secure.foodbankrockies.org
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74.123.155.244
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Submitted URL: https://secure.foodbankrockies.org/site/R?i=QYMryhoxVRQmikeu-8zkjEGts9QHsQx3lgTOvDUqM2xKn8gJ59Caag
Effective URL: https://secure.foodbankrockies.org/site/Donation2?df_id=7561&mfc_pref=T&7561.donation=form1&utm_source=05.03&s_subsrc=2205glfty&utm...
Submission: On May 04 via api from US — Scanned from DE
Effective URL: https://secure.foodbankrockies.org/site/Donation2?df_id=7561&mfc_pref=T&7561.donation=form1&utm_source=05.03&s_subsrc=2205glfty&utm...
Submission: On May 04 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
Name: process — POST https://secure.foodbankrockies.org/site/Donation2
<form name="process" id="ProcessForm" action="https://secure.foodbankrockies.org/site/Donation2" method="post" onsubmit="return checkDoubleClick();">
<div class="donation-form-container responsive">
<script type="text/javascript">
<!--
function reloadPage() {
window.location.reload(true);
}
function testAjax() {
var xmlHttp = null;
// Opera 8.0+, Firefox, Chrome, Safari
try {
xmlHttp = new XMLHttpRequest();
} catch (e) {
// Internet Explorer Browsers
try {
xmlHttp = new ActiveXObject("Msxml2.XMLHTTP");
} catch (e) {
try {
xmlHttp = new ActiveXObject("Microsoft.XMLHTTP");
} catch (e) {
return false;
}
}
}
xmlHttp.open('POST', 'AjaxHelper;jsessionid=00000000.app30037a?NONCE_TOKEN=E9E6A07908F8F2436C5D3C3C4D17B1C3', true);
xmlHttp.send();
}
addOnLoadHandler(testAjax);
//
-->
</script>
<div class="donation-form-content">
<input type="hidden" name="user_donation_amt" id="user_donation_amt" value="">
<input type="hidden" name="company_min_matching_amt" id="company_min_matching_amt" value="">
<input type="hidden" name="currency_locale" id="currency_locale" value="en_US">
<div class="form-row" id="df_mobile_img_container_row">
<div class="html-caption-container">
<h1>Answer the Challenge of Hunger</h1>
<div id="df_mobile_img_container">
<img class="df-mobile-img" src="../images/content/pagebuilder/mobile-7561.jpg" alt="Donation Form Image for Mobile">
</div>
<p>Every $1 you give helps provide the equivalent of 4 meals. Join us. Together, we have the power to answer the challenge of hunger.</p>
<h2 class="section-header-container">Gift Amount</h2>
<div class="gift-types"><a class="selected oneBtn" href="javascript:void(0)">One-time</a> <a class="monthlyBtn" href="javascript:void(0)">Monthly</a>
<p id="monthlyMessage"><img id="monthlyMessageArrow" src="../images/content/pagebuilder/arrow.png" alt="styled orange arrow pointing up">Giving monthly is the most effective way to help us fight food insecurity throughout our community.
</p>
</div>
</div>
</div>
<div class="don-standard-levels form-row">
<div class="levels-label">
</div>
<div id="level_standard_row" class="form-row form-donation-level" style="display: block;">
<div class="form-content">
<span class="field-required"></span> <span class="aural-only">Field Is Required</span>
<span class="FormLabelText">Enter Amount</span>
<div class="donation-level-general-ask">
</div>
<div class="donation-levels">
<div class="donation-level-container one-time">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10064" value="10064" onclick="evalMatchingGift('$1,000.00');
updateDonorCoverAmount('$1,000.00');">
<label for="level_standardexpanded10064" onclick="">
<div class="donation-level-amount-container"> $1,000.00 </div>
<div class="donation-level-label-container"> $1000 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10064expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10062" value="10062" onclick="evalMatchingGift('$500.00');
updateDonorCoverAmount('$500.00');">
<label for="level_standardexpanded10062" onclick="">
<div class="donation-level-amount-container"> $500.00 </div>
<div class="donation-level-label-container"> $500 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10062expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10071" value="10071" onclick="evalMatchingGift('$250.00');
updateDonorCoverAmount('$250.00');">
<label for="level_standardexpanded10071" onclick="">
<div class="donation-level-amount-container"> $250.00 </div>
<div class="donation-level-label-container"> $250 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10071expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10069" value="10069" checked="checked" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');">
<label for="level_standardexpanded10069" onclick="">
<div class="donation-level-amount-container"> $100.00 </div>
<div class="donation-level-label-container"> $100 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10069expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10067" value="10067" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');">
<label for="level_standardexpanded10067" onclick="">
<div class="donation-level-amount-container"> $50.00 </div>
<div class="donation-level-label-container"> $50 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10067expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10065" value="10065" onclick="evalMatchingGift('$25.00');
updateDonorCoverAmount('$25.00');">
<label for="level_standardexpanded10065" onclick="">
<div class="donation-level-amount-container"> $25.00 </div>
<div class="donation-level-label-container"> $25 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10065expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10066" value="10066" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');">
<label for="level_standardexpanded10066" onclick="">
<div class="donation-level-amount-container"> $100.00 </div>
<div class="donation-level-label-container"> $100 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10066expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10068" value="10068" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');">
<label for="level_standardexpanded10068" onclick="">
<div class="donation-level-amount-container"> $50.00 </div>
<div class="donation-level-label-container"> $50 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10068expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10070" value="10070" onclick="evalMatchingGift('$40.00');
updateDonorCoverAmount('$40.00');">
<label for="level_standardexpanded10070" onclick="">
<div class="donation-level-amount-container"> $40.00 </div>
<div class="donation-level-label-container"> $40 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10070expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10072" value="10072" onclick="evalMatchingGift('$30.00');
updateDonorCoverAmount('$30.00');">
<label for="level_standardexpanded10072" onclick="">
<div class="donation-level-amount-container"> $30.00 </div>
<div class="donation-level-label-container"> $30 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10072expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10074" value="10074" onclick="evalMatchingGift('$25.00');
updateDonorCoverAmount('$25.00');">
<label for="level_standardexpanded10074" onclick="">
<div class="donation-level-amount-container"> $25.00 </div>
<div class="donation-level-label-container"> $25 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10074expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10073" value="10073" onclick="evalMatchingGift('$15.00');
updateDonorCoverAmount('$15.00');">
<label for="level_standardexpanded10073" onclick="">
<div class="donation-level-amount-container"> $15.00 </div>
<div class="donation-level-label-container"> $15 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10073expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded10063" value="10063" onclick="evalMatchingGift(document.getElementById('level_standardexpanded10063amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded10063amount').value);">
<label for="level_standardexpanded10063amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded10063amount" id="level_standardexpanded10063amount" value="" size="12"
onfocus="var el = document.getElementById ('level_standardexpanded10063');if (el) el.click(); fire_obs_comp_event('level_standardexpanded10063amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded10063amount', this, event);evalMatchingGift(value);" onkeyup="fire_obs_comp_event('level_standardexpanded10063amount', this, event);evalMatchingGift(value);"
onblur="fire_obs_comp_event('level_standardexpanded10063amount', this);updateDonorCoverAmount(value);" placeholder="Other">
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_10063expandedsubmit" value="true">
</div>
</div>
</div>
</div>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observables
jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
var syncAction = function(obj) {
if (obj.is(':checked')) {
obj.closest('div.donation-level-container').addClass('selected');
} else {
obj.closest('div.donation-level-container').removeClass('selected');
};
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('div.donation-level-container').removeClass('selected');
syncAction(jQuery(this));
});
});
});
});
</script><noscript> </noscript>
</div>
<div class="levels-gift-aid">
</div>
<input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true">
<script type="text/javascript">
function updateDonorCoverAmount(gift) {
if (typeof updateAmount !== "undefined") {
updateAmount(gift);
}
};
function evalMatchingGift(gift) {}
</script><noscript> </noscript>
</div>
<div class="donation-level-container-generic-repeat form-input">
<div class="generic-repeat-label-checkbox-container">
<input type="checkbox" name="level_standardauto_repeatname" id="level_standardauto_repeatname" onclick="fire_obs_comp_event('level_standardauto_repeat', this);" onkeypress="fire_obs_comp_event('level_standardauto_repeat', this);">
<label for="level_standardauto_repeatname"> Make this a monthly gift. </label>
</div>
<input type="hidden" name="level_standardauto_repeatsubmit" id="level_standardauto_repeatsubmit" value="true">
</div>
<h2 class="section-header-container"> Billing Information </h2>
<div class="custom-field-container form-row " id="org-name-prompt-row">
<div class="form-content">
<div class="form-input-label-block">
<label for="org_name_prompt_dropdown">Organization Gift</label>
</div>
<fieldset>
<input type="checkbox" name="org_name_prompt_radio" id="org_name_prompt_radio" value="true">
<label class="custom-element-checkbox-label" for="org_name_prompt_radio"> Make this gift on behalf of a company or organization</label>
</fieldset>
<input type="hidden" name="org_name_promptsubmit" id="org_name_promptsubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row " id="org-name-bypass-row" style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<span class="field-required"></span><label for="org_name_input">Organization / Company Name: </label>
</div>
<input type="text" name="org_name_input" id="org_name_input" value="" maxlength="255">
<input type="hidden" name="org_namesubmit" id="org_namesubmit" value="true">
</div>
</div>
<div class="billing-wrapped">
<div id="billing_first_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name:</label>
<input type="text" name="billing_first_namename" id="billing_first_namename" value="" maxlength="50">
<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_last_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name:</label>
<input type="text" name="billing_last_namename" id="billing_last_namename" value="" maxlength="50">
<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_email_address_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">Email Address:</label>
<input type="text" name="donor_email_addressname" id="donor_email_addressname" value="" maxlength="255">
<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_address', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_address_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street1_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street:</label>
<input type="text" name="billing_addr_street1name" id="billing_addr_street1name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street1_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street2_row" class="form-row form-text">
<div class="form-content">
<label for="billing_addr_street2name">Apt:</label>
<input type="text" name="billing_addr_street2name" id="billing_addr_street2name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street2submit" id="billing_addr_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street2_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_city_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City:</label>
<input type="text" name="billing_addr_cityname" id="billing_addr_cityname" value="" maxlength="50">
<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_city_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_state_row" class="form-row form-selectlist">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_state">State/Province:</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" onchange="fire_obs_comp_event('billing_addr_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_state', src);
}
}
var el = document.getElementById('billing_addr_state');
if (el) {
Utils.addEvent(el, 'change', billing_addr_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_zip_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">ZIP/Postal Code:</label>
<input type="text" name="billing_addr_zipname" id="billing_addr_zipname" value="" maxlength="50">
<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_zip_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_country_row" class="form-row form-selectlist">
<div class="form-content">
<label class="FormLabel" for="billing_addr_country">Country:</label>
<select name="billing_addr_country" id="billing_addr_country" size="1" onchange="fire_obs_comp_event('billing_addr_country', this)">
<option></option>
<option selected="selected" value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivarian Republic of Venezuela">Bolivarian Republic of Venezuela</option>
<option value="Bonaire, Sint Eustatios and Saba">Bonaire, Sint Eustatios and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Democratic People's Republic of Korea">Democratic People's Republic of Korea</option>
<option value="The Democratic Republic of the Congo">The Democratic Republic of the Congo</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="The Former Yugoslav Republic of Macedonia">The Former Yugoslav Republic of Macedonia</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Islamic Republic of Iran">Islamic Republic of Iran</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos People's Democratic Republic">Laos People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Plurinational State of Bolivia">Plurinational State of Bolivia</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Korea">Republic of Korea</option>
<option value="Republic of Moldova">Republic of Moldova</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French)">Saint Martin (French)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls.</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch)">Sint Maarten (Dutch)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United Republic of Tanzania">United Republic of Tanzania</option>
<option value="Uruguay">Uruguay</option>
<option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_countrysubmit" id="billing_addr_countrysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_country_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_country', src);
}
}
var el = document.getElementById('billing_addr_country');
if (el) {
Utils.addEvent(el, 'change', billing_addr_country_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div class="custom-field-container form-row ">
<div class="form-content">
<div class="form-input-label-block">
<label for="partner_name_input">Partner's / Spouse's Name: </label>
</div>
<input type="text" name="partner_name_input" id="partner_name_input" value="" maxlength="255">
<input type="hidden" name="partner_namesubmit" id="partner_namesubmit" value="true">
</div>
</div>
<h2 class="section-header-container"> Payment Information </h2>
<div class="payment-type-element-container">
<div class="payment-type-selection-container payment-field-container">
<h3>Payment Method:</h3>
<div id="responsive_payment_typepay_typeradio_row" class="form-row">
<div class="form-content">
<div class="payment-type-selections" id="responsive_payment_typepay_typeradio_payment_types">
<span class="internal-payment"><span class="payment-type-option selected"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiocredit" value="credit" checked="checked"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiocredit"><a href="javascript:void(0);" class="payment-type-label">Credit Card</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span><span class="payment-type-option"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradioach" value="ach"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradioach"><a href="javascript:void(0);" class="payment-type-label">Checking Account</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span></span>
<span class="external-payment"><span class="payment-type-option"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiopaypal" value="paypal"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiopaypal"><a href="javascript:void(0);" class="payment-type-label"><img src="../images/payment/paypal-logo.png" alt="Pay with Paypal"></a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span></span>
</div>
<input type="hidden" name="responsive_payment_typepay_typeradiosubmit" id="responsive_payment_typepay_typeradiosubmit" value="true">
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observable for payment type options
jQuery('.payment-type-option').each(function() {
var syncAction = function(obj) {
if (obj.hasClass('selected')) {
var radioGroupName = obj.find('input').attr('name');
obj.find('input').prop('checked', true);
fire_obs_comp_event(radioGroupName, obj.find('input').get());
}
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('.payment-type-option').removeClass('selected');
jQuery(this).addClass('selected');
syncAction(jQuery(this));
var selectedValue = jQuery(this).find('input').val();
if (selectedValue == 'paypal' || selectedValue == 'amazon') {
// open up a boxinator dialog
jQuery(document).trigger('redirect-external');
jQuery('#btn_next').click();
}
});
});
});
});
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typepay_typeradio_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_cc_container" class="payment-field-container">
<h3>Credit Card Information:</h3>
<div id="responsive_payment_typecc_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="responsive_payment_typecc_type_Discover" id="responsive_payment_typecc_type_Discover">
</li>
<li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="responsive_payment_typecc_type_American_Express" id="responsive_payment_typecc_type_American_Express">
</li>
<li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="responsive_payment_typecc_type_MasterCard" id="responsive_payment_typecc_type_MasterCard">
</li>
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="responsive_payment_typecc_type_Visa" id="responsive_payment_typecc_type_Visa">
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_typesubmit" id="responsive_payment_typecc_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typecc_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_numbername">Credit Card Number:</label>
<input type="text" name="responsive_payment_typecc_numbername" id="responsive_payment_typecc_numbername" value="" maxlength="22" autocomplete="off">
<input type="hidden" name="responsive_payment_typecc_numbersubmit" id="responsive_payment_typecc_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_number_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typecc_number'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_exp_date_row" class="form-row form-date">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_exp_date_MONTH">
<span class="label-text">Expiration Date:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="responsive_payment_typecc_exp_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<fieldset class="cardExpGroup">
<select name="responsive_payment_typecc_exp_date_MONTH" id="responsive_payment_typecc_exp_date_MONTH" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_MONTH', this)">
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5" selected="selected">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
<select name="responsive_payment_typecc_exp_date_YEAR" id="responsive_payment_typecc_exp_date_YEAR" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_YEAR', this)">
<option value="2022" selected="selected">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
</select>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_exp_date_DAY" id="responsive_payment_typecc_exp_date_DAY" value="1">
<script type="text/javascript">
<!--
var comp1 = new ObservableComponent('responsive_payment_typecc_exp_date_MONTH', '');
comp1.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
var comp2 = new ObservableComponent('responsive_payment_typecc_exp_date_YEAR', '');
comp2.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
</div>
<input type="hidden" name="responsive_payment_typecc_exp_datesubmit" id="responsive_payment_typecc_exp_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_exp_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_row', _display);
disable_submit_flag('responsive_payment_typecc_exp_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('responsive_payment_typecc_exp_date_MONTH', _disabled);
disable_element('responsive_payment_typecc_exp_date_DAY', _disabled);
disable_element('responsive_payment_typecc_exp_date_YEAR', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR12', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('responsive_payment_typecc_exp_date_MINUTE', _disabled);
disable_element('responsive_payment_typecc_exp_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_cvv_row" class="form-row form-text cvv-input">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_cvvname">
<span class="FormLabelText">CVV Number:</span>
</label>
<a href="http://help.convio.net/site/PageServer?s_site=fbr&pagename=user_donation_cvv" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typecc_cvvname" id="responsive_payment_typecc_cvvname" value="" maxlength="4" autocomplete="cc-csc">
<input type="hidden" name="responsive_payment_typecc_cvvsubmit" id="responsive_payment_typecc_cvvsubmit" value="true">
<script type="text/javascript">
//chrome is mapping cvv as card name
if (/Chrome/.test(navigator.userAgent) && /Google Inc/.test(navigator.vendor)) {
document.getElementById('responsive_payment_typecc_cvvname').autocomplete = 'cc-csc';
}
var comp = new ObservableComponent('responsive_payment_typecc_cvv', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_cvv_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_bank_container" class="payment-field-container" style="display: none;">
<h3>Checking Account Information:</h3>
<div id="responsive_payment_typerouting_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typerouting_numbername">Bank Routing Number:</label>
<a href="http://help.convio.net/site/PageServer?s_site=fbr&pagename=User_Donation_ACH" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typerouting_numbername" id="responsive_payment_typerouting_numbername" value="" size="20" maxlength="20" onchange="fire_obs_comp_event('responsive_payment_typerouting_number', this);"
autocomplete="off">
<input type="hidden" name="responsive_payment_typerouting_numbersubmit" id="responsive_payment_typerouting_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typerouting_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typerouting_number_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typebank_account_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typebank_accountname">Bank Account Number:</label>
<input type="text" name="responsive_payment_typebank_accountname" id="responsive_payment_typebank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typebank_accountsubmit" id="responsive_payment_typebank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typebank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typebank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typebank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeverify_bank_account_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typeverify_bank_accountname">Verify Bank Account Number:</label>
<input type="text" name="responsive_payment_typeverify_bank_accountname" id="responsive_payment_typeverify_bank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typeverify_bank_accountsubmit" id="responsive_payment_typeverify_bank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeverify_bank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeverify_bank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typeverify_bank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_type.account_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend><span class="field-required"></span> Account Type:</legend>
<ul class="radio-array-list">
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking" value="CHECKING"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking">Checking</label>
</span>
</li>
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings" value="SAVINGS"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings">Savings</label>
</span>
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_type.account_typesubmit" id="responsive_payment_type.account_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_type.account_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_type.account_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeach_confirm_row" class="form-row form-checkbox">
<div class="form-content">
<span class="field-required"></span>
<input type="checkbox" name="responsive_payment_typeach_confirmname" id="responsive_payment_typeach_confirmname" onclick="fire_obs_comp_event('responsive_payment_typeach_confirm', this);">
<label for="responsive_payment_typeach_confirmname">I agree to use my bank account as a payment method and authorize Food Bank of the Rockies, its affiliates, and/or subsidiaries to debit my bank account to fulfill my donation
commitment.</label>
<input type="hidden" name="responsive_payment_typeach_confirmsubmit" id="responsive_payment_typeach_confirmsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeach_confirm', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeach_confirm_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
document.getElementById('responsive_payment_typeach_confirmname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
return document.getElementById('responsive_payment_typeach_confirmname').checked;
}
}
comp.clear = function() {
this.set(false);
}
observe_component('null', new ComponentEnabler('responsive_payment_typeach_confirm'));
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_check_container" class="payment-field-container" style="display: none;">
<h3>Check Information</h3>
</div>
<input type="hidden" name="responsive_payment_typesubmit" id="responsive_payment_typesubmit" value="true">
<script type="text/javascript">
function PaymentObserver() {
this.observe = function(_event) {
var sVal = _event.component.get();
switch (sVal) {
case 'check':
hide_element('payment_cc_container');
hide_element('payment_bank_container');
show_element('payment_check_container');
break;
case 'credit':
hide_element('payment_bank_container');
hide_element('payment_check_container');
show_element('payment_cc_container');
break;
case 'ach':
hide_element('payment_cc_container');
hide_element('payment_check_container');
show_element('payment_bank_container');
break;
case 'paypal':
case 'amazon':
case 'mobilepay':
default:
// hide all
hide_element('payment_bank_container');
hide_element('payment_cc_container');
hide_element('payment_check_container');
break;
}
}
}
// Set the observer to show/hide the relevant fields
observe_component('responsive_payment_typepay_typeradio', new PaymentObserver());
</script><noscript> </noscript>
</div>
<h2 class="section-header-container"> Honor/Memorial Information </h2>
<div class="tribute-wrapped">
<div id="tribute_show_honor_fields_row" class="form-row form-checkbox">
<div class="form-content">
<input type="checkbox" name="tribute_show_honor_fieldsname" id="tribute_show_honor_fieldsname" onclick="fire_obs_comp_event('tribute_show_honor_fields', this);">
<label for="tribute_show_honor_fieldsname">This gift is to honor or in memory of someone.</label>
<input type="hidden" name="tribute_show_honor_fieldssubmit" id="tribute_show_honor_fieldssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_show_honor_fields', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_show_honor_fields_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('tribute_show_honor_fieldsname')) {
document.getElementById('tribute_show_honor_fieldsname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('tribute_show_honor_fieldsname')) {
return document.getElementById('tribute_show_honor_fieldsname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_type_row" class="form-row form-selectlist" style="display: none;">
<div class="form-content">
<label class="FormLabel" for="tribute_type">Honor Gift Type:</label>
<select name="tribute_type" id="tribute_type" size="1">
<option></option>
<option value="tribute_type_value1">In Memory of</option>
<option value="tribute_type_value2">In Honor of</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_type', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_type_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="tribute_typesubmit_skip" id="tribute_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_type', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_type_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_type'));
function tribute_type_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_type', src);
}
}
var el = document.getElementById('tribute_type');
if (el) {
Utils.addEvent(el, 'change', tribute_type_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_honoree_name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_honoree_namename">Honoree Name:</label>
<input type="text" name="tribute_honoree_namename" id="tribute_honoree_namename" value="" maxlength="50">
<input type="hidden" name="tribute_honoree_namesubmit_skip" id="tribute_honoree_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_honoree_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_honoree_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_honoree_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="send_ecard_row" class="form-row form-checkbox">
<div class="form-content">
<span class="check-box-form-label-text">Would you like to send an email notification?</span>
<input type="checkbox" name="send_ecardname" id="send_ecardname" onclick="fire_obs_comp_event('send_ecard', this);">
<label for="send_ecardname">Yes, I would like to send an email notification.</label>
<input type="hidden" name="send_ecardsubmit" id="send_ecardsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('send_ecard', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('send_ecard_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('send_ecardname')) {
document.getElementById('send_ecardname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('send_ecardname')) {
return document.getElementById('send_ecardname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div class="ecard-wrapped">
<div id="tribute_ecard_subject_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_ecard_subjectname">Subject Line:</label>
<input type="text" name="tribute_ecard_subjectname" id="tribute_ecard_subjectname" value="" maxlength="50" placeholder="Max length is 50 characters.">
<input type="hidden" name="tribute_ecard_subjectsubmit" id="tribute_ecard_subjectsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_ecard_subject', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_ecard_subject_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_ecard_message_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_ecard_messagename">Personal Message:</label>
<textarea cols="60" rows="4" name="tribute_ecard_messagename" id="tribute_ecard_messagename" placeholder="Max length is 255 characters." maxlength="255"></textarea>
<input type="hidden" name="tribute_ecard_messagesubmit" id="tribute_ecard_messagesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_ecard_message', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_ecard_message_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_first_name_row" class="form-row form-text">
<div class="form-content">
<label for="donor_first_namename">Your First Name:</label>
<input type="text" name="donor_first_namename" id="donor_first_namename" value="" maxlength="50">
<input type="hidden" name="donor_first_namesubmit" id="donor_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_last_name_row" class="form-row form-text">
<div class="form-content">
<label for="donor_last_namename">Your Last Name:</label>
<input type="text" name="donor_last_namename" id="donor_last_namename" value="" maxlength="50">
<input type="hidden" name="donor_last_namesubmit" id="donor_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="ecard_send_date_row" class="form-row form-date">
<div class="form-content">
<label for="ecard_send_date_MONTH">
<span class="label-text">Send email notification on:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="ecard_send_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<label for="ecard_send_date_MONTH"><span style="display:none;">Month</span></label>
<label for="ecard_send_date_DAY"><span style="display:none;">Day</span></label>
<label for="ecard_send_date_YEAR"><span style="display:none;">Year</span></label>
<select name="ecard_send_date_MONTH" id="ecard_send_date_MONTH" title="Month">
<option value="1">Jan</option>
<option value="2">Feb</option>
<option value="3">Mar</option>
<option value="4">Apr</option>
<option value="5" selected="selected">May</option>
<option value="6">Jun</option>
<option value="7">Jul</option>
<option value="8">Aug</option>
<option value="9">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
<select name="ecard_send_date_DAY" id="ecard_send_date_DAY" title="Day">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4" selected="selected">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select name="ecard_send_date_YEAR" id="ecard_send_date_YEAR" title="Year">
<option value="2032">2032</option>
<option value="2031">2031</option>
<option value="2030">2030</option>
<option value="2029">2029</option>
<option value="2028">2028</option>
<option value="2027">2027</option>
<option value="2026">2026</option>
<option value="2025">2025</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022" selected="selected">2022</option>
</select>
</div>
<input type="hidden" name="ecard_send_datesubmit" id="ecard_send_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('ecard_send_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('ecard_send_date_row', _display);
disable_submit_flag('ecard_send_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('ecard_send_date_MONTH', _disabled);
disable_element('ecard_send_date_DAY', _disabled);
disable_element('ecard_send_date_YEAR', _disabled);
disable_element('ecard_send_date_HOUR12', _disabled);
disable_element('ecard_send_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('ecard_send_date_MINUTE', _disabled);
disable_element('ecard_send_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="ecard_recpients_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="ecard_recpientsname">Recipient email addresses (separated by commas):</label>
<textarea cols="60" rows="4" name="ecard_recpientsname" id="ecard_recpientsname" placeholder="Max length is 255 characters." maxlength="255"></textarea>
<input type="hidden" name="ecard_recpientssubmit" id="ecard_recpientssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('ecard_recpients', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('ecard_recpients_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="select_grid_row" class="form-row form-text">
<div class="form-content">
<label for="select_gridname">Design:</label>
<input type="hidden" name="stationery_layout_chooser" id="stationery_layout_chooser" value="true">
<div class="layout-chooser-container clearfix">
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2801">
<img src="../images/stationery/layout_thumbnail_2801.1220467604.custom.jpg" alt="Donation eCard: Father's Day" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2801" value="2801" checked="checked">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2630">
<img src="../images/stationery/layout_thumbnail_2630.323172548.custom.jpg" alt="Donation eCard: Girl at school lunch smiling" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2630" value="2630">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2625">
<img src="../images/stationery/layout_thumbnail_2625.579711980.custom.jpg" alt="Donation eCard: Happy Birthday" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2625" value="2625">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_3002">
<img src="../images/stationery/layout_thumbnail_3002.875099065.custom.jpg" alt="Donation eCard: Happy Birthday (Beet)" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_3002" value="3002">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2626">
<img src="../images/stationery/layout_thumbnail_2626.595984362.custom.jpg" alt="Donation eCard: Happy Holidays" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2626" value="2626">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2627">
<img src="../images/stationery/layout_thumbnail_2627.469602479.custom.jpg" alt="Donation eCard: In Honor of" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2627" value="2627">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_3004">
<img src="../images/stationery/layout_thumbnail_3004.1304548545.custom.jpg" alt="Donation eCard: In Honor of You" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_3004" value="3004">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2770">
<img src="../images/stationery/layout_thumbnail_2770.1544440754.custom.jpg" alt="Donation eCard: Little girl in a car with food" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2770" value="2770">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2802">
<img src="../images/stationery/layout_thumbnail_2802.547385042.custom.jpg" alt="Donation eCard: Mother's Day" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2802" value="2802">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2628">
<img src="../images/stationery/layout_thumbnail_2628.239413313.custom.jpg" alt="Donation eCard: Packing Milk" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2628" value="2628">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_3001">
<img src="../images/stationery/layout_thumbnail_3001.1030995717.custom.jpg" alt="Donation eCard: Plum Branding" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_3001" value="3001">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_2631">
<img src="../images/stationery/layout_thumbnail_2631.1645237295.custom.jpg" alt="Donation eCard: Rocky Mountains" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_2631" value="2631">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_3003">
<img src="../images/stationery/layout_thumbnail_3003.871893795.custom.jpg" alt="Donation eCard: The Gift of Hope" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_3003" value="3003">
</div>
</div>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('select_grid', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('select_grid_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
<input type="hidden" name="select_gridsubmit" id="select_gridsubmit" value="true">
</div>
</div>
<div id="e_card_copy_sender_row" class="form-row form-checkbox">
<div class="form-content">
<input type="checkbox" name="e_card_copy_sendername" id="e_card_copy_sendername" onclick="fire_obs_comp_event('e_card_copy_sender', this);">
<label for="e_card_copy_sendername">Yes, please send me a copy of this email notification.</label>
<input type="hidden" name="e_card_copy_sendersubmit" id="e_card_copy_sendersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('e_card_copy_sender', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('e_card_copy_sender_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('e_card_copy_sendername')) {
document.getElementById('e_card_copy_sendername').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('e_card_copy_sendername')) {
return document.getElementById('e_card_copy_sendername').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
</div>
</div>
<h2 class="section-header-container"> My Employer Will Match </h2>
<div class="form-row">
<div class="html-caption-container">
<!--------------------------------------------------------->
<script>
var amplyMatchingData = {
"field_id": "amply_matching_company_input",
"opt_in": true,
"opt_in_text": "I want my employer to match my gift"
};
</script>
<script src="https://giveamply.com/assets/js/company-search.js" type="text/javascript"></script>
<!--------------------------------------------------------->
</div>
</div>
<div class="custom-field-container form-row " id="amply_match_optin_row">
<div class="form-content">
<input type="checkbox" class="ButtonInput" id="amply_match_optin"><label class="CheckboxLabel" for="amply_match_optin">I want my employer to match my gift</label>
<div class="form-input-label-block" style="display: none;">
<label for="amply_matching_company_input">Company / Organization</label>
</div>
<input type="text" name="amply_matching_company_input" id="amply_matching_company_input" value="" maxlength="255" class="ui-autocomplete-input" autocomplete="off" style="display: none;">
<input type="hidden" name="amply_matching_companysubmit" id="amply_matching_companysubmit" value="true">
</div>
</div>
<div class="form-row form-checkbox" id="donor_email_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="checkbox" name="donor_email_opt_inname" id="donor_email_opt_inname" checked="checked" onclick="fire_obs_comp_event('donor_email_opt_in', this);">
<label for="donor_email_opt_inname"> Yes, keep me updated on my impact through email updates </label>
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_opt_in', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_opt_in_Row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_email_opt_inname')) {
document.getElementById('donor_email_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_email_opt_inname')) return document.getElementById('donor_email_opt_inname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true">
</div>
</div>
<input type="hidden" name="upsellhidden" id="upsellhidden" value="">
<div class="button-container clearfix">
<div class="button-sub-container">
<button class="step-button action-button finish-step" type="submit" id="pstep_finish" name="pstep_finish" value="Make My Gift">Make My Gift</button>
</div>
</div>
<input type="hidden" name="idb" id="idb" value="1602515780">
<input type="hidden" name="df_id" id="df_id" value="7561">
<input type="hidden" name="mfc_pref" id="mfc_pref" value="T">
<div class="form-row">
<div class="html-caption-container">
<style type="text/css">
<!--
div.payment-field-container span.payment-type-option {
width: auto;
}
div.responsive div.form-checkbox label,
label.custom-element-checkbox-label {
display: inline;
line-height: 1.4em;
}
select {
-moz-appearance: none;
-webkit-appearance: none;
appearance: none;
border: 1px solid #d9d6cf;
border-radius: 5px;
box-shadow: 3px 3px 3px #f0f0f0 inset;
font-size: 16px;
padding: 2px 7px;
background: transparent url(data:image/svg+xml;base64,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) no-repeat right 50%;
}
select::-ms-expand {
display: none;
}
-->
</style>
<!--<link href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.6/css/bootstrap.min.css" rel="stylesheet" type="text/css" /> -->
<style>
:focus {
outline: 0px dashed red !important;
}
h1 {
color: #961a4b;
font-size: 30px;
margin: 15px 0;
font-family: "Recoleta-Light", Poppins-Regular;
font-weight: bold !important;
font-size: 29px;
text-transform: uppercase;
text-shadow: none;
}
::placeholder {
color: #bbb;
font-family: 'Poppins-Regular', Poppins-Regular;
font-weight: 500;
}
div.responsive {
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
}
main {
background: url(../images/content/pagebuilder/background-7561.jpg);
background-position: center top;
background-repeat: no-repeat;
background-size: cover;
background-attachment: fixed;
}
/******* Hide Mobile on Desktop **********/
#df_mobile_img_container {
display: none;
}
@media(max-width: 767px) {
form#ProcessForm {
margin: 0 auto;
min-width: 85%;
width: auto;
max-width: 100%;
}
form#ProcessForm .donation-form-container {
min-width: 100%;
}
/******* Hide Mobile Image on Desktop **********/
#df_mobile_img_container {
display: block;
}
#df_mobile_img_container .df-mobile-img {
min-width: 80%;
width: auto;
max-width: 100%;
float: none;
display: block;
margin: 1em auto;
}
main {
background: none;
}
}
div.responsive a:visited,
div.responsive a:link {
color: #961a4b;
}
.donation-form-container.responsive {
margin-top: 50px;
}
div.responsive div.form-content {
margin-top: 6px;
margin-bottom: 6px;
margin-right: 0;
}
.donation-level-amount-container {
display: none !important;
}
LABEL.FormLabel {
width: auto;
min-width: initial !important;
}
.payment-type-selection-container.payment-field-container h3 {
display: none !important;
}
div.donation-level-input-container,
div.generic-repeat-label-checkbox-container {
padding: 0;
}
span.payment-type-option {
padding: 13px !important;
}
input[type="text"]::placeholder,
div.responsive input[type="text"]:::placeholder,
div.responsive input[type="number"]::placeholder,
div.responsive input[type="password"]::placeholder,
div.responsive textarea::placeholder {
font-size: 1em;
font-weight: 500;
font-family: 'Poppins-Regular', Poppins-Regular;
}
.donation-level-container:last-child input[type="text"]::placeholder,
.donation-level-user-entered input[type="text"]::placeholder {
font-weight: bold;
}
input[id*="amount"] {
/*height: 56px !important;*/
margin: 0 !important;
}
label[for*="organization-name-visiblename"] {
font-size: 14px;
}
label[for*="tribute_show_honor_fieldsname"] {
font-size: 14px;
}
label[for*="amply_match_optin"] {
font-size: 14px;
}
label.CheckboxLabel {
padding-top: .15em;
}
label[for*="donor_email_opt_inname"] {
font-size: 14px;
max-width: 92.5% !important;
min-width: 92.5%;
width: 92.5%;
padding-top: .6em;
}
@media screen and (max-width: 767px) {
label[for*="donor_email_opt_inname"] {
min-width: 88%;
width: auto;
max-width: 88% !important;
}
}
label[for*="send_ecardname"] {
font-size: 14px;
}
label[for="responsive_payment_typeach_confirmname"] {
font-size: 14px;
line-height: 1.4em !important;
min-width: auto;
width: auto;
max-width: 88% !important;
vertical-align: top;
}
div.responsive input#responsive_payment_typeach_confirmname[type="checkbox"] {
vertical-align: top !important;
}
label[for*="e_card_copy_sendername"] {
font-size: 14px !important;
}
div#responsive_payment_typepay_typeradio_row {
margin-bottom: 25px;
}
/*Giving Level Button Styles*/
:root {
--color-green: #3c833a;
--color-plum: #961A4B;
--transition-fast: 0.1s;
}
.donation-levels {
display: flex;
flex-wrap: wrap;
margin-top: 0px;
}
.donation-levels div.form-content {
width: 100%;
}
div.donation-level-container {
flex: 1 1 33%;
margin-top: 0;
/*margin-right: 5px !important;*/
margin-bottom: 0;
margin-left: 0;
}
div.donation-level-amount-container {
margin-top: 0 !important;
/*Overriding LO stylesheet*/
}
.donation-level-container input[type="radio"] {
visibility: hidden;
height: 0;
width: 0;
margin: 0;
display: block;
}
.donation-level-container label {
display: flex;
flex: auto;
vertical-align: middle;
align-items: center;
justify-content: center;
text-align: center;
cursor: pointer;
background-color: #E2E5E5;
color: #666;
padding: 12px 21px;
border-radius: 5px;
border: 2px solid #e2e5e5;
user-select: none;
margin-right: 8px;
width: 100%;
font-weight: normal !important;
}
.donation-level-container label:last-of-type {
margin-right: 0;
}
.donation-level-container input[type="radio"]:checked+label {
background-color: #fff;
color: #961a4b;
border-color: #961a4b;
font-weight: bold !important
}
/*.donation-level-container input[type="radio"]:hover:not(:checked) + label {
background-color: #697777;
color: #fff;
}*/
/* Hides Labels for Other amount *** Assuming its the last element */
.donation-level-container:last-child label {
display: none;
}
/*Applying styles to the Other input field
Update to fit your needs
*/
input[id*="amount"] {
width: 100%;
}
@media(max-width: 767px) {
input[id*="amount"] {
max-width: 100%;
}
}
.donation-level-container:last-child {
float: left;
clear: both;
margin: 0 auto .5em auto;
min-width: 100%;
max-width: 100%;
width: 100%;
}
.donation-level-container:last-child input[type="text"],
.donation-level-user-entered input[type="text"] {
background-image: url('../images/content/pagebuilder/dollor.png') !important;
background-position: 11px 50% !important;
background-repeat: no-repeat !important;
background-attachment: scroll;
background-size: auto auto;
padding-left: 28px !important;
}
/*Donation Form Styles*/
#donor_email_opt_in_Row {
float: left;
clear: both;
}
.button-container.clearfix,
#amply_match_optin_row {
float: left;
clear: both;
min-width: 100%;
max-width: 100%;
width: 100%;
margin: .5em auto;
}
#amply_match_optin_row .form-input-label-block {
float: left;
clear: both;
margin-left: 0px;
padding-left: 0px;
}
#amply_match_optin_row .form-input-label-block label {
float: left;
clear: both;
margin: .5em 0 .15em 0;
}
@media(max-width: 767px) {
section.wo3.pv.st.grandchild-page-header {
padding: 0;
}
}
div#payment_cc_container h3 {
display: none;
}
div#payment_typecc_type_row .form-content fieldset legend {
display: none;
}
.ecard-wrapped,
#send_ecard_row {
display: none;
}
.ecard-wrapped.active,
#send_ecard_row.active {
display: block;
width: 100%;
}
div#send_ecard_row .form-content .check-box-form-label-text {
display: none;
}
fieldset.cardExpGroup {
display: flex;
}
#ecard_send_date_MONTH,
#ecard_send_date_DAY,
#ecard_send_date_YEAR {
flex: 1 1 auto;
margin-right: 15px
}
div.responsive div#ecard_send_date_row select {
display: inline-block;
width: 29%;
margin-left: 0;
}
#ecard_send_date_YEAR {
margin-right: 0;
}
div#scrollWrapper {
background-size: cover !important;
background-position: center bottom !important;
background-repeat: no-repeat !important;
background-attachment: fixed !important;
}
.donation-level-container-generic-repeat.form-input {
padding: 10px;
}
.gift-types {
margin-bottom: 15px;
}
.monthly {
display: none;
}
/*
a.oneBtn,
a.monthlyBtn {
background: #3C833A;
display: inline-block;
padding: 20px 40px;
border-bottom: 0;
font-size: 16px;
color: #fff !important;
border-radius: 28px;
font-weight: bold;
}*/
.gift-types a.oneBtn,
.gift-types a.monthlyBtn {
background-color: #E2E5E5;
border-radius: 5px;
border: 2px solid #E2E5E5;
color: #666 !important;
cursor: pointer;
display: inline-block;
font-size: 16px;
text-align: center;
font-weight: normal;
-webkit-transition: 0.25s;
-o-transition: 0.25s;
transition: 0.25s;
margin: 0;
text-transform: capitalize;
padding: 6px 10px;
width: 48%;
}
.gift-types a.oneBtn:active,
.gift-types a.monthlyBtn:active,
.gift-types a.oneBtn:focus,
.gift-types a.monthlyBtn:focus,
.gift-types a.oneBtn.selected,
.gift-types a.monthlyBtn.selected {
border: 2px solid #961a4b;
background-color: #fff;
color: #961a4b !important;
font-weight: bold;
}
#monthlyMessage {
color: #961a4b;
padding: 14px 20px 0;
text-align: left;
font-size: 12px;
position: relative;
margin-top: 20px;
font-style: italic;
font-weight: bold;
}
#monthlyMessageArrow {
position: absolute;
right: 25%;
top: -18%;
}
div#tribute_show_honor_fields_row {
/*border: 1px solid #333;
padding: 10px;*/
border-radius: 3px;
line-height: 24px;
}
#cc-fees-row {
border: 1px solid #00306b;
padding: 10px;
border-radius: 3px;
padding: 10px;
line-height: normal;
margin-top: 10px;
}
.html-caption-container {
width: 100%;
max-width: 100% !important;
}
.don-standard-levels.form-row {
margin: 0 !important;
}
@media(max-width: 767px) {
.html-caption-container {
max-width: 100% !important;
width: 100% !important;
}
.don-standard-levels.form-row {
margin: 0 !important;
}
.mobile div.responsive div.form-checkbox label,
label.custom-element-checkbox-label {
max-width: 90% !important;
}
div.donation-level-container {
width: 100%;
/*flex: 1 1 auto;*/
}
.donation-level-container .mobile div.donation-level-container div.responsive div.form-content,
.donation-level-container .mobile div.responsive div.form-content {
margin-top: 0 !important;
margin-bottom: 0 !important;
}
div.form-row {
flex: 1 1 100%;
margin: 0 !important;
}
}
@media only screen and (max-width: 767px) {
.donation-levels div.form-content {
margin-top: 0 !important;
margin-bottom: 0 !important;
}
}
div.donation-level-input-container,
div.generic-repeat-label-checkbox-container {
display: block;
width: 100%;
}
div.donation-level-amount-container+div.donation-level-label-container {
display: block;
margin-top: 0;
margin-left: 0;
}
@media (min-width:768px) {
div.form-row {
margin-top: 4px;
margin-bottom: 4px;
flex: auto;
margin-right: 15px;
}
div#captcha_row {
max-width: 250px;
}
}
div.responsive a.step-button:hover,
div.responsive button.step-button:hover,
div.responsive input.step-button:hover {
filter: progid:DXImageTransform.Microsoft.gradient(startColorstr='#3C833A', endColorstr='#3C833A');
-ms-filter: "progid:DXImageTransform.Microsoft.gradient(startColorstr='#3C833A', endColorstr='#eaeaea')";
background-image: -ms-linear-gradient(top, #3C833A, #3C833A);
background-image: -webkit-linear-gradient(top, #3C833A, #3C833A);
background-image: -moz-linear-gradient(top, #3C833A, #3C833A);
background-image: -o-linear-gradient(top, #3C833A, #3C833A);
background-image: linear-gradient(top, #3C833A, #3C833A);
}
label {
font-weight: normal !important;
}
div.responsive select {
-moz-box-shadow: 0 1px 3px rgba(0, 0, 0, .1);
-webkit-box-shadow: 0 1px 3px rgba(0, 0, 0, .1);
box-shadow: 0 1px 3px rgba(0, 0, 0, .1)
}
textarea:focus,
input:focus,
select:focus {
outline: 1px solid #ccc;
outline-radius: 0;
}
div.donation-form-container.responsive {
padding: 0 15px;
background: transparent;
border-radius: 0;
border: 0;
margin: 0;
}
div.responsive input[type="text"],
div.responsive input[type="number"],
div.responsive input[type="password"],
div.responsive textarea {
-webkit-appearance: button;
-webkit-border-radius: 2px;
-webkit-box-shadow: 0 1px 3px rgba(0, 0, 0, .1);
-webkit-padding-end: 20px;
-webkit-padding-start: 2px;
/*-webkit-user-select: none;*/
background-image: -webkit-linear-gradient(#fff, #fff 40%, #fff);
background-position: 97% center;
background-repeat: no-repeat;
border: 1px solid #ccc !important;
color: #555;
font-size: inherit;
overflow: hidden;
padding: 10px;
text-overflow: ellipsis;
white-space: nowrap;
font-weight: 600;
border-radius: 0;
width: 100%;
margin: 0;
/*padding: 6px;*/
margin: 0 0 5px 0;
height: 34px;
}
div.responsive input[type="text"]:hover,
div.responsive input[type="number"]:hover,
div.responsive input[type="password"]:hover,
div.responsive input[type="text"]:focus,
div.responsive input[type="number"]:focus,
div.responsive input[type="password"]:focus,
div.responsive input[type="text"]:active,
div.responsive input[type="number"]:active,
div.responsive input[type="password"]:active {
outline: initial !important;
background-image: -webkit-linear-gradient(#fff, #fff 40%, #fff);
background: #fff;
border: 1px solid #ccc !important;
color: #333;
}
select {
padding: 6px;
border: 1px solid #ccc;
color: #4e4e4e;
background-color: #fff;
width: 100%;
border-radius: 0;
}
fieldset {
border: 0;
margin: 5px 0;
}
div.responsive button.action-button {
border: 1px solid #3C833A;
background-color: #3C833A;
filter: progid:DXImageTransform.Microsoft.gradient(startColorstr='#3C833A', endColorstr='#00306b');
-ms-filter: "progid:DXImageTransform.Microsoft.gradient(startColorstr='#3C833A', endColorstr='#3C833A')";
background-image: -ms-linear-gradient(top, #3C833A, #3C833A);
background-image: -webkit-linear-gradient(top, #3C833A, #3C833A);
background-image: -moz-linear-gradient(top, #3C833A, #3C833A);
background-image: -o-linear-gradient(top, #3C833A, #3C833A);
background-image: linear-gradient(top, #3C833A, #3C833A);
color: #fff;
}
button#pstep_finish {
width: 100%;
max-width: 100%;
font-weight: bold;
}
a.payment-type-label:Hover {
background: transparent;
}
/*
h2.section-header-container {
color: #961A4B;
font-weight: 700;
font-size: 28px;
margin-top: 25px;
margin-bottom: 25px;
line-height: 34px;
padding-top: 0;
border-top: 0;
}
*/
h2.section-header-container {
color: #000;
font-size: 16px;
padding-top: 0;
border-top: 0;
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
font-weight: bold;
text-transform: none;
font-size: 16px;
line-height: 38px !important;
font-weight: bold;
text-align: left;
padding-top: 22px;
border-top: 1px solid #c4c4c4;
margin-top: 20px;
margin-bottom: 6px;
width: 100%;
display: block;
text-shadow: none;
}
div#level_standard_row span.FormLabelText {
display: none;
color: #000;
font-size: 16px;
padding-top: 0;
border-top: 0;
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
font-weight: bold;
text-transform: none;
font-size: 16px;
line-height: 32px;
font-weight: bold;
text-align: left;
padding-top: 22px;
border-top: 1px solid #c4c4c4;
margin-top: 0;
width: 100%;
}
h3 {
color: #961A4B;
font-weight: 700;
font-size: 22px !important;
margin-top: 25px;
line-height: 34px;
}
div.donation-form-container.responsive h3 {
color: #000;
font-size: 16px;
padding-top: 0;
border-top: 0;
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
font-weight: bold;
text-transform: none;
font-size: 16px !important;
line-height: 38px !important;
font-weight: bold;
text-align: left;
padding-top: 22px;
border-top: 1px solid #c4c4c4;
margin-top: 20px;
margin-bottom: 6px;
width: 100%;
display: block;
text-shadow: none;
}
ul.radio-array-list {
/* display: none; */
}
div#responsive_payment_typecc_type_row {
display: none;
}
div#employer_match_label_row {
display: none;
}
div.form-captcha div.form-input {
background: transparent;
padding: 0;
}
label.FormLabel {
font-weight: bold;
}
.breadcrumbs {
display: none;
}
div.form-row div.form-content {
display: block;
}
#employer_street_row input,
#billing_addr_street1_row input,
#billing_addr_street2_row input,
#billing_addr_street3_row input,
#billing_addr_country_row input.ui-autocomplete-input,
#donor_addr_street1_row input,
#donor_addr_street2_row input,
#donor_addr_street3_row input,
#donor_addr_country_row input.ui-autocomplete-input,
#shipping_addr_street1_row input,
#shipping_addr_street2_row input,
#shipping_addr_street3_row input,
#shipping_addr_country_row input.ui-autocomplete-input,
#tribute_notify_recip_street1_row input,
#tribute_notify_recip_street2_row input,
#tribute_notify_recip_street3_row input,
#tribute_notify_recip_country_row input.ui-autocomplete-input,
#tribute_signature_row input,
#tribute_message_closing_row input,
div.employer-address-container input#employer_street {
width: 100%;
}
div#tribute_show_honor_fields_row {
width: 100%;
}
.billing-wrapped,
.employer-address-container,
.tribute-wrapped {
display: flex;
flex-wrap: wrap;
}
.employer-address-container>.form-row:first-child,
.employer-address-container>.form-row:nth-child(2) {
display: none;
}
fieldset.cardExpGroup {
max-width: 100%;
width: 100%;
}
fieldset.cardExpGroup select {
margin-right: 10px;
}
select#responsive_payment_typecc_exp_date_YEAR {
margin-right: 0;
}
fieldset {
padding: 0;
}
@media(max-width: 992px) {
#billing_first_name_row,
#billing_middle_name_row,
#billing_last_name_row {
margin-right: 0px !important;
}
}
@media(max-width: 767px) {
#billing_first_name_row,
#billing_middle_name_row,
#billing_last_name_row {
margin-right: 0px !important;
}
}
div#payment_typecc_number_row,
div#payment_typecc_cvv_row {
max-width: 45%;
width: 100%;
}
#organization-name-visible_row,
.billing-wrapped {
min-width: 100%;
max-width: 100%;
width: 100%;
float: left;
clear: both;
}
#organization-name-visiblename {
float: left;
margin-right: .3em;
margin-top: .1em;
}
label[for="ecard_recpientsname"] {
max-width: 92%;
float: left;
}
label[for="organization-name-visiblename"] {
max-width: 92%;
float: left;
}
#ecard_recpients_row span.field-required {
float: left;
clear: both;
margin-right: .3em;
}
@media(max-width: 767px) {
div.payment-field-container #responsive_payment_typecc_number_row input,
fieldset.cardExpGroup,
div.payment-field-container #responsive_payment_typecc_cvv_row input {
width: 100%;
max-width: 100%;
display: flex;
}
}
/*
select#responsive_payment_typecc_exp_date_MONTH {
margin-bottom: 15px;
}
*/
@media only screen and (max-width: 767px) {
.mobile #billing_addr_street1_row input,
.mobile #billing_addr_street2_row input,
.mobile #billing_addr_street3_row input,
.mobile #billing_addr_country_row input.ui-autocomplete-input,
.mobile #donor_addr_street1_row input,
.mobile #donor_addr_street2_row input,
.mobile #donor_addr_street3_row input,
.mobile #donor_addr_country_row input.ui-autocomplete-input,
.mobile #shipping_addr_street1_row input,
.mobile #shipping_addr_street2_row input,
.mobile #shipping_addr_street3_row input,
.mobile #shipping_addr_country_row input.ui-autocomplete-input,
.mobile #tribute_notify_recip_street1_row input,
.mobile #tribute_notify_recip_street2_row input,
.mobile #tribute_notify_recip_street3_row input,
.mobile #tribute_notify_recip_country_row input.ui-autocomplete-input,
.mobile #tribute_signature_row input,
.mobile #tribute_message_closing_row input,
.mobile div.employer-address-container input#employer_street,
.mobile #billing_addr_country_row select,
.mobile #billing_addr_state_row select,
.mobile #donor_addr_state_row select,
.mobile #donor_addr_country_row select,
.mobile #donor_occupation_row select,
.mobile #shipping_addr_country_row select,
.mobile #shipping_addr_state_row select,
.mobile #tribute_notify_recip_state_row select,
.mobile #tribute_notify_recip_country_row select,
.mobile .custom-field-container select,
.mobile div.employer-address-container select {
width: 100% !important;
max-width: 100% !important;
}
.mobile div.payment-field-container div.payment-type-selections {
width: 100%;
/*display: flex;*/
}
}
div.responsive {
width: auto;
}
/*
form#ProcessForm {
max-width: 700px;
background: #fff;
width: 100%;
margin-top: 45px;
}
*/
div.donation-form-container.responsive {
max-width: 400px;
background: #fff;
width: 100%;
margin-top: 45px;
}
@media(max-width: 767px) {
div.donation-form-container.responsive {
margin-top: 0;
}
}
.donation-form-container.responsive {
width: auto;
}
button#pstep_finish {
max-width: 100%;
padding: 20px 40px;
font-size: 18px;
border-radius: 35px;
text-transform: uppercase;
background: #df6a2b;
border-color: #df6a2b;
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
font-weight: bold;
}
div.payment-field-container span.internal-payment span.payment-type-option {
border: none;
padding: 10px !important;
margin: 0 5px 0 0;
font-size: 13px;
text-align: center;
width: 50%;
}
div.payment-field-container span.internal-payment {
margin-right: 0;
}
div.responsive a.payment-type-label {
color: #666;
}
div.payment-field-container div.payment-type-selections span {
line-height: 30px;
}
div.payment-field-container span.payment-type-option.selected {
background-color: #fff;
background: -webkit-linear-gradient(top, #fff 0%, #fff 100%);
background: -moz-linear-gradient(top, #fff 0%, #fff 100%);
background: -webkit-gradient(linear, left top, left bottom, color-stop(0%, #fff), color-stop(100%, #fff));
background: -webkit-linear-gradient(top, #fff 0%, #fff 100%);
background: -o-linear-gradient(top, #fff 0%, #fff 100%);
background: -ms-linear-gradient(top, #fff 0%, #fff 100%);
filter: progid:DXImageTransform.Microsoft.gradient(startColorstr='#fff', endColorstr='transparent', GradientType=0);
background: linear-gradient(top, #fff 0%, #fff 100%);
border: 2px solid #961a4b !important;
}
span.payment-type-option.selected a.payment-type-label {
color: #961a4b !important;
font-weight: bold;
}
div.payment-field-container span.payment-type-option {
border: none;
background-color: #E2E5E5;
background: -moz-linear-gradient(top, #E2E5E5 0%, #E2E5E5 100%);
background: -webkit-gradient(linear, left top, left bottom, color-stop(0%, #E2E5E5), color-stop(100%, #eee));
background: -webkit-linear-gradient(top, #E2E5E5 0%, #E2E5E5 100%);
background: -o-linear-gradient(top, #E2E5E5 0%, #E2E5E5 100%);
background: -ms-linear-gradient(top, #E2E5E5 0%, #E2E5E5 100%);
filter: progid:DXImageTransform.Microsoft.gradient(startColorstr='#E2E5E5', endColorstr='#eee', GradientType=0);
background: linear-gradient(top, #E2E5E5 0%, #E2E5E5 100%);
}
.payment-type-option,
div.payment-field-container span.external-payment span.payment-type-option {
padding: 10px 20px !important;
border-radius: 4px !important;
line-height: 34px;
}
div.payment-field-container div.payment-type-selections span {
border: none;
}
.payment-type-selection-container.payment-field-container h3 {
font-size: 16px !important;
color: #3c3c3c;
font-weight: normal !important;
margin-bottom: 5px;
}
@media(max-width:767px) {
div#level_standard_row {
margin: 30px 0 !important;
}
}
span.internal-payment,
div#responsive_payment_typepay_typeradio_payment_types {
background: none !important;
display: flex !important;
}
/*==================================================================================
====================================================================================
====================================================================================
Upsell Lightbox Section
====================================================================================
====================================================================================*/
a.btn,
a.btn:visited,
a.editBtn,
a.editBtn:visited,
input.btn,
input.btnMini,
input.btnSm,
input.btnMed,
input.btnLg {
background:
/*#0468ab*/
#DB1616;
}
blockquote {
font-size: 14px;
}
.modal {
z-index: 9250;
}
.modal a.btn {
width: 100%;
text-transform: none;
white-space: normal;
border-radius: 20px;
border: none;
font-size: 16px;
padding: 10px;
line-height: 32px;
height: auto;
max-width: 49%;
white-space: nowrap;
background: #697777;
color: #fff;
display: inline-block;
}
#acceptUpsell {
background: #df6a2b;
}
@media(max-width: 767px) {
.modal a.btn {
display: block;
margin: 15px 0;
max-width: 100%;
width: 100%;
}
}
.modal a.btn:hover {
color: #fff;
}
.modal-content {
border-radius: 10px;
padding: 15px;
}
.modal a.btn p {
font-size: 12px;
}
.modal a.btn strong {
/*text-decoration:underline;*/
text-decoration: none;
}
a.btn-success {
background-color: #7A7C7D;
}
a.btn-success:hover {
background-color: #6B6B6B;
}
a.btn-info {
background-color: #005c84;
}
a.btn-info:hover {
background-color: #1DBA9B;
opacity: .8;
}
.modal-body {
text-align: center;
}
.modal-body p {
padding: 10px;
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
}
.modal-body img.banner {
margin: 0px 0 24px 0;
width: 100%;
}
.modal-title {
padding: 10px;
text-align: center;
font-family: 'Basis Grotesque Pro', Arial, sans-serif;
font-size: 18px;
font-weight: 500;
}
/* Extra Small Devices, Phones */
@media only screen and (max-width : 480px) {
.modal a.btn {
min-height: 100px;
}
}
@media (min-width: 768px) {
.container {
width: 100%;
}
}
@media (min-width: 992px) {
.container {
width: 100%;
}
}
@media (min-width: 1200px) {
.container {
width: 100%;
}
}
label {
font-weight: normal;
/*display:inline;*/
}
input[type=checkbox],
input[type=radio] {
margin: 3px;
}
.modal-body {
padding: 0 0 20px 0;
}
.modal-header {
background-color:
/*#F36923*/
#DB1616;
border-bottom: none;
color: white;
}
div.responsive div.ErrorMessage.page-error>span.field-error-text {
width: auto;
}
/*
.modal-open .modal {
overflow-x: hidden;
overflow-y: auto;
}
*/
.fade.in {
opacity: 1;
}
.modal {
position: fixed;
top: 25%;
right: 0;
bottom: 0;
left: 0;
z-index: 1050;
display: none;
/* overflow: hidden; */
-webkit-overflow-scrolling: touch;
outline: 0;
max-width: 650px;
margin: 0 auto;
}
.fade {
opacity: 0;
-webkit-transition: opacity .15s linear;
-o-transition: opacity .15s linear;
transition: opacity .15s linear;
}
.modal.in .modal-dialog {
-webkit-transform: translate(0, 0);
-ms-transform: translate(0, 0);
-o-transform: translate(0, 0);
transform: translate(0, 0);
}
.modal.fade .modal-dialog {
-webkit-transition: -webkit-transform .3s ease-out;
-o-transition: -o-transform .3s ease-out;
transition: transform .3s ease-out;
-webkit-transform: translate(0, -25%);
-ms-transform: translate(0, -25%);
-o-transform: translate(0, -25%);
transform: translate(0, -25%);
}
@media (min-width: 768px) {
.modal-dialog {
width: 600px;
margin: 30px auto;
}
}
.modal-dialog {
position: relative;
width: auto;
margin: 10px;
}
.modal-content {
border-radius: 0;
padding: 15px;
}
@media (min-width: 768px) {
.modal-content {
-webkit-box-shadow: 0 5px 15px rgba(0, 0, 0, .5);
box-shadow: 0 5px 15px rgba(0, 0, 0, .5);
}
}
.modal-content {
position: relative;
background-color: #fff;
-webkit-background-clip: padding-box;
background-clip: padding-box;
border: 1px solid #999;
border: 1px solid rgba(0, 0, 0, .2);
border-radius: 6px;
outline: 0;
-webkit-box-shadow: 0 3px 9px rgba(0, 0, 0, .5);
box-shadow: 0 3px 9px rgba(0, 0, 0, .5);
}
.modal-body {
padding: 0 0 20px 0;
text-align: center;
position: relative;
}
.modal-body img.banner {
margin: 0px 0 24px 0;
width: 100%;
display: block;
max-width: 100%;
height: auto;
}
.modal-body p {
padding: 10px;
}
.modal-title {
padding: 10px;
text-align: center;
font-size: 18px;
font-weight: 500;
}
.modal-title {
margin: 0;
line-height: 1.42857143;
}
a.btn-success {
background-color: #7A7C7D;
}
a.btn-info {
background-color: #005c84;
}
/*
.modal-backdrop.in {
filter: alpha(opacity=50);
opacity: .5;
}
*/
.modal-backdrop.fade {
filter: alpha(opacity=0);
opacity: 0;
position: relative;
}
.modal-backdrop.fade.in {
position: fixed;
top: 0;
right: 0;
bottom: 0;
left: 0;
z-index: 1040;
background-color: #000;
filter: alpha(opacity=50);
opacity: .5;
}
@media only screen and (max-width: 767px) and (min-width: 480px) {
.mobile div.responsive {
width: 100% !important;
}
.mobile div.button-sub-container {
min-width: 250px;
max-width: 100%;
width: auto;
}
}
@media only screen and (max-width: 767px) {
.mobile div.responsive {
width: 100% !important;
}
span.payment-type-option {
flex: 1 1 auto;
}
span.internal-payment,
.mobile div.payment-field-container div.payment-type-selections span {
/*display: flex;*/
/*width: 100%;*/
}
}
@media(max-width: 767px) {
.modal {
position: absolute;
top: 50%;
overflow: visible;
}
.mobile div.donation-form-container.responsive {
margin-top: 0;
}
}
@media only screen and (max-width: 480px) {
.modal a.btn {
min-height: initial;
}
.mobile div.button-sub-container {
min-width: 250px;
max-width: 100%;
width: auto;
}
}
div.responsive textarea,
div.responsive input,
div.responsive select,
div.responsive option {
vertical-align: middle;
}
div.form-row div.form-content>select {
padding: 4px;
}
a.HelpLink {
display: none;
}
.donation-level-container-generic-repeat {
display: none;
}
div.form-row {
margin-right: 0;
}
div#donor_email_address_row {
width: 100%;
}
div#level_standard_row .field-required {
display: none;
}
div#level_standard_row.form-row.form-donation-level {
margin: 0;
}
div.payment-field-container #responsive_payment_typecc_number_row input {
width: 100%;
}
.donate_img_container {
margin-top: 1em;
text-align: center;
}
.donate_img_container img {
width: 15%;
margin-right: 10px;
vertical-align: middle;
}
img.donate-img.bbb {
width: 30%;
}
div#tribute_type_row {
width: 100%;
}
.date-input-container label[for*="ecard_send_date_MONTH"] {
display: none;
}
.date-input-container label[for*="ecard_send_date_DAY"] {
display: none;
}
.date-input-container label[for*="ecard_send_date_YEAR"] {
display: none;
}
div#donor_first_name_row,
div#donor_last_name_row {
display: none;
}
#donor_comments_input {
min-height: 75px;
}
textarea#ecard_recpientsname {
width: 100%;
max-width: 100% !important;
min-height: 75px;
height: 75px;
max-height: 100%;
}
textarea#tribute_ecard_messagename {
max-width: 100% !important;
width: 100% !important;
min-height: 100px;
height: auto;
max-height: 100%;
}
@media only screen and (max-width: 767px) {
.mobile div.payment-field-container span.payment-type-option {
margin-bottom: 0 !important;
margin-right: 10px !important;
}
}
/*Style updates for Amply on new form design*/
label[for*="amply_matching_company_input"] {
display: none;
}
input#amply_match_optin {
width: initial;
}
/*hide until JS is finished loading*/
#level_standard_row {
display: none;
}
.field-error-text {
width: 100% !important;
}
media only screen and (min-width: 768px) and (max-width: 991px) {
.mobile div.responsive div.ErrorMessage.page-error>span.field-error-text {
width: 100% !important;
}
}
.errorMessageContainer {
padding-top: 20px;
display: block;
}
.layout-chooser-container.clearfix {
margin: auto;
width: 300px;
}
.label-text {
display: block;
margin: 10px 0;
}
</style>
<!-- remove these if they are already on the site -->
<script src="//code.jquery.com/jquery-1.11.0.min.js" integrity="sha256-spTpc4lvj4dOkKjrGokIrHkJgNA0xMS98Pw9N7ir9oI=" crossorigin="anonymous"></script>
<script type="text/javascript" src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.6/js/bootstrap.min.js"></script>
<!-- <script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/1.6.4/jquery.min.js" integrity="sha512-SW0bB7zYONzOFdTogLM8mF+lpvSaPH55g+RyyV8+dRZkiW5n/c1gNgGk5i2xfzDLTmPHvSCqsaiEoZJDiToTWg==" crossorigin="anonymous"></script> -->
<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/2.0.0/jquery.min.js" integrity="sha512-0nVWK03Ud0k6o8wDkri8jxX9zQIn00ZHVud3iqBTwd2bGFwJDQShGVb3+vX1adCRxQckKQrIQMFmIA3tfWe+Mg==" crossorigin="anonymous"></script>
<script type="text/javascript" src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.6/js/bootstrap.min.js"></script>
<script>
jQuery(document).ready(function() {
Y.use('jquery-noconflict', function() {
// Add ID to row containing mobile image
jQuery('#df_mobile_img_container').parent('.html-caption-container').parent('.form-row').attr('id', 'df_mobile_img_container_row');
var donateModule = (function() {
function makeButtons() {
//Removes div that wraps the giving level amount
//This puts the radio button and label next to eachother to more easily style
jQuery('input[id*="level_standardexpanded"]').unwrap();
jQuery('input[id*="amount"]').attr("placeholder", "Other");
//Clicks the radio button when user clicks on
jQuery('input[id*="amount"]').on('click touchend', function() {
jQuery('.donation-level-container:last-child > .form-content > .donation-level-input-container > input[type="radio"]');
});
}
function givingLevels() {
var givingArr = [];
jQuery('.donation-level-container').each(function(idx, el) {
var $el = jQuery(el)
givingArr.push($el);
});
var otherAmountArr = givingArr.pop();
var onetimeArr = givingArr.splice(0, Math.ceil(givingArr.length / 2));
var monthlyArr = givingArr;
jQuery.each(onetimeArr, function(index, value) {
onetimeArr[index].addClass("one-time");
});
jQuery.each(monthlyArr, function(index, value) {
monthlyArr[index].addClass("monthly");
});
}
function chooseFreq(btn) {
if (btn.hasClass('oneBtn')) {
jQuery('.monthly').hide();
jQuery('.one-time').show();
jQuery('.monthlyBtn').removeClass('selected');
jQuery('.oneBtn').addClass('selected');
jQuery('#level_standardauto_repeatname').prop("checked", false);
}
if (btn.hasClass('monthlyBtn')) {
jQuery('.one-time').hide();
jQuery('.monthly').show();
jQuery('.oneBtn').removeClass('selected');
jQuery('.monthlyBtn').addClass('selected');
jQuery('#level_standardauto_repeatname').prop("checked", true);
}
}
function wrapForms() {
//Used to wrap specific sections of the donation form in order to use flexbox to format
jQuery('div[id*="tribute"],#send_ecard_row').wrapAll('<div class="tribute-wrapped" />');
jQuery('div[id*="billing"], #donor_email_address_row').wrapAll('<div class="billing-wrapped" />');
jQuery('#tribute_ecard_subject_row,#tribute_ecard_message_row,#ecard_send_date_row,#ecard_recpients_row,#select_grid_row,#preview_button_row,#e_card_copy_sender_row,#donor_first_name_row, #donor_last_name_row')
.wrapAll('<div class="ecard-wrapped" />');
}
function upsellLightbox() {
jQuery(document.body).append(jQuery("#monthlyModal").detach());
var monthlyCheckbox = jQuery('#level_standardauto_repeatname'); //checkbox input
var otherAmountInput = jQuery('input[id*="amount"]').first(); //Input where the user enters their own giving amount
var givingLevelSelecor = '[id^=level_standardexpanded]:checked'; // Get the radio element of the selected giving level. This will vary depending on standard vs installment etc
//define thresholds. Add or objects from the array remove to adjust. You must manually sort these by max.
var thresholds = [{
max: 100,
upsell: 10
}, {
max: 175,
upsell: 15
}, {
max: 200,
upsell: 20
}, {
max: 250,
upsell: 25
}, {
max: 300,
upsell: 30
}, {
max: 350,
upsell: 35
}, {
max: 400,
upsell: 40
}, {
max: 450,
upsell: 45
}, {
max: 500,
upsell: 50
}, {
max: 600,
upsell: 60
}, {
max: 650,
upsell: 65
}, {
max: 700,
upsell: 70
}, {
max: 750,
upsell: 75
}, {
max: 800,
upsell: 80
}, {
max: 850,
upsell: 85
}, {
max: 900,
upsell: 90
}, {
max: 950,
upsell: 95
}, {
max: 1000,
upsell: 100
}];
//The maximum amount to not display the upsell modal. For example, if the donor is giving $1,000 and this is set to $300, the donor will not be shown the upsell modal.
var maxThreshold = 500;
//show hidden monthly checkbox on page load if selected so that if the form errors out, the user can modify
/* if (monthlyCheckbox.prop('checked')) {
monthlyCheckbox.parent().show();
} else {
monthlyCheckbox.parent().hide();
}
*/
//prevent form submission and show modal
// jQuery("#ProcessForm").submit(function(e) {
jQuery('#pstep_finish').on('click', function(e) {
console.log('submit clicked');
e.preventDefault();
var amt = getDonationAmount();
console.log('getDonationAmount ' + amt);
var suggestedAmt = 0;
var thisForm = this;
if (amt === 0) {
return;
} //don't display the modal since the user hasn't made a selection yet.
if (monthlyCheckbox.prop('checked') || amt > maxThreshold) { //if monthly checkbox is checked or amount is greater than x, don't present the upsell modal and submit the form
// this.submit();
//jQuery("#ProcessForm").submit();
jQuery("#pstep_finish").unbind();
jQuery('#pstep_finish').click()
} else {
jQuery('#monthlyModal').modal(); //display modal
//Calculate suggested amount
jQuery.each(thresholds, function(index, obj) {
if (amt <= obj.max) {
suggestedAmt = obj.upsell;
return false; //break the loop
}
});
//update button labels
jQuery('.oneTimeAmt').html(amt);
jQuery('.suggestedAmt').html(suggestedAmt);
jQuery('#acceptUpsell').on('click', function() { //user wants the upgrade level_standardauto_repeatname
//select other amount
otherAmountInput.parent().parent().find('input').first().prop('checked', true);
//update input value
otherAmountInput.val(suggestedAmt);
//update hidden field for reporting the conversion
jQuery('#upsellhidden').prop("value", true);
//select hidden recurring monthly checkbox
monthlyCheckbox.prop('checked', true);
//if it is hidden show it so the user can modify
//monthlyCheckbox.parent().show();
//amounts are hidden SA -- you may not need these so you can hide them
jQuery('div.donation-level-container').hide();
jQuery('div.donation-level-container:last-child').show();
otherAmountInput.parent().parent().parent().parent().css('display', 'none');
//jQuery("#ProcessForm").unbind('submit');
//jQuery('#pstep_finish').click(); //submit form as is
jQuery("#pstep_finish").unbind();
jQuery('#pstep_finish').click();
//Note: For LO form error to display, we can't submit with this.submit()
});
jQuery('#declineUpsell').on('click', function() {
// jQuery("#ProcessForm").unbind('submit');
// jQuery('#pstep_finish').click(); //submit form as is
jQuery("#pstep_finish").unbind();
jQuery('#pstep_finish').click();
});
}
});
function getDonationAmount() {
console.log('start getDonationAmount function');
//get selected amount from checkbox
var amt = jQuery(givingLevelSelecor).parent().parent().find('.donation-level-amount-container').html();
console.log('amt1 ' + amt);
if (amt === undefined) {
amt = otherAmountInput.val();
if (amt === undefined) {
amt = '0';
}
}
//Convert currency string to number
amt = Number(amt.replace(/[^0-9\.]+/g, ""));
console.log(amt);
return amt;
}
}
function payment_switcher() {
if (jQuery('[id$=payment_typepay_typeradiocredit]').length > 0) {
// cc button exists
console.log('cc button exists');
ccType = jQuery('[id$=payment_typepay_typeradiocredit]');
var ccLabel = ccType.parent().children('label');
jQuery(ccType).parent().click(function() {
console.log('cc span clicked');
console.log(this);
if (jQuery(this).hasClass('selected')) {
console.log('cc is selected');
jQuery(this).children('input[type="radio"]').prop('checked', true);
jQuery('div#payment_cc_container').css('display', 'block');
jQuery('div#payment_bank_container').css('display', 'none');
}
});
jQuery(ccLabel).click(function() {
console.log('label selected');
jQuery(ccType).parent().trigger('click');
});
}
if (jQuery('[id$=payment_typepay_typeradioach]').length > 0) {
// ach button exists
console.log('ach button exists');
achType = jQuery('[id$=payment_typepay_typeradioach]');
var achLabel = achType.parent().children('label');
jQuery(achType).parent().click(function() {
console.log('ach span clicked');
console.log(this);
if (jQuery(this).hasClass('selected')) {
console.log('ach is selected');
jQuery(this).children('input[type="radio"]').prop('checked', true);
jQuery('div#payment_cc_container').css('display', 'none');
jQuery('div#payment_bank_container').css('display', 'block');
} else {
console.log('ach not selected');
}
});
jQuery(achLabel).click(function() {
console.log('label selected');
jQuery(achType).parent().trigger('click');
});
}
if (jQuery('[id$=payment_typepay_typeradiopaypal]').length > 0) {
// paypal button exists
console.log('paypal button exists');
paypalType = jQuery('[id$=payment_typepay_typeradiopaypal]');
var paypalLabel = paypalType.parent().children('label');
jQuery(paypalType).parent().click(function() {
console.log('paypal span clicked');
console.log(this);
if (jQuery(this).hasClass('selected')) {
console.log('paypal is selected');
jQuery(this).children('input[type="radio"]').prop('checked', true);
jQuery('#payment_bank_container').css('display', 'none');
jQuery('#payment_cc_container').css('display', 'none');
}
});
jQuery(paypalLabel).click(function() {
console.log('label selected');
jQuery(paypalType).parent().trigger('click');
});
}
}
return {
chooseFreq: chooseFreq,
makeButtons: makeButtons,
givingLevels: givingLevels,
upsellLightbox: upsellLightbox,
wrapForms: wrapForms,
payment_switcher: payment_switcher
};
})();
donateModule.wrapForms();
donateModule.makeButtons();
// donateModule.upsellLightbox();
donateModule.payment_switcher();
// Check if the Gift Type div exist
// If it does exist run givingLevels() and chooseFreq
// Otherwise they will not run
if (jQuery('.gift-types').length) {
donateModule.givingLevels();
jQuery('.gift-types a').click(function(event) {
donateModule.chooseFreq(jQuery(this));
});
}
// Ecard Toggle
jQuery("#send_ecardname").click(function() {
jQuery('.ecard-wrapped').toggleClass("active");
});
jQuery("#tribute_show_honor_fieldsname").click(function() {
jQuery('#send_ecard_row').toggleClass("active");
if (jQuery('.ecard-wrapped').hasClass("active")) {
jQuery('.ecard-wrapped').toggleClass("active");
jQuery('#send_ecardname').prop("checked", false);
}
});
jQuery("#tribute_show_honor_fieldsname").click(function() {
if (jQuery("#tribute_show_honor_fieldsname").prop('checked')) {
jQuery("#donor_first_name_row").show();
jQuery("#donor_last_name_row").show();
} else {
jQuery("#donor_first_name_row").hide();
jQuery("#donor_last_name_row").hide();
}
});
jQuery('#level_standard_row .form-content span.FormLabelText').text("Enter Amount");
jQuery('#donor_comments_input').attr('placeholder', 'Leave a comment, Max 255 characters.');
// Personal Postal Message Override Placeholder
jQuery('#postal_message_override_input').attr('placeholder', 'Max length is 255 characters.');
jQuery('#donor_comments_input').attr({
placeholder: 'Max length is 255 characters.',
maxlength: '255'
});
//End Honor/Memorial
jQuery('#tribute_ecard_messagename, #ecard_recpientsname').attr({
placeholder: 'Max length is 255 characters.',
maxlength: '255'
});
jQuery('#donor_comments_input, #tribute_ecard_subjectname').attr({
placeholder: 'Max length is 50 characters.',
maxlength: '50'
});
jQuery('#level_standard_row').show();
jQuery("#amply_match_optin").click(function() {
if (jQuery("input#amply_matching_company_input:visible")) {
jQuery("label[for*='amply_matching_company_input']").show();
}
});
jQuery('#amply_match_optin').parent('.form-content').parent('.custom-field-container.form-row').attr('id', 'amply_match_optin_row');
});
});
</script>
<div class="modal fade" id="monthlyModal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true" style="display: none;">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-body">
<img src="../images/content/pagebuilder/girl-holding-bear.jpg" class="img-responsive banner" alt="">
<!-- text copy update -->
<div> <!-- class="modal-header" -->
<p class="modal-title"><strong>Thank you for your support of Food Bank of the Rockies! </strong><br> You can make an impact by choosing to make a monthly gift of $<span class="suggestedAmt"></span>. Your monthly support will help
make a difference in the lives of the patients and families we serve.</p> <br>
</div>
<!-- content reusable would end here -->
<!-- buttons -->
<a class="btn btn-lg btn-success" id="declineUpsell"><strong>Keep my one-time $<span class="oneTimeAmt"></span> gift.</strong></a>
<a class="btn btn-lg btn-info" id="acceptUpsell"><strong>Make it a $<span class="suggestedAmt"></span> monthly gift instead.</strong>
</a>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<p style="font-size: 13px;">Questions? Contact us at <a style="color: #502b3a !important;" href="mailto:donatenow@foodbankrockies.org">donatenow@foodbankrockies.org</a>.</p>
<div class="donate_img_container">
<a href="https://www.bbb.org/denver/Charity-Reviews/charity-local/food-bank-of-the-rockies-in-denver-co-7148" target="_blank" rel="external noopener"><img class="donate-img bbb" src="../images/content/pagebuilder/bbb-charity-color.png" alt="BBB Charity Logo"></a>
<a href="https://www.charitynavigator.org/index.cfm?bay=search.summary&orgid=3710" target="_blank" rel="external noopener"><img class="donate-img charitynav" src="../images/content/pagebuilder/charity-nav.jpg" alt="Charity Navigator Logo"></a>
<!--<img class="donate-img colorado" src="../images/content/pagebuilder/best-colorado.png" alt="Best Colordao Logo">
<img class="donate-img workplace" src="../images/content/pagebuilder/workplace.png" alt="Work Place Logo">-->
</div>
</div>
</div>
</div>
<input type="hidden" name="7561.donation" id="7561.donation" value="form1">
</div>
<script type="text/javascript">
var submitted = false;
function checkDoubleClick() {
var elCheck = '';
if (elCheck == 'el') {
alert('Form submission is not enabled when previewing an individual data element.');
return false;
} else if (submitted) {
alert('You have already submitted this payment. Please wait....');
return false;
} else {
submitted = true;
return true;
}
}
</script><noscript> </noscript>
</form>Name: Newsletter — POST
<form class="elementor-form" id="Newsletter" method="post" name="Newsletter">
<input name="post_id" type="hidden" value="442"> <input name="form_id" type="hidden" value="3198083"> <input name="queried_id" type="hidden" value="582">
<div class="elementor-form-fields-wrapper elementor-labels-above">
<div class="elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required elementor-mark-required">
<label class="elementor-field-label" for="form-field-email">Email</label><input aria-required="true" class="elementor-field elementor-size-sm elementor-field-textual" id="form-field-email" name="form_fields[email]" required="required" size="1"
type="email">
</div>
<div class="elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons">
<button class="elementor-button elementor-size-sm" type="submit"><span><span class=" elementor-button-icon"></span> <span class="elementor-button-text">Submit</span></span></button>
</div>
</div>
</form>Text Content
Skip to content Menu Menu ANSWER THE CHALLENGE OF HUNGER Every $1 you give helps provide the equivalent of 4 meals. Join us. Together, we have the power to answer the challenge of hunger. GIFT AMOUNT One-time Monthly Giving monthly is the most effective way to help us fight food insecurity throughout our community. Field Is Required Enter Amount $1,000.00 $1000 $500.00 $500 $250.00 $250 $100.00 $100 $50.00 $50 $25.00 $25 $100.00 $100 $50.00 $50 $40.00 $40 $30.00 $30 $25.00 $25 $15.00 $15 Enter amount Make this a monthly gift. BILLING INFORMATION Organization Gift Make this gift on behalf of a company or organization Organization / Company Name: First Name: Last Name: Email Address: Street: Apt: City: State/Province: AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required ZIP/Postal Code: Country: United States Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivarian Republic of Venezuela Bonaire, Sint Eustatios and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic People's Republic of Korea The Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Federated States of Micronesia Fiji Finland The Former Yugoslav Republic of Macedonia France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Islamic Republic of Iran Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Plurinational State of Bolivia Poland Portugal Puerto Rico Qatar Republic of Korea Republic of Moldova Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles S. Georgia & S. Sandwich Isls. Sierra Leone Singapore Sint Maarten (Dutch) Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania Uruguay USA Minor Outlying Islands Uzbekistan Vanuatu Viet Nam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Required Partner's / Spouse's Name: PAYMENT INFORMATION PAYMENT METHOD: Credit Card Checking Account CREDIT CARD INFORMATION: Credit Card Type: * * * * Credit Card Number: Expiration Date:Select month of credit card Select Expiration Year 01 02 03 04 05 06 07 08 09 10 11 12 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 CVV Number: What is this? CHECKING ACCOUNT INFORMATION: Bank Routing Number: What is this? Bank Account Number: Verify Bank Account Number: Account Type: * Checking * Savings I agree to use my bank account as a payment method and authorize Food Bank of the Rockies, its affiliates, and/or subsidiaries to debit my bank account to fulfill my donation commitment. CHECK INFORMATION HONOR/MEMORIAL INFORMATION This gift is to honor or in memory of someone. Honor Gift Type: In Memory of In Honor of Required Honoree Name: Would you like to send an email notification? Yes, I would like to send an email notification. Subject Line: Personal Message: Your First Name: Your Last Name: Send email notification on:Select month of credit card Select Expiration Year Month Day Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2032 2031 2030 2029 2028 2027 2026 2025 2024 2023 2022 Recipient email addresses (separated by commas): Design: Yes, please send me a copy of this email notification. MY EMPLOYER WILL MATCH I want my employer to match my gift Company / Organization Yes, keep me updated on my impact through email updates Make My Gift Thank you for your support of Food Bank of the Rockies! You can make an impact by choosing to make a monthly gift of $. Your monthly support will help make a difference in the lives of the patients and families we serve. Keep my one-time $ gift. Make it a $ monthly gift instead. Questions? Contact us at donatenow@foodbankrockies.org. EXPLORE Find Food Give Get Involved News About CONTACT Food Bank of the Rockies 303.371.9250 Western Slope Food Bank of the Rockies 970.464.1138 877-953-3937 (toll-free) Food Bank of Wyoming 307.265.2172 877.265.2172 (toll-free) Hours & Additional Contact Info FOLLOW Facebook Twitter LinkedIn YouTube Instagram LEGAL Privacy Subscribe to our newsletter Email Submit Wherever hunger rises, so can we. Proud Partnerships © 2022 Food Bank of the Rockies. Food Bank of the Rockies is a 501(c)(3) non-profit organization recognized by the IRS, ID 84-0772672. All donations are tax-deductible.