</option>
              <option value="BJ" aria-label="Benin" id="Benin" role="option">Benin</option>
              <option value="BM" aria-label="Bermuda" id="Bermuda" role="option">Bermuda</option>
              <option value="BT" aria-label="Bhutan" id="Bhutan" role="option">Bhutan</option>
              <option value="BO" aria-label="Bolivia" id="Bolivia" role="option">Bolivia</option>
              <option value="BA" aria-label="Bosnia and Herzegovina" id="Bosnia and Herzegovina" role="option">Bosnia and Herzegovina</option>
              <option value="BW" aria-label="Botswana" id="Botswana" role="option">Botswana</option>
              <option value="BV" aria-label="Bouvet Island" id="Bouvet Island" role="option">Bouvet Island</option>
              <option value="BR" aria-label="Brazil" id="Brazil" role="option">Brazil</option>
              <option value="IO" aria-label="British Indian Ocean Territory" id="British Indian Ocean Territory" role="option">British Indian Ocean Territory</option>
              <option value="VG" aria-label="British Virgin Islands" id="British Virgin Islands" role="option">British Virgin Islands</option>
              <option value="BN" aria-label="Brunei" id="Brunei" role="option">Brunei</option>
              <option value="BG" aria-label="Bulgaria" id="Bulgaria" role="option">Bulgaria</option>
              <option value="BF" aria-label="Burkina Faso" id="Burkina Faso" role="option">Burkina Faso</option>
              <option value="BI" aria-label="Burundi" id="Burundi" role="option">Burundi</option>
              <option value="KH" aria-label="Cambodia" id="Cambodia" role="option">Cambodia</option>
              <option value="CM" aria-label="Cameroon" id="Cameroon" role="option">Cameroon</option>
              <option value="CA" aria-label="Canada" id="Canada" role="option">Canada</option>
              <option value="CV" aria-label="Cape Verde" id="Cape Verde" role="option">Cape Verde</option>
              <option value="BQ" aria-label="Caribbean Netherlands" id="Caribbean Netherlands" role="option">Caribbean Netherlands</option>
              <option value="KY" aria-label="Cayman Islands" id="Cayman Islands" role="option">Cayman Islands</option>
              <option value="CF" aria-label="Central African Republic" id="Central African Republic" role="option">Central African Republic</option>
              <option value="TD" aria-label="Chad" id="Chad" role="option">Chad</option>
              <option value="CL" aria-label="Chile" id="Chile" role="option">Chile</option>
              <option value="CN" aria-label="China" id="China" role="option">China</option>
              <option value="CX" aria-label="Christmas Island" id="Christmas Island" role="option">Christmas Island</option>
              <option value="CC" aria-label="Cocos (Keeling) Islands" id="Cocos (Keeling) Islands" role="option">Cocos (Keeling) Islands</option>
              <option value="CO" aria-label="Colombia" id="Colombia" role="option">Colombia</option>
              <option value="KM" aria-label="Comoros" id="Comoros" role="option">Comoros</option>
              <option value="CG" aria-label="Congo (Brazzaville)" id="Congo (Brazzaville)" role="option">Congo (Brazzaville)</option>
              <option value="CD" aria-label="Congo (Kinshasa)" id="Congo (Kinshasa)" role="option">Congo (Kinshasa)</option>
              <option value="CK" aria-label="Cook Islands" id="Cook Islands" role="option">Cook Islands</option>
              <option value="CR" aria-label="Costa Rica" id="Costa Rica" role="option">Costa Rica</option>
              <option value="HR" aria-label="Croatia" id="Croatia" role="option">Croatia</option>
              <option value="CU" aria-label="Cuba" id="Cuba" role="option">Cuba</option>
              <option value="CW" aria-label="Curaçao" id="Curaçao" role="option">Curaçao</option>
              <option value="CY" aria-label="Cyprus" id="Cyprus" role="option">Cyprus</option>
              <option value="CZ" aria-label="Czech Republic" id="Czech Republic" role="option">Czech Republic</option>
              <option value="DK" aria-label="Denmark" id="Denmark" role="option">Denmark</option>
              <option value="DJ" aria-label="Djibouti" id="Djibouti" role="option">Djibouti</option>
              <option value="DM" aria-label="Dominica" id="Dominica" role="option">Dominica</option>
              <option value="DO" aria-label="Dominican Republic" id="Dominican Republic" role="option">Dominican Republic</option>
              <option value="EC" aria-label="Ecuador" id="Ecuador" role="option">Ecuador</option>
              <option value="EG" aria-label="Egypt" id="Egypt" role="option">Egypt</option>
              <option value="SV" aria-label="El Salvador" id="El Salvador" role="option">El Salvador</option>
              <option value="GQ" aria-label="Equatorial Guinea" id="Equatorial Guinea" role="option">Equatorial Guinea</option>
              <option value="ER" aria-label="Eritrea" id="Eritrea" role="option">Eritrea</option>
              <option value="EE" aria-label="Estonia" id="Estonia" role="option">Estonia</option>
              <option value="ET" aria-label="Ethiopia" id="Ethiopia" role="option">Ethiopia</option>
              <option value="FK" aria-label="Falkland Islands" id="Falkland Islands" role="option">Falkland Islands</option>
              <option value="FO" aria-label="Faroe Islands" id="Faroe Islands" role="option">Faroe Islands</option>
              <option value="FJ" aria-label="Fiji" id="Fiji" role="option">Fiji</option>
              <option value="FI" aria-label="Finland" id="Finland" role="option">Finland</option>
              <option value="FR" aria-label="France" id="France" role="option">France</option>
              <option value="GF" aria-label="French Guiana" id="French Guiana" role="option">French Guiana</option>
              <option value="PF" aria-label="French Polynesia" id="French Polynesia" role="option">French Polynesia</option>
              <option value="TF" aria-label="French Southern Territories" id="French Southern Territories" role="option">French Southern Territories</option>
              <option value="GA" aria-label="Gabon" id="Gabon" role="option">Gabon</option>
              <option value="GM" aria-label="Gambia" id="Gambia" role="option">Gambia</option>
              <option value="GE" aria-label="Georgia" id="Georgia" role="option">Georgia</option>
              <option value="DE" aria-label="Germany" id="Germany" role="option">Germany</option>
              <option value="GH" aria-label="Ghana" id="Ghana" role="option">Ghana</option>
              <option value="GI" aria-label="Gibraltar" id="Gibraltar" role="option">Gibraltar</option>
              <option value="GR" aria-label="Greece" id="Greece" role="option">Greece</option>
              <option value="GL" aria-label="Greenland" id="Greenland" role="option">Greenland</option>
              <option value="GD" aria-label="Grenada" id="Grenada" role="option">Grenada</option>
              <option value="GP" aria-label="Guadeloupe" id="Guadeloupe" role="option">Guadeloupe</option>
              <option value="GU" aria-label="Guam" id="Guam" role="option">Guam</option>
              <option value="GT" aria-label="Guatemala" id="Guatemala" role="option">Guatemala</option>
              <option value="GG" aria-label="Guernsey" id="Guernsey" role="option">Guernsey</option>
              <option value="GN" aria-label="Guinea" id="Guinea" role="option">Guinea</option>
              <option value="GW" aria-label="Guinea-Bissau" id="Guinea-Bissau" role="option">Guinea-Bissau</option>
              <option value="GY" aria-label="Guyana" id="Guyana" role="option">Guyana</option>
              <option value="HT" aria-label="Haiti" id="Haiti" role="option">Haiti</option>
              <option value="HM" aria-label="Heard Island and McDonald Islands" id="Heard Island and McDonald Islands" role="option">Heard Island and McDonald Islands</option>
              <option value="HN" aria-label="Honduras" id="Honduras" role="option">Honduras</option>
              <option value="HK" aria-label="Hong Kong S.A.R., China" id="Hong Kong S.A.R., China" role="option">Hong Kong S.A.R., China</option>
              <option value="HU" aria-label="Hungary" id="Hungary" role="option">Hungary</option>
              <option value="IS" aria-label="Iceland" id="Iceland" role="option">Iceland</option>
              <option value="IN" aria-label="India" id="India" role="option">India</option>
              <option value="ID" aria-label="Indonesia" id="Indonesia" role="option">Indonesia</option>
              <option value="IR" aria-label="Iran" id="Iran" role="option">Iran</option>
              <option value="IQ" aria-label="Iraq" id="Iraq" role="option">Iraq</option>
              <option value="IE" aria-label="Ireland" id="Ireland" role="option">Ireland</option>
              <option value="IM" aria-label="Isle of Man" id="Isle of Man" role="option">Isle of Man</option>
              <option value="IL" aria-label="Israel" id="Israel" role="option">Israel</option>
              <option value="IT" aria-label="Italy" id="Italy" role="option">Italy</option>
              <option value="CI" aria-label="Ivory Coast" id="Ivory Coast" role="option">Ivory Coast</option>
              <option value="JM" aria-label="Jamaica" id="Jamaica" role="option">Jamaica</option>
              <option value="JP" aria-label="Japan" id="Japan" role="option">Japan</option>
              <option value="JE" aria-label="Jersey" id="Jersey" role="option">Jersey</option>
              <option value="JO" aria-label="Jordan" id="Jordan" role="option">Jordan</option>
              <option value="KZ" aria-label="Kazakhstan" id="Kazakhstan" role="option">Kazakhstan</option>
              <option value="KE" aria-label="Kenya" id="Kenya" role="option">Kenya</option>
              <option value="KI" aria-label="Kiribati" id="Kiribati" role="option">Kiribati</option>
              <option value="KW" aria-label="Kuwait" id="Kuwait" role="option">Kuwait</option>
              <option value="KG" aria-label="Kyrgyzstan" id="Kyrgyzstan" role="option">Kyrgyzstan</option>
              <option value="LA" aria-label="Laos" id="Laos" role="option">Laos</option>
              <option value="LV" aria-label="Latvia" id="Latvia" role="option">Latvia</option>
              <option value="LB" aria-label="Lebanon" id="Lebanon" role="option">Lebanon</option>
              <option value="LS" aria-label="Lesotho" id="Lesotho" role="option">Lesotho</option>
              <option value="LR" aria-label="Liberia" id="Liberia" role="option">Liberia</option>
              <option value="LY" aria-label="Libya" id="Libya" role="option">Libya</option>
              <option value="LI" aria-label="Liechtenstein" id="Liechtenstein" role="option">Liechtenstein</option>
              <option value="LT" aria-label="Lithuania" id="Lithuania" role="option">Lithuania</option>
              <option value="LU" aria-label="Luxembourg" id="Luxembourg" role="option">Luxembourg</option>
              <option value="MO" aria-label="Macao S.A.R., China" id="Macao S.A.R., China" role="option">Macao S.A.R., China</option>
              <option value="MK" aria-label="Macedonia" id="Macedonia" role="option">Macedonia</option>
              <option value="MG" aria-label="Madagascar" id="Madagascar" role="option">Madagascar</option>
              <option value="MW" aria-label="Malawi" id="Malawi" role="option">Malawi</option>
              <option value="MY" aria-label="Malaysia" id="Malaysia" role="option">Malaysia</option>
              <option value="MV" aria-label="Maldives" id="Maldives" role="option">Maldives</option>
              <option value="ML" aria-label="Mali" id="Mali" role="option">Mali</option>
              <option value="MT" aria-label="Malta" id="Malta" role="option">Malta</option>
              <option value="MH" aria-label="Marshall Islands" id="Marshall Islands" role="option">Marshall Islands</option>
              <option value="MQ" aria-label="Martinique" id="Martinique" role="option">Martinique</option>
              <option value="MR" aria-label="Mauritania" id="Mauritania" role="option">Mauritania</option>
              <option value="MU" aria-label="Mauritius" id="Mauritius" role="option">Mauritius</option>
              <option value="YT" aria-label="Mayotte" id="Mayotte" role="option">Mayotte</option>
              <option value="MX" aria-label="Mexico" id="Mexico" role="option">Mexico</option>
              <option value="FM" aria-label="Micronesia" id="Micronesia" role="option">Micronesia</option>
              <option value="MD" aria-label="Moldova" id="Moldova" role="option">Moldova</option>
              <option value="MC" aria-label="Monaco" id="Monaco" role="option">Monaco</option>
              <option value="MN" aria-label="Mongolia" id="Mongolia" role="option">Mongolia</option>
              <option value="ME" aria-label="Montenegro" id="Montenegro" role="option">Montenegro</option>
              <option value="MS" aria-label="Montserrat" id="Montserrat" role="option">Montserrat</option>
              <option value="MA" aria-label="Morocco" id="Morocco" role="option">Morocco</option>
              <option value="MZ" aria-label="Mozambique" id="Mozambique" role="option">Mozambique</option>
              <option value="MM" aria-label="Myanmar" id="Myanmar" role="option">Myanmar</option>
              <option value="NA" aria-label="Namibia" id="Namibia" role="option">Namibia</option>
              <option value="NR" aria-label="Nauru" id="Nauru" role="option">Nauru</option>
              <option value="NP" aria-label="Nepal" id="Nepal" role="option">Nepal</option>
              <option value="NL" aria-label="Netherlands" id="Netherlands" role="option">Netherlands</option>
              <option value="AN" aria-label="Netherlands Antilles" id="Netherlands Antilles" role="option">Netherlands Antilles</option>
              <option value="NC" aria-label="New Caledonia" id="New Caledonia" role="option">New Caledonia</option>
              <option value="NZ" aria-label="New Zealand" id="New Zealand" role="option">New Zealand</option>
              <option value="NI" aria-label="Nicaragua" id="Nicaragua" role="option">Nicaragua</option>
              <option value="NE" aria-label="Niger" id="Niger" role="option">Niger</option>
              <option value="NG" aria-label="Nigeria" id="Nigeria" role="option">Nigeria</option>
              <option value="NU" aria-label="Niue" id="Niue" role="option">Niue</option>
              <option value="NF" aria-label="Norfolk Island" id="Norfolk Island" role="option">Norfolk Island</option>
              <option value="MP" aria-label="Northern Mariana Islands" id="Northern Mariana Islands" role="option">Northern Mariana Islands</option>
              <option value="KP" aria-label="North Korea" id="North Korea" role="option">North Korea</option>
              <option value="NO" aria-label="Norway" id="Norway" role="option">Norway</option>
              <option value="OM" aria-label="Oman" id="Oman" role="option">Oman</option>
              <option value="PK" aria-label="Pakistan" id="Pakistan" role="option">Pakistan</option>
              <option value="PW" aria-label="Palau" id="Palau" role="option">Palau</option>
              <option value="PS" aria-label="Palestinian Territory" id="Palestinian Territory" role="option">Palestinian Territory</option>
              <option value="PA" aria-label="Panama" id="Panama" role="option">Panama</option>
              <option value="PG" aria-label="Papua New Guinea" id="Papua New Guinea" role="option">Papua New Guinea</option>
              <option value="PY" aria-label="Paraguay" id="Paraguay" role="option">Paraguay</option>
              <option value="PE" aria-label="Peru" id="Peru" role="option">Peru</option>
              <option value="PH" aria-label="Philippines" id="Philippines" role="option">Philippines</option>
              <option value="PN" aria-label="Pitcairn" id="Pitcairn" role="option">Pitcairn</option>
              <option value="PL" aria-label="Poland" id="Poland" role="option">Poland</option>
              <option value="PT" aria-label="Portugal" id="Portugal" role="option">Portugal</option>
              <option value="PR" aria-label="Puerto Rico" id="Puerto Rico" role="option">Puerto Rico</option>
              <option value="QA" aria-label="Qatar" id="Qatar" role="option">Qatar</option>
              <option value="RE" aria-label="Reunion" id="Reunion" role="option">Reunion</option>
              <option value="RO" aria-label="Romania" id="Romania" role="option">Romania</option>
              <option value="RU" aria-label="Russia" id="Russia" role="option">Russia</option>
              <option value="RW" aria-label="Rwanda" id="Rwanda" role="option">Rwanda</option>
              <option value="BL" aria-label="Saint Barthélemy" id="Saint Barthélemy" role="option">Saint Barthélemy</option>
              <option value="SH" aria-label="Saint Helena" id="Saint Helena" role="option">Saint Helena</option>
              <option value="KN" aria-label="Saint Kitts and Nevis" id="Saint Kitts and Nevis" role="option">Saint Kitts and Nevis</option>
              <option value="LC" aria-label="Saint Lucia" id="Saint Lucia" role="option">Saint Lucia</option>
              <option value="MF" aria-label="Saint Martin (French part)" id="Saint Martin (French part)" role="option">Saint Martin (French part)</option>
              <option value="PM" aria-label="Saint Pierre and Miquelon" id="Saint Pierre and Miquelon" role="option">Saint Pierre and Miquelon</option>
              <option value="VC" aria-label="Saint Vincent and the Grenadines" id="Saint Vincent and the Grenadines" role="option">Saint Vincent and the Grenadines</option>
              <option value="WS" aria-label="Samoa" id="Samoa" role="option">Samoa</option>
              <option value="SM" aria-label="San Marino" id="San Marino" role="option">San Marino</option>
              <option value="ST" aria-label="Sao Tome and Principe" id="Sao Tome and Principe" role="option">Sao Tome and Principe</option>
              <option value="SA" aria-label="Saudi Arabia" id="Saudi Arabia" role="option">Saudi Arabia</option>
              <option value="SN" aria-label="Senegal" id="Senegal" role="option">Senegal</option>
              <option value="RS" aria-label="Serbia" id="Serbia" role="option">Serbia</option>
              <option value="SC" aria-label="Seychelles" id="Seychelles" role="option">Seychelles</option>
              <option value="SL" aria-label="Sierra Leone" id="Sierra Leone" role="option">Sierra Leone</option>
              <option value="SG" aria-label="Singapore" id="Singapore" role="option">Singapore</option>
              <option value="SX" aria-label="Sint Maarten" id="Sint Maarten" role="option">Sint Maarten</option>
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IRC


DEVASTATING EARTHQUAKES: SYRIA AND TURKEY





Multiple devastating earthquakes have hit Syria and Turkey leaving thousands of
families without shelter in freezing temperatures. Please rush an emergency
gift now.

A 7.8 magnitude earthquake followed by a second 7.5 magnitude earthquake in
Turkey and Syria has left thousands of families without shelter in
freezing temperatures.

Your gift will help us provide emergency services to families in Syria and
refugee families around the world. Please give what you can today.

Please, make a gift now as we rush to support this crisis and all children and
families in urgent need.



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A 7.8 magnitude earthquake followed by a second 7.5 magnitude earthquake in
Turkey and Syria has left thousands of families without shelter in
freezing temperatures.

Your gift will help us provide emergency services to families in Syria and
refugee families around the world. Please give what you can today.

Please, make a gift now as we rush to support this crisis and all children and
families in urgent need.





Multiple devastating earthquakes have hit Syria and Turkey leaving thousands of
families without shelter in freezing temperatures. Please rush an emergency
gift now.




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