hsrail.salsalabs.org Open in urlscan Pro
18.233.129.87  Public Scan

Submitted URL: https://default.salsalabs.org/Tf934d27a-7417-4b34-bc82-a74040e603e9/9880a190-4407-4351-92a0-ab5f4e34d96b
Effective URL: https://hsrail.salsalabs.org/donate-bif/index.html?eType=EmailBlastContent&eId=c03d52e2-9c33-49ef-94ec-1981d863dae5
Submission: On March 21 via manual from IN — Scanned from DE

Form analysis 1 forms found in the DOM

<form class="sli-form fv-form fv-form-salsa" data-fv-framework="salsa" novalidate="novalidate" data-ignite-form-id="d167fb42-0425-45df-b49d-e2ffe8e4af9c" id="form_igbQpQPBVYSg">
  <div class="sli-step-navigation-wrapper sli-element" id="id_90296f1b-bfd5-4bfe-9e8f-48a46801b0fd">
    <div class="sli-step-navigation-steps sli-flex-container">
      <div class="sli-step-navigation-step sli-flex-item sli-vertical-align-top sli-selected" data-ignite-for-step-id="1" tabindex="0"> <a class="sli-step-marker">1</a>
        <div class="sli-step-label"> <span class="sli-step-check">✓</span>Amount </div>
      </div>
      <div class="sli-step-navigation-step sli-flex-item sli-vertical-align-top" data-ignite-for-step-id="2" tabindex="0"> <a class="sli-step-marker">2</a>
        <div class="sli-step-label"> <span class="sli-step-check">✓</span>Your Info </div>
      </div>
      <div class="sli-step-navigation-step sli-flex-item sli-vertical-align-top" data-ignite-for-step-id="3" tabindex="0"> <a class="sli-step-marker">3</a>
        <div class="sli-step-label"> <span class="sli-step-check">✓</span>Payment </div>
      </div>
      <div class="sli-progress-line"></div>
    </div>
  </div>
  <div class="sli-row" id="id_246fb2f8-7667-4daa-8ae1-86ef5a724944">
    <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="elementStep" id="id_fea5054a-85d1-4039-81d9-831a484c1b32" data-ignite-step-id="1">
      <div class="sli-row" id="id_3e041a76-589d-4ccb-a88c-38b4629a4dfa">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_002b54ac-610c-463a-ab13-5467004ea42b">
          <div class="sli-selectRecurring sli-element " id="id_3bf54b47-915f-47d6-9f51-af387136e6a9_JPCTWGLvKq" data-ignite-field-id="MakeRecurring"> <label class="sli-label"
              for="id_3bf54b47-915f-47d6-9f51-af387136e6a9_JPCTWGLvKq_makeRecurring_input"><input class="sli-input" id="id_3bf54b47-915f-47d6-9f51-af387136e6a9_JPCTWGLvKq_makeRecurring_input" type="checkbox" name="makeRecurring" value="true"
                style="margin-right: 5px;" salsa-reference-name="makerecurringcb">Make this donation recurring!</label> </div>
          <div class="sli-donorPaysFees sli-element " id="id_292d878f-346c-46e3-a8e4-6a6ae4fea13a_MgHUsTRQua" data-ignite-field-id="DonorPaysFees"> <label class="sli-label"
              for="id_292d878f-346c-46e3-a8e4-6a6ae4fea13a_MgHUsTRQua_donorPaysFees_input"><input class="sli-input" id="id_292d878f-346c-46e3-a8e4-6a6ae4fea13a_MgHUsTRQua_donorPaysFees_input" type="checkbox" name="donorPaysFees" value="true"
                style="margin-right: 5px;" salsa-reference-name="donorpaysfeescb">Increase donation amount to cover processing fees?</label> </div>
        </div>
      </div>
      <div class="sli-row" id="id_74ff32da-60dc-4a92-a30c-488b3ba6b312">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_7dcc3c27-a221-49b9-8990-7d554ae63b3b"></div>
      </div>
      <div class="sli-row" id="id_6e0bb1f7-85a1-46fb-ae9c-b17daa1075e5">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_a99b3332-be5a-425d-bfcd-8f158218cb9d">
          <div class="sli-donation-amountblock sli-element" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1" data-ignite-enable-onetime="true" data-ignite-enable-recurring-amounts="true" data-ignite-field-id="DonationAmount">
            <div class="sli-donationAmounts">
              <div class="sli-oneTimeDonation" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_oneTime" data-ignite-onetime-amount="data-ignite-onetime-amount">
                <ul class="sli-oneTimeDonationAmounts sli-style-button" style="justify-content: center;">
                  <li><input class="sli-oneTimeAmountRadio" name="donationAmtToggle" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_10" type="radio" data-ignite-amount="10.00" data-fv-onetimeamount="true"
                      data-sli-widget="_igbQpQPBVYSg" data-fv-row=".sli-oneTimeDonation" data-fv-err-container=".sli-oneTimeDonationError" data-fv-onetimeamount-message="Please select a donation amount, or enter your own amount"
                      data-fv-field="donationAmtToggle"><label class="sli-oneTimeAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_10_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_10">$10</label></li>
                  <li><input class="sli-oneTimeAmountRadio" name="donationAmtToggle" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_35" type="radio" data-ignite-amount="35.00" data-fv-field="donationAmtToggle"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-oneTimeAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_35_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_35">$35</label></li>
                  <li><input class="sli-oneTimeAmountRadio" name="donationAmtToggle" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_50" type="radio" data-ignite-amount="50.00" data-fv-field="donationAmtToggle"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-oneTimeAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_50_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_50">$50</label></li>
                  <li><input class="sli-oneTimeAmountRadio" name="donationAmtToggle" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_75" type="radio" data-ignite-amount="75.00" data-fv-field="donationAmtToggle"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-oneTimeAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_75_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_75">$75</label></li>
                  <li><input class="sli-oneTimeAmountRadio" name="donationAmtToggle" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_100" type="radio" data-ignite-amount="100.00" data-fv-field="donationAmtToggle"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-oneTimeAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_100_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_amt_100">$100</label></li>
                  <li id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_custom" style=" display: block;"><input class="sli-oneTimeAmountRadio sli-oneTimeCustomAmount" name="donationAmtToggleOther"
                      id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_custom_radio" type="radio" data-ignite-custom-onetime="data-ignite-custom-onetime" aria-label="custom one-time donation amount" data-sli-widget="_igbQpQPBVYSg">
                    <div class="sli-input-group"> <label class="sli-oneTimeAmountLabel sli-amount-label sli-customAmount sli-input-group-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_custom_label"
                        for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_custom" autocomplete="off">$</label> <input class="sli-oneTimeAmountInput sli-customAmount sli-input sli-input-group-field" size="5"
                        id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_onetime_custom" type="text" placeholder="Other" name="customOneTime" data-ignite-custom-onetime-input="donationAmtToggle" data-fv-row=".sli-oneTimeDonation"
                        data-fv-err-container=".sli-oneTimeDonationError" data-fv-numeric="true" data-fv-numeric-message="Please enter a dollar amount" data-fv-notempty="true" data-fv-notempty-message="An amount is required"
                        data-fv-greaterthan="true" data-fv-greaterthan-inclusive="false" data-fv-greaterthan-value="0.0" data-fv-greaterthan-message="Please enter a positive amount" autocomplete="off" data-fv-field="customOneTime"> </div>
                  </li>
                </ul>
                <div class="sli-oneTimeDonationError sli-field-error"><small class="sli-field-error" data-fv-validator="onetimeAmount" data-fv-for="donationAmtToggle" data-fv-result="NOT_VALIDATED" style="display: none;">Please select a donation
                    amount, or enter your own amount</small><small class="sli-field-error" data-fv-validator="greaterThan" data-fv-for="customOneTime" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter a positive amount</small><small
                    class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="customOneTime" data-fv-result="NOT_VALIDATED" style="display: none;">An amount is required</small><small class="sli-field-error" data-fv-validator="numeric"
                    data-fv-for="customOneTime" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter a dollar amount</small></div>
              </div>
              <div class="sli-recurringDonation" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurring" data-ignite-recurring-amount="data-ignite-recurring-amount" style="display:none;">
                <p data-ignite-recurrence-frequency="Monthly" class=" sli-recurringFrequency" style="margin: 0;">Donation will repeat monthly.</p>
                <ul class="sli-recurringDonationAmounts sli-style-button" style="justify-content: center;">
                  <li><input class="sli-recurringAmountRadio" name="donationAmtToggle2" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_10" type="radio" data-ignite-amount="10.00" data-fv-recurringamount="true"
                      data-sli-widget="_igbQpQPBVYSg" data-fv-row=".sli-recurringDonation" data-fv-err-container=".sli-recurringDonationError" data-fv-recurringamount-message="Please select a donation amount, or enter your own amount"
                      data-fv-field="donationAmtToggle2"><label class="sli-recurringAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_10_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_10">$10</label></li>
                  <li><input class="sli-recurringAmountRadio" name="donationAmtToggle2" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_25" type="radio" data-ignite-amount="25.00" data-fv-field="donationAmtToggle2"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-recurringAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_25_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_25">$25</label></li>
                  <li><input class="sli-recurringAmountRadio" name="donationAmtToggle2" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_50" type="radio" data-ignite-amount="50.00" data-fv-field="donationAmtToggle2"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-recurringAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_50_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_50">$50</label></li>
                  <li><input class="sli-recurringAmountRadio" name="donationAmtToggle2" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_75" type="radio" data-ignite-amount="75.00" data-fv-field="donationAmtToggle2"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-recurringAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_75_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_75">$75</label></li>
                  <li><input class="sli-recurringAmountRadio" name="donationAmtToggle2" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_100" type="radio" data-ignite-amount="100.00" data-fv-field="donationAmtToggle2"
                      data-sli-widget="_igbQpQPBVYSg"><label class="sli-recurringAmountLabel sli-amount-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_100_label"
                      for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_100">$100</label></li>
                  <li id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_custom" style=" display: block;"><input class="sli-recurringAmountRadio sli-recurringCustomAmount" name="donationAmtToggle2Other"
                      id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_custom_radio" type="radio" aria-label="recurring donation custom amount" data-sli-widget="_igbQpQPBVYSg">
                    <div class="sli-input-group"> <label class="sli-recurringAmountLabel sli-amount-label sli-customAmount sli-input-group-label sli-small sli-flat" id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_custom_label"
                        for="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_custom" autocomplete="off">$</label> <input class="sli-recurringAmountInput sli-customAmount sli-input sli-input-group-field" size="5"
                        id="id_0b341d8f-8a69-4fc3-924b-7faf16b363e1_oGmtAkqmeE_recurringAmt_custom" type="text" placeholder="Other" name="customRecurringAmount" data-fv-row=".sli-recurringDonation" data-fv-err-container=".sli-recurringDonationError"
                        data-fv-numeric="true" data-fv-numeric-message="Please enter a dollar amount" data-fv-notempty="true" data-fv-notempty-message="An amount is required" data-fv-greaterthan="true" data-fv-greaterthan-inclusive="false"
                        data-fv-greaterthan-value="0.0" data-fv-greaterthan-message="Please enter a positive amount" autocomplete="off" data-fv-field="customRecurringAmount"> </div>
                  </li>
                </ul>
                <div class="sli-recurringDonationError sli-field-error"><small class="sli-field-error" data-fv-validator="recurringAmount" data-fv-for="donationAmtToggle2" data-fv-result="NOT_VALIDATED" style="display: none;">Please select a donation
                    amount, or enter your own amount</small><small class="sli-field-error" data-fv-validator="greaterThan" data-fv-for="customRecurringAmount" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter a positive
                    amount</small><small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="customRecurringAmount" data-fv-result="NOT_VALIDATED" style="display: none;">An amount is required</small><small class="sli-field-error"
                    data-fv-validator="numeric" data-fv-for="customRecurringAmount" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter a dollar amount</small></div>
              </div>
            </div>
          </div>
        </div>
      </div>
      <div class="sli-row" id="id_85b0c3b4-b630-4c92-9b80-87cbbb7db6f6">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_2a5403be-c54f-4cee-8ee5-91ebefd9192e">
          <div class="sli-element sli-button-element" id="id_93e69aaa-b60b-40f0-b94a-2ca850cfe7f3"> <a class="sli-button sli-flat sli-small" track="true" data-ignite-button-step="2" data-ignite-skip-validation="false" tabindex="0">Next</a> </div>
        </div>
      </div>
    </div>
    <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="elementStep" id="id_e4201cd8-2e3a-4a40-b833-634e7074271b" style="display: none;" data-ignite-step-id="2">
      <div class="sli-element sli-text" id="id_44118ab9-0a39-4ed3-8c0c-96d124b4e390">
        <div id="id_44118ab9-0a39-4ed3-8c0c-96d124b4e390_inner">
          <p style="font-size: 24px;">Your Information</p>
        </div>
      </div>
      <div class="sli-row" id="id_ec4c401b-c648-463f-9645-8a88414ff404">
        <div class="sli-large-6 sli-medium-6 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_8b5f2d34-2cb7-44e0-8806-f4a6972da758">
          <div class="sli-field-person-firstname sli-form-field sli-element" data-ignite-field-id="5d5a2165-f19e-4371-851b-183a6b92402b" id="id_3c56f63e-d32b-4420-9c80-bec5774b4448"> <label class="sli-required-true sli-label"
              for="id_3c56f63e-d32b-4420-9c80-bec5774b4448_input" id="id_3c56f63e-d32b-4420-9c80-bec5774b4448_label">First Name*</label> <input class="sli-input sli-input-person-firstname" type="text"
              data-ignite-field-id="5d5a2165-f19e-4371-851b-183a6b92402b" name="field-person-firstname" maxlength="36" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 36 characters." id="id_3c56f63e-d32b-4420-9c80-bec5774b4448_input" salsa-reference-name="person-firstname" data-fv-field="field-person-firstname"> <small
              class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="field-person-firstname" data-fv-result="NOT_VALIDATED" style="display: none;">This field requires a value</small><small class="sli-field-error"
              data-fv-validator="stringLength" data-fv-for="field-person-firstname" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
          <div class="sli-field-62541b93-3d63-49b3-9247-a410f4b57026 sli-form-field sli-element" data-ignite-field-id="62541b93-3d63-49b3-9247-a410f4b57026" id="id_3e4b2a34-9ce1-426f-9f71-7c978b8f5064"> <label class="sli-required-false sli-label"
              for="id_3e4b2a34-9ce1-426f-9f71-7c978b8f5064_input" id="id_3e4b2a34-9ce1-426f-9f71-7c978b8f5064_label">Company/Organization</label> <input class="sli-input sli-input-62541b93-3d63-49b3-9247-a410f4b57026" type="text"
              data-ignite-field-id="62541b93-3d63-49b3-9247-a410f4b57026" name="field-62541b93-3d63-49b3-9247-a410f4b57026" placeholder="" maxlength="256" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 256 characters." id="id_3e4b2a34-9ce1-426f-9f71-7c978b8f5064_input" salsa-reference-name="scf_organization" data-fv-field="field-62541b93-3d63-49b3-9247-a410f4b57026">
            <small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="field-62541b93-3d63-49b3-9247-a410f4b57026" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
        </div>
        <div class="sli-large-6 sli-medium-6 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_208ab66d-1344-4a66-aaac-f54dd651c325">
          <div class="sli-field-person-lastname sli-form-field sli-element" data-ignite-field-id="8d21a878-287a-491f-a362-b8ee2aa71819" id="id_05bd172a-074a-4660-8afe-1857a5fa4b51"> <label class="sli-required-true sli-label"
              for="id_05bd172a-074a-4660-8afe-1857a5fa4b51_input" id="id_05bd172a-074a-4660-8afe-1857a5fa4b51_label">Last Name*</label> <input class="sli-input sli-input-person-lastname" type="text"
              data-ignite-field-id="8d21a878-287a-491f-a362-b8ee2aa71819" name="field-person-lastname" maxlength="100" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 100 characters." id="id_05bd172a-074a-4660-8afe-1857a5fa4b51_input" salsa-reference-name="person-lastname" data-fv-field="field-person-lastname"> <small
              class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="field-person-lastname" data-fv-result="NOT_VALIDATED" style="display: none;">This field requires a value</small><small class="sli-field-error"
              data-fv-validator="stringLength" data-fv-for="field-person-lastname" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
        </div>
      </div>
      <div class="sli-row" id="id_e0f90986-7d6a-43fd-b06c-39b3cb3f72cb">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_804a6e56-3b5d-436e-af1e-c151bbe97121">
          <div class="sli-field-address-line1 sli-form-field sli-element" data-ignite-field-id="f775c79a-df41-43fb-96de-ee2360254689" id="id_9d59dfc9-9b32-4ac0-8c5f-c222da4915cf"> <label class="sli-required-true sli-label"
              for="id_9d59dfc9-9b32-4ac0-8c5f-c222da4915cf_input" id="id_9d59dfc9-9b32-4ac0-8c5f-c222da4915cf_label">Address, line 1*</label> <input class="sli-input sli-input-address-line1" type="text"
              data-ignite-field-id="f775c79a-df41-43fb-96de-ee2360254689" name="field-address-line1" maxlength="128" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 128 characters." id="id_9d59dfc9-9b32-4ac0-8c5f-c222da4915cf_input" salsa-reference-name="address-line1" data-fv-field="field-address-line1"> <small class="sli-field-error"
              data-fv-validator="notEmpty" data-fv-for="field-address-line1" data-fv-result="NOT_VALIDATED" style="display: none;">This field requires a value</small><small class="sli-field-error" data-fv-validator="stringLength"
              data-fv-for="field-address-line1" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
          <div class="sli-field-address-line2 sli-form-field sli-element" data-ignite-field-id="1ddcfe7f-7201-4a70-aa73-f1c93b4ca5a3" id="id_ed02f84b-2f3f-4833-94c1-5fb40b5a8c52"> <label class="sli-required-false sli-label"
              for="id_ed02f84b-2f3f-4833-94c1-5fb40b5a8c52_input" id="id_ed02f84b-2f3f-4833-94c1-5fb40b5a8c52_label">Address, line 2</label> <input class="sli-input sli-input-address-line2" type="text"
              data-ignite-field-id="1ddcfe7f-7201-4a70-aa73-f1c93b4ca5a3" name="field-address-line2" maxlength="128" data-fv-stringlength="true" data-fv-stringlengthmessage="Please limit your input to at most 128 characters."
              id="id_ed02f84b-2f3f-4833-94c1-5fb40b5a8c52_input" salsa-reference-name="address-line2" data-fv-field="field-address-line2"> <small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="field-address-line2"
              data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
        </div>
      </div>
      <div class="sli-row" id="id_f1faa737-9e26-471f-a16a-eebedcfa9835">
        <div class="sli-large-4 sli-medium-4 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_377d63f5-f0de-4b45-9d81-10bde4d1605b">
          <div class="sli-field-address-city sli-form-field sli-element" data-ignite-field-id="a102d60f-f8ab-47eb-8ee0-864cfa1fc5b2" id="id_875b2165-8be7-40d0-8a71-ee171c5da607"> <label class="sli-required-true sli-label"
              for="id_875b2165-8be7-40d0-8a71-ee171c5da607_input" id="id_875b2165-8be7-40d0-8a71-ee171c5da607_label">City*</label> <input class="sli-input sli-input-address-city" type="text" data-ignite-field-id="a102d60f-f8ab-47eb-8ee0-864cfa1fc5b2"
              name="field-address-city" maxlength="64" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 64 characters." id="id_875b2165-8be7-40d0-8a71-ee171c5da607_input" salsa-reference-name="address-city" data-fv-field="field-address-city"> <small class="sli-field-error"
              data-fv-validator="notEmpty" data-fv-for="field-address-city" data-fv-result="NOT_VALIDATED" style="display: none;">This field requires a value</small><small class="sli-field-error" data-fv-validator="stringLength"
              data-fv-for="field-address-city" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
        </div>
        <div class="sli-large-4 sli-medium-4 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_4e8b2f76-c5bb-4bcc-a43c-368090e45787">
          <div class="sli-field-address-state sli-form-field sli-element" data-ignite-field-id="3f8b9098-ff2d-4384-bb95-425f113028c0" id="id_61a3dcd8-0a86-4707-9820-d22f8864a24e"> <label class="sli-required-true sli-label"
              for="id_61a3dcd8-0a86-4707-9820-d22f8864a24e_input" id="id_61a3dcd8-0a86-4707-9820-d22f8864a24e_label">State*</label> <select class="sli-select-address-state sli-input" name="field-address-state"
              data-ignite-field-id="3f8b9098-ff2d-4384-bb95-425f113028c0" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" id="id_61a3dcd8-0a86-4707-9820-d22f8864a24e_input"
              salsa-reference-name="address-state" data-fv-field="field-address-state">
              <option value="" selected="selected"> Choose one...</option>
              <option value="AL">Alabama</option>
              <option value="AK">Alaska</option>
              <option value="AS">American Samoa</option>
              <option value="AZ">Arizona</option>
              <option value="AR">Arkansas</option>
              <option value="AA">Armed Forces America</option>
              <option value="AE">Armed Forces Europe</option>
              <option value="AP">Armed Forces Pacific</option>
              <option value="CA">California</option>
              <option value="CO">Colorado</option>
              <option value="CT">Connecticut</option>
              <option value="DE">Delaware</option>
              <option value="DC">District of Columbia</option>
              <option value="FL">Florida</option>
              <option value="GA">Georgia</option>
              <option value="GU">Guam</option>
              <option value="HI">Hawaii</option>
              <option value="ID">Idaho</option>
              <option value="IL">Illinois</option>
              <option value="IN">Indiana</option>
              <option value="IA">Iowa</option>
              <option value="KS">Kansas</option>
              <option value="KY">Kentucky</option>
              <option value="LA">Louisiana</option>
              <option value="ME">Maine</option>
              <option value="MD">Maryland</option>
              <option value="MA">Massachusetts</option>
              <option value="MI">Michigan</option>
              <option value="MN">Minnesota</option>
              <option value="MS">Mississippi</option>
              <option value="MO">Missouri</option>
              <option value="MT">Montana</option>
              <option value="NE">Nebraska</option>
              <option value="NV">Nevada</option>
              <option value="NH">New Hampshire</option>
              <option value="NJ">New Jersey</option>
              <option value="NM">New Mexico</option>
              <option value="NY">New York</option>
              <option value="NC">North Carolina</option>
              <option value="ND">North Dakota</option>
              <option value="MP">Northern Mariana Islands</option>
              <option value="OH">Ohio</option>
              <option value="OK">Oklahoma</option>
              <option value="OR">Oregon</option>
              <option value="PA">Pennsylvania</option>
              <option value="PR">Puerto Rico</option>
              <option value="RI">Rhode Island</option>
              <option value="SC">South Carolina</option>
              <option value="SD">South Dakota</option>
              <option value="TN">Tennessee</option>
              <option value="TX">Texas</option>
              <option value="UM">United States Minor Outlying Islands</option>
              <option value="UT">Utah</option>
              <option value="VT">Vermont</option>
              <option value="VI">Virgin Islands</option>
              <option value="VA">Virginia</option>
              <option value="WA">Washington</option>
              <option value="WV">West Virginia</option>
              <option value="WI">Wisconsin</option>
              <option value="WY">Wyoming</option>
            </select> <small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="field-address-state" data-fv-result="NOT_VALIDATED" style="display: none;">This field requires a value</small></div>
        </div>
        <div class="sli-large-4 sli-medium-4 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_b613ac27-b1d8-4f3a-9cd9-916c312323ff">
          <div class="sli-field-address-zip sli-form-field sli-element" data-ignite-field-id="44e5ad15-1fdd-4ba8-bf38-f5cbaad023c2" id="id_2e974709-2283-41c8-b1e1-90b3ed42a69c"> <label class="sli-required-true sli-label"
              for="id_2e974709-2283-41c8-b1e1-90b3ed42a69c_input" id="id_2e974709-2283-41c8-b1e1-90b3ed42a69c_label">Zip Code*</label> <input class="sli-input sli-input-address-zip" type="text"
              data-ignite-field-id="44e5ad15-1fdd-4ba8-bf38-f5cbaad023c2" name="field-address-zip" maxlength="20" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 20 characters." data-fv-zipcode="true" data-fv-zipcode-priority="1" data-fv-zipcode-country="US" data-fv-zipcode-message="This value is not valid as a %s postal code"
              data-fv-regexp="true" data-fv-regexp-priority="2" data-fv-regexp-regexp="^(\d{5}|\d{5}-\d{4})?$" data-fv-regexp-message="Zip Code must be formatted as: &quot;55555&quot; or &quot;55555-5555&quot;"
              id="id_2e974709-2283-41c8-b1e1-90b3ed42a69c_input" salsa-reference-name="address-zip" data-fv-field="field-address-zip"> <small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="field-address-zip"
              data-fv-result="NOT_VALIDATED" style="display: none;">This field requires a value</small><small class="sli-field-error" data-fv-validator="regexp" data-fv-for="field-address-zip" data-fv-result="NOT_VALIDATED" style="display: none;">Zip
              Code must be formatted as: "55555" or "55555-5555"</small><small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="field-address-zip" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not
              valid</small><small class="sli-field-error" data-fv-validator="zipCode" data-fv-for="field-address-zip" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid as a %s postal code</small></div>
        </div>
      </div>
      <div class="sli-row" id="id_65d387f9-c6e1-4b8f-ba5c-9fd18f9f1648">
        <div class="sli-large-6 sli-medium-6 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_92277438-6601-4cc6-98af-9ba005c5333a">
          <div class="sli-field-contact-email sli-form-field sli-element" data-ignite-field-id="2851b463-606f-40c8-bb3d-d31f399e6896" id="id_602502e2-4a2a-4bc5-8532-69569bc20ff3"> <label class="sli-required-true sli-label"
              for="id_602502e2-4a2a-4bc5-8532-69569bc20ff3_input" id="id_602502e2-4a2a-4bc5-8532-69569bc20ff3_label">Email Address*</label> <input class="sli-input sli-input-contact-email" type="email"
              data-ignite-field-id="2851b463-606f-40c8-bb3d-d31f399e6896" name="field-contact-email" maxlength="128" required="required" data-fv-notempty="true" data-fv-notempty-message="This field requires a value" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 128 characters." data-fv-regexp="true" data-fv-regexp-regexp="^[^@\s]+@([^@\s]+\.)+[^@\s]+$" data-fv-regexp-message="Please enter a valid email address"
              id="id_602502e2-4a2a-4bc5-8532-69569bc20ff3_input" salsa-reference-name="contact-email" data-fv-field="field-contact-email"> <small class="sli-field-error" data-fv-validator="emailAddress" data-fv-for="field-contact-email"
              data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small><small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="field-contact-email" data-fv-result="NOT_VALIDATED"
              style="display: none;">This field requires a value</small><small class="sli-field-error" data-fv-validator="regexp" data-fv-for="field-contact-email" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter a valid email
              address</small><small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="field-contact-email" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
        </div>
        <div class="sli-large-6 sli-medium-6 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_5f110b1d-2aa2-4e69-87e4-07bd03fcecbe">
          <div class="sli-field-person-home_phone sli-form-field sli-element" data-ignite-field-id="6e201e0b-8208-453f-b393-a5f0d9059726" id="id_20122ad3-59b5-4081-9205-93024d69b527"> <label class="sli-required-false sli-label"
              for="id_20122ad3-59b5-4081-9205-93024d69b527_input" id="id_20122ad3-59b5-4081-9205-93024d69b527_label">Phone</label> <input class="sli-input sli-input-person-home_phone" type="text"
              data-ignite-field-id="6e201e0b-8208-453f-b393-a5f0d9059726" name="field-person-home_phone" placeholder="555-555-5555" maxlength="12" data-fv-stringlength="true"
              data-fv-stringlengthmessage="Please limit your input to at most 128 characters." id="id_20122ad3-59b5-4081-9205-93024d69b527_input" salsa-reference-name="person-home_phone" data-fv-field="field-person-home_phone"> <small
              class="sli-field-error" data-fv-validator="stringLength" data-fv-for="field-person-home_phone" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
        </div>
      </div>
      <div class="sli-row" id="id_85468720-b3ca-4483-a615-37dc80213925">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_b098bda0-415a-4731-a453-98219a8267c9">
          <div class="sli-contact-types sli-element " id="id_39659316-c644-467d-a67e-76b99499ee44" data-ignite-field-id="ContactOptIn"> <label class="sli-label"><input class="sli-input sli-contact-type Email" type="checkbox"
                id="id_39659316-c644-467d-a67e-76b99499ee44_contact_types_input" checked="checked" name="contactOptIn" value="accepted" style="margin-right: 5px;" data-ignite-contact-value="Email" salsa-reference-name="contactoptincb">&nbsp;I'd like
              to receive updates from the High Speed Rail Alliance. (We'll never sell or share your information.)</label>
            <div class="sli-contact-type"></div>
          </div>
        </div>
      </div>
      <div class="sli-row" id="id_3d6b0bb3-f56d-4e4c-8592-6e18e4d2ee63">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_815ac259-c8bf-4a2f-a3fa-32a945ef9557">
          <div class="sli-element sli-button-element" id="id_d6789bce-a256-4f3c-a055-aada2c07218a"> <a class="sli-button sli-flat sli-large" track="true" data-ignite-button-step="3" data-ignite-skip-validation="false" tabindex="0">Next</a> </div>
          <div class="sli-element sli-button-element" id="id_50ddab9e-8cc0-42cc-9849-f901aade43a4">
            <a class="sli-button sli-flat sli-small" track="true" data-ignite-button-step="1" data-ignite-skip-validation="true" style="color:rgb(32, 119, 176);background-color:rgba(67, 67, 67, 0);" tabindex="0">&lt;&lt; Back</a> </div>
        </div>
      </div>
    </div>
    <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="elementStep" id="id_b0a5d6aa-07fd-444d-8f4d-265a9a8f6d46" style="display: none;" data-ignite-step-id="3">
      <div class="sli-row" id="id_d0f04fe5-c69d-4eec-956d-99132f5514fe">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_85f1b70e-4f80-4703-995c-3baf880cbfbb">
          <div class="sli-element sli-text" id="id_f552e008-182d-4437-bcec-ba7ef03cdc14">
            <div id="id_f552e008-182d-4437-bcec-ba7ef03cdc14_inner">
              <p style="font-size: 24px;">Payment Information</p>
            </div>
          </div>
          <div class="sli-donation-paymentblock sli-element" id="id_cc316cc3-bffe-4b81-b5f9-f0c7766400aa">
            <div class="sli-paymentType" id="id_cc316cc3-bffe-4b81-b5f9-f0c7766400aa_paymentType" style="display: block;">
              <div class="sli-ccType sli-label" for="payment_type"> Payment Type: </div>
              <div style="display:inline-block;"> <input name="payment_type" type="radio" value="CREDIT_CARD" checked="checked" id="zVCNjHSGDw"> <label class="sli-label" for="zVCNjHSGDw">Credit Card</label> </div>
              <div style="display:inline-block;"> <input name="payment_type" sli-payment-type="ACH" style="display:none;" type="radio" value="ACH" id="MpnxZuQTPk"> <label class="sli-label" style="display:none;" sli-payment-type="ACH"
                  for="MpnxZuQTPk">eCheck</label> </div>
              <div style="display:inline-block;"> <input name="payment_type" sli-payment-type="PAYPAL" style="" type="radio" value="PAYPAL" id="zDkflRVHaU"> <label class="sli-label" style="" sli-payment-type="PAYPAL" for="zDkflRVHaU">PayPal</label>
              </div>
            </div>
            <div id="id_cc316cc3-bffe-4b81-b5f9-f0c7766400aa_echeck_wepay" data-ignite-echeck-wepay="ignite-echeck-wepay"> <label class="sli-ccLabel sli-label" for="iWUeZhliDv">Bank Account*</label>
              <div class="sli-row">
                <div class="sli-columns sli-medium-4 sli-large-4 sli-end sli-form-field"></div> <input class="sli-ccInput sli-input" type="text" id="iWUeZhliDv" data-fv-field="wepay_bank" data-fv-notempty-message="Bank Account is required"
                  readonly="readonly" required="required" name="wepay_bank">
                <div class="sli-columns sli-large-8 sli-medium-8"> <input class="sli-button" id="id_cc316cc3-bffe-4b81-b5f9-f0c7766400aa_bankSelect" type="button" value="Select a Bank Account" name="bank-popup"> <small
                    class="sli-field-error sli-wepay-error" style="display: none;"></small> </div> <small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="wepay_bank" data-fv-result="NOT_VALIDATED" style="display: none;">Bank Account
                  is required</small>
              </div>
            </div>
            <div id="id_cc316cc3-bffe-4b81-b5f9-f0c7766400aa_echeck" data-ignite-echeck="ignite-echeck">
              <div class="sli-row">
                <div class="sli-columns sli-medium-8 sli-large-8 sli-small-12 sli-end sli-form-field"> <label class="sli-ccLabel sli-label" for="xhcOJedHxC">Name on Account*</label> <input class="sli-ccInput sli-input" type="text" name="holder_name"
                    id="xhcOJedHxC" required="required" data-fv-notempty="true" data-fv-notemtpy-message="Please enter the holder name" pattern="^.+\s+.*$" data-fv-regexp-message="Holder name must have at least 2 parts" data-fv-field="holder_name">
                  <small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="holder_name" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small><small class="sli-field-error" data-fv-validator="regexp"
                    data-fv-for="holder_name" data-fv-result="NOT_VALIDATED" style="display: none;">Holder name must have at least 2 parts</small></div>
              </div>
              <div class="sli-row">
                <div class="sli-columns sli-large-8 sli-medium-8 sli-form-field"> <label class="sli-ccLabel sli-label" for="camOOBwbQP">Bank Routing Number*</label> <input class="sli-ccInput sli-input" type="text" name="bank_routing" id="camOOBwbQP"
                    required="required" maxlength="9" dava-fv-field="bank_routing" data-fv-notempty="true" data-fv-notemtpy-message="Bank Routing Number is required" data-fv-stringlength="true" data-fv-stringlength-min="9"
                    data-fv-stringlength-max="9" data-fv-stringlength-message="Bank Routing Number must be 9 characters long" data-fv-digits="true" data-fv-digits-message="Please enter only digits" data-fv-field="bank_routing"> <small
                    class="sli-field-error" data-fv-validator="digits" data-fv-for="bank_routing" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter only digits</small><small class="sli-field-error" data-fv-validator="notEmpty"
                    data-fv-for="bank_routing" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small><small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="bank_routing"
                    data-fv-result="NOT_VALIDATED" style="display: none;">Bank Routing Number must be 9 characters long</small></div>
              </div>
              <div class="sli-row">
                <div class="sli-columns sli-large-8 sli-medium-8 sli-form-field"> <label class="sli-ccLabel sli-label" for="rRuDUveSZk">Bank Account Number*</label> <input class="sli-bankAccount sli-ccInput sli-input" type="text" name="bank_account"
                    id="rRuDUveSZk" required="required" maxlength="17" dava-fv-field="bank_account" data-fv-notempty="true" data-fv-notemtpy-message="Bank Account Number is required" data-fv-stringlength="true" data-fv-stringlength-min="4"
                    data-fv-stringlength-max="17" data-fv-stringlength-message="Bank Account Number must be from 4 to 17 characters long" data-fv-digits="true" data-fv-digits-message="Please enter only digits" data-fv-field="bank_account"> <small
                    class="sli-field-error" data-fv-validator="digits" data-fv-for="bank_account" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter only digits</small><small class="sli-field-error" data-fv-validator="notEmpty"
                    data-fv-for="bank_account" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small><small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="bank_account"
                    data-fv-result="NOT_VALIDATED" style="display: none;">Bank Account Number must be from 4 to 17 characters long</small></div>
              </div>
            </div>
            <div id="id_cc316cc3-bffe-4b81-b5f9-f0c7766400aa_cc" data-ignite-cc="ignite-cc">
              <ul class="sli-cards">
                <li class="sli-visa off" style=""></li>
                <li class="sli-mastercard off" style=""></li>
                <li class="sli-discover off" style=""></li>
                <li class="sli-amex off" style=""></li>
              </ul>
              <div class="sli-row">
                <div class="sli-columns sli-large-8 sli-medium-8 sli-form-field"> <label class="sli-ccLabel sli-label" for="NyYVhOTHZL">Card Number*</label> <input class="sli-ccInput sli-input" name="card_number" id="NyYVhOTHZL" type="text"
                    required="required" data-fv-notempty-message="A credit card number is required" maxlength="16" autocomplete="off" data-fv-creditcard="true" data-fv-creditcard-message="Please enter a valid credit card number"
                    data-fv-field="card_number"> <small class="sli-field-error" data-fv-validator="creditCard" data-fv-for="card_number" data-fv-result="NOT_VALIDATED" style="display: none;">Please enter a valid credit card number</small><small
                    class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="card_number" data-fv-result="NOT_VALIDATED" style="display: none;">A credit card number is required</small><small class="sli-field-error"
                    data-fv-validator="stringLength" data-fv-for="card_number" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
                <div class="sli-columns sli-large-4 sli-medium-4 sli-end sli-form-field"> <label class="sli-ccExpCcvLabel sli-label" for="gFBkPXQJAA">Security Code*</label> <input class="sli-ccExpCcvInput sli-input" name="cvv" id="gFBkPXQJAA"
                    type="text" required="required" data-fv-notempty-message="CVV/CCV is required" maxlength="4" size="4" autocomplete="off" data-fv-cvv="true" data-fv-cvv_ccfield="card_number" data-dv-cvv-message="Your CVV is invalid"
                    data-fv-field="cvv"> <small class="sli-field-error" data-fv-validator="cvv" data-fv-for="cvv" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small><small class="sli-field-error"
                    data-fv-validator="notEmpty" data-fv-for="cvv" data-fv-result="NOT_VALIDATED" style="display: none;">CVV/CCV is required</small><small class="sli-field-error" data-fv-validator="stringLength" data-fv-for="cvv"
                    data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small></div>
              </div>
              <div class="sli-row">
                <div class="sli-columns sli-large-6 sli-medium-6 sli-form-field"> <label class="sli-ccExpMonthLabel sli-label" for="mobBTFSdGv">Expiration Month*</label> <select class="sli-ccInput sli-input" name="expiry_month" id="mobBTFSdGv"
                    required="required" data-fv-notempty-message="Month is required" style="display: block;" data-fv-field="expiry_month">
                    <option value="" selected="selected">MM</option>
                    <option value="01">01</option>
                    <option value="02">02</option>
                    <option value="03">03</option>
                    <option value="04">04</option>
                    <option value="05">05</option>
                    <option value="06">06</option>
                    <option value="07">07</option>
                    <option value="08">08</option>
                    <option value="09">09</option>
                    <option value="10">10</option>
                    <option value="11">11</option>
                    <option value="12">12</option>
                  </select> <small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="expiry_month" data-fv-result="NOT_VALIDATED" style="display: none;">Month is required</small></div>
                <div class="sli-columns sli-large-6 sli-medium-6 sli-end sli-form-field"> <label class="sli-ccExpMonthLabel sli-label" for="YFupIzicGt">Expiration Year*</label> <select class="sli-ccInput sli-input" name="expiry_year" id="YFupIzicGt"
                    required="required" data-fv-notempty-message="Year is required" style="display: block;" data-fv-field="expiry_year">
                    <option value="" selected="">YYYY</option>
                    <option value="22">2022</option>
                    <option value="23">2023</option>
                    <option value="24">2024</option>
                    <option value="25">2025</option>
                    <option value="26">2026</option>
                    <option value="27">2027</option>
                    <option value="28">2028</option>
                    <option value="29">2029</option>
                    <option value="30">2030</option>
                    <option value="31">2031</option>
                    <option value="32">2032</option>
                    <option value="33">2033</option>
                    <option value="34">2034</option>
                    <option value="35">2035</option>
                    <option value="36">2036</option>
                    <option value="37">2037</option>
                    <option value="38">2038</option>
                    <option value="39">2039</option>
                    <option value="40">2040</option>
                    <option value="41">2041</option>
                  </select> <small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="expiry_year" data-fv-result="NOT_VALIDATED" style="display: none;">Year is required</small></div>
              </div>
              <div class="sli-row">
                <div class="sli-columns sli-large-12 sli-small-12 sli-end sli-form-field"> <label class="sli-ccNameLabel sli-label" for="UyjAXjPrpP">Name on Card*</label> <input class="sli-ccNameInput sli-input" name="name_on_card" id="UyjAXjPrpP"
                    type="text" autocomplete="off" required="required" data-fv-callback="true" data-fv-callback-callback="validateCCName" data-fv-field="name_on_card"> <small class="sli-field-error" data-fv-validator="callback"
                    data-fv-for="name_on_card" data-fv-result="NOT_VALIDATED" style="display: none;">This value is not valid</small><small class="sli-field-error" data-fv-validator="notEmpty" data-fv-for="name_on_card" data-fv-result="NOT_VALIDATED"
                    style="display: none;">This value is not valid</small></div>
              </div>
            </div>
          </div>
        </div>
      </div>
      <div class="sli-row" id="id_3c05ec0d-e79a-4215-a885-a4b328568f2c">
        <div class="sli-large-12 sli-medium-12 sli-small-12 sli-columns " data-ignite-container-type="DEFAULT" id="id_f5e00653-330a-49b8-978c-7db647091b67">
          <div class="sli-element sli-button-element" id="id_d211aad6-3700-485f-a165-acf14d675318"> <a class="sli-button sli-flat sli-large" track="true" data-ignite-submit-button="data-ignite-submit-button" tabindex="0">Donate Now!</a>
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          <div class="sli-element sli-button-element" id="id_cb4762f2-5500-479f-bc5d-a2d103a21ce3">
            <a class="sli-button sli-flat sli-small" track="true" data-ignite-button-step="2" data-ignite-skip-validation="true" style="color:rgb(32, 119, 176);background-color:rgba(67, 67, 67, 0);" tabindex="0">&lt;&lt; Back</a> </div>
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</form>

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