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mssociety.donordrive.com Open in urlscan Pro
2606:4700::6812:dee4  Public Scan

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Submitted URL: https://bndfr.com/jRlh
Effective URL: https://mssociety.donordrive.com/index.cfm?fuseaction=donate.participant&participantID=220227&referrer=bfIphEmPfMsg
Submission: On February 21 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

Name: donate — POST index.cfm?

<form name="donate" id="donate" class="form-horizontal js-payment-form" action="index.cfm?" method="post" novalidate="novalidate">
  <input type="hidden" name="donationData" id="donation-data">
  <input type="hidden" name="recurring" id="recurring" value="0">
  <input type="hidden" name="fulfillmentNoteExists" value="0">
  <input type="hidden" name="formSubmit" value="1">
  <input type="hidden" name="fuseaction" id="fuseaction" value="donate.ajaxConfirmValidate">
  <div class="support-row" style="border: 0; margin-bottom: 0">
    <img class="member-avatar pull-left" alt="Rick Martinez profile picture" src="https://assets.donordrive.com/mssociety/images/$avatars$/constituent_AF95ACA3-0C20-A8FC-A33ED244FEDCA4A2.jpg" width="125" height="125">
    <div class="member-detail">
      <h2>Supporting Rick Martinez</h2>
      <p>Participating in Bike MS: Round-Up Ride 2023</p>
      <div class="progress progress-success" style="clear: both; position: relative">
        <div class="bar" style="width: 94%">
          <small class="total">$11,341.00 / $12,086.00</small>
        </div>
      </div>
    </div>
    <div class="clr"></div>
  </div>
  <fieldset class="dd-u-mb-40">
    <legend>Your Donation</legend>
    <div class="control-group">
      <label class="control-label" for="incentives">
        <strong class="required" aria-required="true">Incentives<span>*</span></strong>
      </label>
      <div class="controls dd-incentives-list">
        <ul class="span8">
          <li class="dd-incentive">
            <a href="javascript:void(0);" role="button" class="js-pick-incentive dd-incentive-button" data-incentive-id="D9CFCFA6-A7D0-5F4C-D07BC28EC8D6F313" data-amount="300.0000" data-fulfillment-note="Please include your jersey size. If you're not in the Georgetown, Texas area, I'll also need your shipping address. Thanks very much!" data-quantity="0" data-quantity-claimed="3">
<div class="dd-incentive-amount">
$300
<small></small>
</div>
<div class="dd-incentive-description dd-incentive-link">
<img alt="" src="https://assets.donordrive.com/mssociety/images/$constituents$/AF95ACA3-0C20-A8FC-A33ED244FEDCA4A2/Jacks_Jersey_NEW_Perspective_Front_Right.jpg">
Cycling Jersey - JACK'S CYCLING
</div>
<div class="dd-incentive-action"></div>
</a>
          </li>
          <li class="dd-incentive text-center">
            <div class="dd-incentive-description dd-incentive-link">
              <input type="hidden" name="incentiveState" value="NONESELECTED">
              <a class="js-no-incentive block" href="javascript:void(0);" role="button">Donate an amount of your choice</a>
            </div>
          </li>
        </ul>
        <input type="hidden" name="incentiveID" value="">
      </div>
    </div>
    <div class="control-group" id="fulfillment-note" style="display:none;">
      <label class="control-label"><strong class="required js-fulfillmentnote" aria-required="true"></strong></label>
      <input type="hidden" name="fulfillmentNoteQuestion" value="">
      <div class="controls">
        <textarea class="span8" name="fulfillmentNote" rows="4" cols="50" maxlength="200"></textarea>
      </div>
    </div>
    <div class="control-group js-donation-option" style="display: none;">
      <label class="control-label" for="donationOption"><strong class="required" aria-required="true">Donation Option<span>*</span></strong></label>
      <div class="controls">
        <div class="dd-c-tabs-donation-options">
          <label class="js-one-time">
            <input class="dd-u-sr-only" name="donationOption" type="radio" value="">
            <strong> One-Time </strong>
          </label>
          <label class="js-recurring-monthly">
            <input class="dd-u-sr-only" name="donationOption" type="radio" value="monthly">
            <strong> Monthly </strong>
            <div class="js-recurring-monthly" style="display:none;">
              <span style="font-size: 20px; color: #888">per month</span>
            </div>
          </label>
        </div>
      </div>
    </div>
    <div class="control-group suggested-donation-option-group js-recurring-check-target js-processing-fee-check-target js-recurring-input-target" style="display:none;">
      <label class="control-label" for="donation-amount-input"><strong class="required" aria-required="true">Donation Amount<span>*</span></strong></label>
      <div class="controls">
        <div class="js-amount-div post input-big" data-activity-label="Pledge Amount per Mile" data-standard-label="Donation Amount" data-monthly-label="Donation Amount per Month">
          <input type="hidden" name="donationAmount" id="donation-amount-hidden-input" value="0.00" aria-required="true">
          <input type="hidden" name="suggestedDonationID" value="">
          <input type="hidden" name="currency" id="currency" value="USD">
          <input type="hidden" name="currencySymbol" id="currencysymbol" value="$">
          <div class="row-fluid js-option-container js-option-single" style="">
            <div class="span8 js-donation-options dd-sda-option-simple-group" style="float: none;"><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$1,000</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$500</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$250</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$100</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$50</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$35</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title js-option-other">Other</button>
              </span></div>
          </div>
          <div class="row-fluid js-option-container js-option-monthly" style="display: none;">
            <div class="span8 js-donation-options dd-sda-option-simple-group" style="float: none;"><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$1,000</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$500</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$250</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$100</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$50</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title">$35</button>
              </span><span class="js-option-simple dd-sda-option-simple">
                <button type="button" class="dd-btn js-option js-option-title js-option-other">Other</button>
              </span></div>
          </div>
        </div>
      </div>
    </div>
    <div class="control-group js-activity-pledge-max-amount js-processing-fee-check-target" style="display: none;">
      <label class="control-label" for="activity-pledge-max-amount"><strong>Maximum Amount to Donate (Optional)</strong></label>
      <div class="controls">
        <div class="row-fluid">
          <div class="pre post span8 input-big">
            <span class="addon js-currency-symbol">$</span>
            <input type="text" placeholder="0" name="activityPledgeMaxAmount" id="activity-pledge-max-amount" class="span12 no-ms-clear" pattern="[0-9]*" inputmode="decimal" autocomplete="new-password">
            <span class="addon" style="right: 15px">Total</span>
          </div>
        </div>
      </div>
    </div>
    <div class="control-group js-processing-fee-check" style="display: none;">
      <div class="controls">
        <label class="checkbox" style="padding-top: 0;">
          <input type="checkbox" name="coverProcessingFee" value="1"> 🧡 Yes! I'd like to help offset service and processing fees. (<span class="js-processing-fee-amount">$0.00</span><span class="js-processing-fee-currency"></span><span
            class="js-processing-fee-recurring-monthly" style="display: none;"> per month</span><span class="js-processing-fee-recurring-annual" style="display: none;"> per year</span><span class="js-processing-fee-activity-pledge"
            style="display: none;"> per mile</span>) </label>
      </div>
    </div>
    <div class="control-group" style="display:none;">
      <label class="control-label" for="donation-message"><strong>Write a message (optional). This message will be included in an email to the fundraiser. This message will also appear on the public fundraising page unless you check the box below the
          message field.</strong></label>
      <div class="controls">
        <textarea class="span8" rows="8" cols="35" name="donationMessage" id="donation-message" placeholder="Write a message (optional). 

This message will be included in an email to the fundraiser. This message will also appear on the public fundraising page unless you check the box below the message field."></textarea>
        <div class="span8 textarea-cap bottom" style="margin: 0 0 10px 0; float: none">
          <label class="checkbox show-message">
            <input type="checkbox" name="displayDonationMsg" id="display-donation-msg" value="0">
            <small>Show this message to Rick Martinez only</small>
          </label>
        </div>
      </div>
    </div>
    <div class="js-form-questions" style="display: none;">
      <input type="hidden" name="formID" value="9D8DB288-CB7B-FB93-9004AA28EE6226D8">
    </div>
    <fieldset class="control-group dd-matching-gifts dd-u-mb-0" style="display: none;">
      <legend class="control-label legend-label" style="margin-top: 0;">Corporate Giving</legend>
      <div class="controls">
        <label class="radio">
          <input checked="" name="giftType" type="radio" value="matchingGift">
          <strong>Individual Gift</strong>
        </label>
        <label class="radio">
          <input name="giftType" type="radio" value="behalfOfCompany">
          <strong>Gift on behalf of my company</strong>
        </label>
      </div>
      <div class="control-group dd-matching-gifts dd-u-mt-0">
        <div class="controls">
          <div id="employer-matching" class="row-fluid" style="">
            <p class="dd-u-mb-5 dd-u-mt-10" style="line-height: 20px;">See if your company will match your donation!</p>
            <div class="js-append-company-name-input span8 dd-u-relative" style="margin-left: 0;">
              <input class="dd-u-w-full" type="text" name="matchingEmployer" id="matching-employer" maxlength="80" placeholder="Find your Employer" style="display: none;">
              <button type="button" class="js-clear-matching-company dd-u-absolute dd-u-bg-none dd-u-border-none dd-u-cursor-pointer dd-u-flex dd-u-h-full dd-u-items-center dd-u-px-20 dd-u-right-0 dd-u-top-0" style="display: none;"><span
                  class="dd-u-sr-only">Clear matching company</span><i class="icon-remove icon dd-u-m-0" aria-hidden="true"></i> </button>
              <div id="dd-company-name-input" data-doublethedonation-widget-id="G__2">
                <div class="dtd-streamlined-plugin"><input type="hidden" name="doubledonation_status" value="no_interaction"><input type="hidden" name="doublethedonation_status" value="no_interaction"><input type="hidden"
                    name="doublethedonation_entered_text"><input type="hidden" name="doubledonation_company_id"><input type="hidden" name="doublethedonation_company_id"><input type="hidden" name="doubledonation_company_name"><input type="hidden"
                    name="doublethedonation_company_name">
                  <div class="dtd-search-box" style="width: 100%; margin-bottom: 0px;">
                    <div aria-live="assertive" style="display: block; font-size: 0px; color: rgb(255, 255, 255); opacity: 0; position: absolute; height: 0px; margin: 0px; z-index: -99999;"></div>
                    <div aria-live="polite" style="display: block; font-size: 0px; color: rgb(255, 255, 255); opacity: 0; position: absolute; height: 0px; margin: 0px; z-index: -99999;"></div><input role="listbox" aria-expanded="false"
                      name="doublethedonation_company_name_input" autocomplete="new-password" type="text" id="dd-input" class="dtd-search-input form-control BBFormTextbox" aria-label="Search company" placeholder="Search company name..."
                      style="width: 100%;">
                  </div>
                </div>
              </div>
            </div>
          </div>
          <div class="new-user dd-u-mt-10" id="company-name-div" style="display:none;">
            <label for="company-name">Company Name</label>
            <input class="span8" type="text" name="companyName" id="company-name" maxlength="80" autocomplete="new-password">
          </div>
          <div class="js-selected-company-message dd-u-mt-20"></div>
        </div>
      </div>
    </fieldset>
  </fieldset>
  <fieldset class="dd-u-mb-40" style="">
    <legend>Payment</legend>
    <div class="control-group js-payment-type payment-options-group dd-u-mb-0">
      <label class="control-label" for=""><strong class="required" aria-required="true">Payment Method<span>*</span></strong></label>
      <div class="controls">
        <label aria-label="Apple Pay" class="radio payment-type-option" style="display: none;" data-payment-type="APPLEPAY">
          <input type="radio" name="paymentType" value="APPLEPAY" disabled="">
          <img alt="Apple Pay" class="paymenttype" src="https://assets.donordrive.com/resources/img/apple-pay-mark.svg?v=20230221130">
        </label>
        <label aria-label="Credit Card" class="radio payment-type-option js-currency-usd" style="" data-payment-type="CC">
          <input type="radio" name="paymentType" value="CC" style="">
          <span class="payment-type-option-icon" data-payment-state="new">
            <img alt="Credit Card" class="paymenttype" src="https://assets.donordrive.com/resources/img/cc_gen.svg?v=20230221130"> <img style="display: none" alt="Visa" class="paymenttype visa"
              src="https://assets.donordrive.com/resources/img/cc_visa.svg?v=20230221130"> <img style="display: none" alt="Mastercard" class="paymenttype mc" src="https://assets.donordrive.com/resources/img/cc_mc.svg?v=20230221130"> <img
              style="display: none" alt="American Express" class="paymenttype amex" src="https://assets.donordrive.com/resources/img/cc_amex.svg?v=20230221130"> <img style="display: none" alt="Discover" class="paymenttype discover"
              src="https://assets.donordrive.com/resources/img/cc_discover.svg?v=20230221130">
          </span>
        </label>
        <label aria-label="PayPal" class="radio payment-type-option js-currency-usd" style="" data-payment-type="PAYPAL">
          <input type="radio" name="paymentType" value="PAYPAL">
          <img alt="PayPal" id="paypal" class="paymenttype" src="https://assets.donordrive.com/resources/img/paypal.svg?v=20230221130">
        </label>
        <label aria-label="Bank Account" class="radio payment-type-option" style="display: none;" data-payment-type="ACH">
          <input type="radio" name="paymentType" value="ACH" disabled="">
          <span class="payment-type-option-icon" data-payment-state="new">
            <img alt="Bank Account" id="ach" class="paymenttype" src="https://assets.donordrive.com/resources/img/bank-account-en.svg?v=20230221130">
          </span>
        </label>
        <label aria-label="Amazon Pay" class="radio payment-type-option" style="display: none;" data-payment-type="AMAZONPAY">
          <input type="radio" name="paymentType" value="AMAZONPAY" disabled="">
          <img alt="Amazon Pay" class="paymenttype" src="https://assets.donordrive.com/resources/img/amazon-pay.svg?v=20230221130">
        </label>
        <label aria-label="Venmo" class="radio payment-type-option" style="display: none;" data-payment-type="VENMO">
          <input type="radio" name="paymentType" value="VENMO" disabled="">
          <img alt="Venmo" class="paymenttype" src="https://assets.donordrive.com/resources/img/blue_venmo_acceptance_mark.svg?v=20230221130">
        </label>
        <div class="payment-type-pod js-saved-payments" data-payment-state="saved" style="display: none;">
          <label aria-label="Saved Bank Account" class="payment-saved js-saved-ach" style="display: none;" data-payment-type="ACH">
            <input type="radio" name="savedPaymentType" value="ACH" class="pull-left" disabled="">
            <img alt="Saved Bank Account" class="pull-left paymenttype" src="https://assets.donordrive.com/resources/img/bank-account-en.svg?v=20230221130">
            <div class="payment-saved-details">
              <span class="js-saved-name"></span>
              <span class="js-saved-institution"><br><span class="js-saved-institution-name"></span></span>
              <br>
              <span class="js-saved-summary">{accountType} ending in {accountLastFour}</span>
            </div>
            <div class="clr"></div>
            <div class="option-check">
              <i class="icon-ok" aria-hidden="true" style="margin: 10px 0 0 0;"></i>
            </div>
          </label>
          <label aria-label="Saved Credit Card" class="payment-saved js-saved-cc js-currency-usd" style="" data-payment-type="CC">
            <input type="radio" name="savedPaymentType" value="CC" class="pull-left">
            <img src="data:image/gif;base64,R0lGODlhAQABAAD/ACwAAAAAAQABAAACADs=" alt="Saved Card" class="pull-left paymenttype">
            <div class="pull-left">
              <span class="js-saved-name"></span>
              <span class="js-saved-institution"><br><span class="js-saved-institution-name"></span></span>
              <br>
              <span class="js-saved-summary">{accountType} ending in {accountLastFour}</span>
            </div>
            <div class="clr"></div>
            <div class="option-check">
              <i class="icon-ok" aria-hidden="true" style="margin: 10px 0 0 0;"></i>
            </div>
          </label>
          <div class="clr"></div>
          <a href="#" class="js-saved-discard">Choose a different way to pay</a>
        </div>
      </div>
    </div>
  </fieldset>
  <fieldset class="contact-fieldset dd-u-mb-40">
    <legend>Contact Details</legend>
    <div class="beenherebefore" id="welcome-back" style="display:none;">
      <i class="icon-ok" aria-hidden="true"></i> &nbsp;<strong id="welcome-back-msg"></strong>
    </div>
    <div class="inline-login" id="beenhereblock">
      <span class="icon-stack">
        <i class="icon-circle icon-stack-base"></i>
        <i class="icon-user icon icon-light" aria-hidden="true"></i>
      </span>
      <h1>Are you a returning participant?</h1>
      <p>
        <a href="#" class="forgotpasswordhide beenhereloginshow">LOGIN TO YOUR ACCOUNT</a> - If you are a New Participant, please enter your information in the fields below to create a new account.
      </p>
      <div id="beenherelogin" style="display: none;">
        <div class="row-fluid">
          <div class="span6">
            <label for="emaillogin">
              <strong class="required" aria-required="true">Email Address<span>*</span></strong>
              <input type="email" name="emaillogin" id="emaillogin" maxlength="60">
            </label>
          </div>
          <div class="span6">
            <label for="passwordlogin">
              <strong class="required" aria-required="true">Password<span>*</span></strong>
              <input type="password" name="passwordlogin" id="passwordlogin" maxlength="60" autocomplete="new-password">
            </label>
          </div>
        </div>
        <br>
        <div id="formbtns" class="row-fluid">
          <div class="span6">
            <input class="btn-form inline-login-submit" type="button" value="Login">
            <span class="hidden-mobile">&nbsp;</span>
            <a href="#" class="cancel beenhereloginhide">Cancel</a>
          </div>
          <div class="span6">
            <a href="#" class="beenhereloginhide forgotpasswordshow">Forgot Password?</a>
          </div>
        </div>
      </div>
      <div id="forgotpasswordbox" style="display: none;">
        <div class="row-fluid">
          <div class="span6">
            <label for="emailpassword">
              <strong class="required" aria-required="true">Email Address<span>*</span></strong>
              <input type="email" name="emailpassword" id="emailpassword" maxlength="60">
            </label>
          </div>
        </div>
        <br>
        <div class="row-fluid">
          <div class="span6">
            <span id="sendpasswordbtns">
              <input class="btn-form inline-login-forgot-password" type="button" value="Reset My Password">
              <span class="hidden-mobile">&nbsp;</span>
              <a href="#" class="cancel forgotpasswordhide beenherelogintoggle">Cancel</a>
            </span>
          </div>
        </div>
      </div>
    </div>
    <fieldset class="dd-u-mb-0">
      <div class="control-group" data-payment-field="accountName" style="margin-top: 0 !important;">
        <label class="control-label"><strong class="required" aria-required="true">Name<span>*</span></strong></label>
        <div class="controls new-user" id="constituent-name">
          <div class="span8 js-name-fields">
            <div class="inline-block" style="width: 48%;">
              <label class="dd-u-sr-only" for="first-name"> First Name </label>
              <input class="dd-u-w-full" type="text" name="firstName" id="first-name" maxlength="40" placeholder="First Name" autocomplete="given-name">
            </div>
            <div class="inline-block pull-right" style="width: 48%">
              <label class="dd-u-sr-only" for="last-name"> Last Name </label>
              <input class="dd-u-w-full" type="text" name="lastName" id="last-name" maxlength="60" placeholder="Last Name" autocomplete="family-name">
            </div>
          </div>
          <div class="clr"></div>
        </div>
      </div>
    </fieldset>
    <div class="control-group">
      <label class="control-label" for="donor-name-visibility"><strong class="required" aria-required="true">Donation Privacy<span>*</span></strong></label>
      <div class="controls">
        <select class="span8" name="donorNameVisibility" id="donor-name-visibility">
          <option value="ALL" selected="true">Show my name publicly</option>
          <option value="TARGET">Show my name to Rick Martinez only</option>
          <option value="NONE">Hide my name from everyone</option>
        </select>
      </div>
    </div>
    <div class="control-group js-display-name-container">
      <label class="control-label" for="displayname"><strong>Show my name as (Optional)</strong></label>
      <div class="controls">
        <input type="text" class="span8" name="displayName" id="displayname" maxlength="101" placeholder="Ex: Grandma, The Smith Family">
      </div>
    </div>
    <div class="control-group js-donation-visibility">
      <div class="controls">
        <label class="checkbox">
          <input type="checkbox" name="donationAmountVisibility" id="donationamountvisibility" value="TARGET"> Show my donation amount to Rick Martinez only </label>
      </div>
    </div>
    <div class="control-group" data-payment-field="email">
      <label class="control-label" for="email">
        <strong class="required" aria-required="true">Email Address<span>*</span></strong>
      </label>
      <div class="controls new-user" id="constituent-email">
        <input class="span8 dd-u-mr-5" type="email" name="email" id="email" maxlength="60" autocomplete="email">
        <span class="inline-block dd-u-mt-10">
          <a class="privacy fancybox" href="#privacy-text" tabindex="-1">Privacy Policy</a>
        </span>
      </div>
    </div>
    <div id="company-name-after-login" style="display:none;"></div>
    <span class="new-user">
      <input type="hidden" name="constituent_formID" value="CONSTITUENT">
      <fieldset class="control-group question" data-display-question-option-id="" data-question-type="checkbox" aria-hidden="false">
        <legend class="control-label dd-c-legend"> Relationship to MS </legend>
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SUPPORTING RICK MARTINEZ

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