action.mealsonwheelsamerica.org
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18.245.60.47
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URL:
https://action.mealsonwheelsamerica.org/a/mv-transportation?ms=MVTHeadquarters
Submission: On December 19 via manual from US — Scanned from DE
Submission: On December 19 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST v1
<form class="clearfix" method="post" novalidate="" action="v1" accept-charset="utf-8" autocomplete="on">
<div class="at-markup FastAction" id="NVContributionForm2054297-FastAction">
<div class="fastaction-block">
<div class="fastAction clearfix">
<p>
<span class="fa-cta">
<a href="#fastaction-login" class="profile-link" aria-label="FastAction">
<img class="profile-link-fa-image" src="//static.everyaction.com/ea-actiontag/assets/images/fast-action.svg">
</a>
<span><a href="https://fastaction.ngpvan.com##whats-this" class="circle" id="fastaction-whatsthis" data-popup="true" data-popup-width="515" data-popup-height="540" target="_blank">?</a></span>
</span>
<span class="fa-lead"> Take future action with a single click.<br>
<a href="#fastaction-login" class="call-modal" id="fastaction-widget-login">Log in</a> or <a href="#fastaction-signup" class="call-modal" id="fastaction-widget-signup">Sign up</a> for <i>Fast</i><b>Action</b>
</span>
</p>
</div>
</div>
</div>
<ol class="at-steps clearfix">
<li data-step="0" class="at-step active">
<a title="" href="#ContributionInformation">
<span class="step-title">Amount</span>
</a>
</li>
<li data-step="1" class="at-step ">
<a title="" href="#ContactInformation">
<span class="step-title">Details</span>
</a>
</li>
<li data-step="2" class="at-step ">
<a title="" href="#PaymentInformation">
<span class="step-title">Payment</span>
</a>
</li>
</ol>
<div class="at-error-console"></div>
<div data-name="undefined" data-subview="submit_view" data-subview-index="3"></div>
<fieldset class="at-fieldset ContributionInformation" id="NVContributionForm2054297-ContributionInformation" style="border: none;">
<legend class="at-legend">Amount</legend>
<div class="at-fields">
<div class="at-row at-row-full ">
<div class="form-unit form-unit-radio form-item-selectedfrequency" id="NVContributionForm2054297-ContributionInformation-SelectedFrequency">
<div class="radios" role="radiogroup" aria-labelledby="NVContributionForm2054297-ContributionInformation-SelectedFrequency">
<label title="One-Time" class="at-radio-label-0" role="radio">
<input type="radio" name="SelectedFrequency" checked="" value="0"> One-Time </label><label title="Monthly" class="at-radio-label-4" role="radio">
<input type="radio" name="SelectedFrequency" value="4"> Monthly </label>
<div class="radio-description radio-description-value-0">Consider giving monthly</div>
</div>
</div>
</div>
<div class="at-row at-row-full ">
<input id="ProcessingCurrency_Value" type="hidden" name="ProcessingCurrency.Value" value="USD">
</div>
<div class="at-row at-row-full ">
<div class="form-item form-type-radios form-item-selectamount" id="NVContributionForm2054297-ContributionInformation-SelectAmount">
<div class="at-row SelectAmount OtherAmount NonRecurringButtons">
<div class="at-radio">
<div class="at-radios clearfix">
<label class="label-amount" title="$20">
<input name="SelectAmount" type="radio" value="20.00"> $20 <a></a> </label><label class="label-amount" title="$50">
<input name="SelectAmount" type="radio" value="50.00"> $50 <a></a> </label><label class="label-amount" title="$100">
<input name="SelectAmount" type="radio" value="100.00"> $100 <a></a> </label><label class="label-amount" title="$250">
<input name="SelectAmount" type="radio" value="250.00"> $250 <a></a> </label><label class="label-amount" title="$500">
<input name="SelectAmount" type="radio" value="500.00"> $500 <a></a> </label><label class="label-amount label-otheramount" title="Other">
<input name="SelectAmount" type="radio" class="radio-other" value="other"> Other <input type="number" tabindex="-1" autocomplete="transaction-amount" class="edit-otheramount" name="OtherAmount" title="Other Amount"
placeholder="0.00">
<span class="label-otheramount-prefix">$</span>
</label>
</div>
</div>
</div>
</div>
</div><label class="at-check CoverCostsAmount" id="NVContributionForm2054297-ContributionInformation-CoverCostsAmount"><input type="checkbox" checked="" name="CoverCostsAmount"> <span class="at-checkbox-title-container"><span
class="at-checkbox-title" id="NVContributionForm2054297-ContributionInformation-CoverCostsAmount-label">I'd like to help cover the transaction fees for my donation. </span><span class="at-cover-costs-info">My total amount will be
<strong>$103.75</strong>.</span></span>
</label>
</div>
</fieldset>
<fieldset class="at-fieldset TributeGift" id="NVContributionForm2054297-TributeGift">
<div class="at-fields">
<div class="at-row at-row-full EnableTributeGift">
<label class="at-check EnableTributeGift" id="NVContributionForm2054297-TributeGift-EnableTributeGift"><input type="checkbox" name="EnableTributeGift"> <span class="at-checkbox-title-container"><span class="at-checkbox-title"
id="NVContributionForm2054297-TributeGift-EnableTributeGift-label">I'd like to make this contribution in honor or in memory of someone</span></span>
</label>
</div>
<div class="at-row">
<div class="at-tribute-gift" style="display:none">
<div class="form-unit form-unit-radio form-item-inhonororinmemoryof" id="NVContributionForm2054297-TributeGift-InHonorOrInMemoryOf"><label id="NVContributionForm2054297-TributeGift-InHonorOrInMemoryOf"> Is this an Honorary or Memorial
Gift?</label>
<div class="radios" role="radiogroup" aria-labelledby="NVContributionForm2054297-TributeGift-InHonorOrInMemoryOf">
<label title="In honor of" class="at-radio-label-2" role="radio">
<input type="radio" name="InHonorOrInMemoryOf" checked="" value="2"> In honor of </label><label title="In memory of" class="at-radio-label-1" role="radio">
<input type="radio" name="InHonorOrInMemoryOf" value="1"> In memory of </label>
</div>
</div><label class="at-text HonoreeName" id="NVContributionForm2054297-TributeGift-HonoreeName">Honoree Name<input type="text" autocomplete="on" required="" title="Honoree Name (required)" name="HonoreeName" value="" maxlength="100">
</label>
</div>
</div>
</div>
</fieldset>
<fieldset class="at-fieldset RecipientInformation" id="NVContributionForm2054297-RecipientInformation" style="display: none;">
<div class="at-fields">
<div class="at-row">
<label class="at-check IncludeRecipient" id="NVContributionForm2054297-RecipientInformation-IncludeRecipient"><input type="checkbox" name="IncludeRecipient"> <span class="at-checkbox-title-container"><span class="at-checkbox-title"
id="NVContributionForm2054297-RecipientInformation-IncludeRecipient-label">I'd like to notify someone of this contribution</span></span>
</label>
</div>
<div class="at-recipient-info" style="display: none;">
<div class="at-title">Who would you like to notify?</div>
<div class="at-row at-row-solo at-row-full RecipientInfoHeaderHtml">
<div class="at-markup RecipientInfoHeaderHtml" id="NVContributionForm2054297-RecipientInformation-RecipientInfoHeaderHtml">
<p>Please choose either email or mail to notify the recipient.</p>
</div>
</div>
<div class="at-row RecipientFirstName RecipientLastName"><label class="at-text RecipientFirstName" id="NVContributionForm2054297-RecipientInformation-RecipientFirstName">First Name <small>(Optional)</small><input type="text"
autocomplete="on" false="" title="First Name" name="RecipientFirstName" value="" maxlength="50">
</label><label class="at-text RecipientLastName" id="NVContributionForm2054297-RecipientInformation-RecipientLastName">Last Name <small>(Optional)</small><input type="text" autocomplete="on" false="" title="Last Name"
name="RecipientLastName" value="" maxlength="50">
</label></div>
<div class="at-row at-row-solo RecipientStreetAddress"><label class="at-text RecipientStreetAddress" id="NVContributionForm2054297-RecipientInformation-RecipientStreetAddress">Street Address <small>(Optional)</small><input type="text"
autocomplete="on" false="" title="Street Address" name="RecipientStreetAddress" value="" maxlength="100">
</label></div>
<div class="at-row RecipientCountry RecipientPostalCode RecipientCity RecipientStateProvince"><label class="at-select RecipientCountry" id="NVContributionForm2054297-RecipientInformation-RecipientCountry">Country
<small>(Optional)</small><select autocomplete="on" title="Country" name="RecipientCountry" class="select2-hidden-accessible" id="NVContributionForm2054297-RecipientInformation-RecipientCountry-select" tabindex="-1" aria-hidden="true">
<option value="">- Select -</option>
<option value="AF">Afghanistan</option>
<option value="AX">Åland Islands</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia (Plurinational State of)</option>
<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet Island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="VG">British Virgin Islands</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="CV">Cabo Verde</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CG">Congo</option>
<option value="CD">Congo (Democratic Republic of the)</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="CI">Côte d'Ivoire</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curaçao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czechia</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="SZ">Eswatini</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="VA">Holy See</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran (Islamic Republic of)</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IM">Isle of Man</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JE">Jersey</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KP">Korea (Democratic People's Republic of)</option>
<option value="KR">Korea (Republic of)</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macao</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia (Federated States of)</option>
<option value="MD">Moldova (Republic of)</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="MK">North Macedonia</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestine (State of)</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="QA">Qatar</option>
<option value="RE">Réunion</option>
<option value="RO">Romania</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda</option>
<option value="BL">Saint Barthélemy</option>
<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="MF">Saint Martin (French part)</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SX">Sint Maarten (Dutch part)</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania (United Republic of)</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela (Bolivarian Republic of)</option>
<option value="VN">Viet Nam</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 100px;"><span class="selection"><span class="select2-selection select2-selection--single" role="combobox" aria-haspopup="true"
aria-expanded="false" title="Country" tabindex="0" aria-labelledby="select2-NVContributionForm2054297-RecipientInformation-RecipientCountry-select-container"><span class="select2-selection__rendered"
id="select2-NVContributionForm2054297-RecipientInformation-RecipientCountry-select-container" title="United States">United States</span><span class="select2-selection__arrow"
role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
</label><label class="at-text RecipientPostalCode" id="NVContributionForm2054297-RecipientInformation-RecipientPostalCode">Postal Code <small>(Optional)</small><input type="tel" autocomplete="on" pattern="^\d{5}([\-]\d{4})?$" false=""
title="Postal Code" name="RecipientPostalCode" value="" maxlength="10">
</label><label class="at-text RecipientCity" id="NVContributionForm2054297-RecipientInformation-RecipientCity">City <small>(Optional)</small><input type="text" autocomplete="on" false="" title="City" name="RecipientCity" value=""
maxlength="25">
</label><label class="at-select RecipientStateProvince" id="NVContributionForm2054297-RecipientInformation-RecipientStateProvince">State/Province <small>(Optional)</small><select autocomplete="on" title="State/Province"
name="RecipientStateProvince" class="" id="NVContributionForm2054297-RecipientInformation-RecipientStateProvince-select">
<option value="">- State -</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AR">AR</option>
<option value="AZ">AZ</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="GA">GA</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="AS">AS</option>
<option value="FM">FM</option>
<option value="GU">GU</option>
<option value="MH">MH</option>
<option value="MP">MP</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="VI">VI</option>
<option value="AA">AA</option>
<option value="AE">AE</option>
<option value="AP">AP</option>
</select>
</label></div>
<div class="at-row at-row-solo RecipientEmailAddress"><label class="at-text RecipientEmailAddress" id="NVContributionForm2054297-RecipientInformation-RecipientEmailAddress">Email <small>(Optional)</small><input type="email"
autocomplete="on" pattern="^([\w!#$%&'*+\-\/=?\^`\{\|\}~]+\.)*[\w!#$%&'*+\-\/=?\^`\{\|\}~]+@((((([a-zA-Z0-9]{1}[a-zA-Z0-9\-]{0,62}[a-zA-Z0-9]{1})|[a-zA-Z])\.)+[a-zA-Z]{2,62})|(\d{1,3}\.){3}\d{1,3}(:\d{1,5})?)$" false=""
title="Email" name="RecipientEmailAddress" value="" maxlength="100">
</label></div>
<div class="at-row at-row-solo Ecard">
<div class="form-unit form-unit-radio form-item-ecard" id="NVContributionForm2054297-RecipientInformation-Ecard"></div>
</div>
<div class="at-row at-row-solo NotificationSendDate"><label class="at-date notificationsenddate" id="NVContributionForm2054297-RecipientInformation-NotificationSendDate"></label></div>
<div class="at-row at-row-solo NotificationMessage"><label class="at-area NotificationMessage" id="NVContributionForm2054297-RecipientInformation-NotificationMessage"></label></div>
</div>
<div class="at-row">
<div class="at-recipient-msg" style="display: none;">
<div class="form-unit form-unit-radio form-item-ecard" id="NVContributionForm2054297-RecipientInformation-Ecard">
<div class="at-title"> Select an Ecard </div>
<div class="at-ecards clearfix">
<div class="at-ecard selected">
<div class="at-ecard-img">
<img src="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_4.png" alt="eCard_4">
</div>
<input name="ecard" type="radio" value="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_4.png" checked="">
</div>
<div class="at-ecard">
<div class="at-ecard-img">
<img src="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_3.png" alt="eCard_3">
</div>
<input name="ecard" type="radio" value="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_3.png">
</div>
<div class="at-ecard">
<div class="at-ecard-img">
<img src="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_2.png" alt="eCard_2">
</div>
<input name="ecard" type="radio" value="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_2.png">
</div>
<div class="at-ecard">
<div class="at-ecard-img">
<img src="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_1.png" alt="eCard_1">
</div>
<input name="ecard" type="radio" value="//nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/111812/images/E-Cards/eCard_1.png">
</div>
<button type="button" class="at-preview-ecard btn-at btn-at-link">Preview Ecard</button>
</div>
</div><label class="at-date notificationsenddate" id="NVContributionForm2054297-RecipientInformation-NotificationSendDate">Send Date <small>(Optional)</small><input type="text" title="Send Date" name="NotificationSendDate" value=""
maxlength="10" size="10" class="hasDatepicker" placeholder="MM/DD/YYYY" autocomplete="off" id="dp1734645435946">
</label><label class="at-area NotificationMessage" id="NVContributionForm2054297-RecipientInformation-NotificationMessage">Message <small>(Optional)</small><textarea false="" title="Message" name="NotificationMessage"
maxlength="4000"></textarea>
</label>
</div>
</div>
</div>
</fieldset>
<fieldset class="at-fieldset ContactInformation hideStep" id="NVContributionForm2054297-ContactInformation" style="display: block;">
<legend class="at-legend">Details</legend>
<div class="at-fields">
<div class="at-row FirstName LastName"><label class="at-text FirstName" id="NVContributionForm2054297-ContactInformation-FirstName">First Name<input type="text" autocomplete="given-name" x-autocompletetype="given-name" required=""
title="First Name (required)" name="FirstName" value="" maxlength="20">
</label><label class="at-text LastName" id="NVContributionForm2054297-ContactInformation-LastName">Last Name<input type="text" autocomplete="family-name" x-autocompletetype="surname" required="" title="Last Name (required)" name="LastName"
value="" maxlength="25">
</label></div>
<div class="at-row at-row-solo AddressLine1"><label class="at-text AddressLine1" id="NVContributionForm2054297-ContactInformation-AddressLine1">Street Address<input type="text" autocomplete="address-line1" x-autocompletetype="address-line1"
required="" title="Street Address (required)" name="AddressLine1" value="" maxlength="99">
</label></div>
<div class="at-row PostalCode City StateProvince"><label class="at-text PostalCode" id="NVContributionForm2054297-ContactInformation-PostalCode">Postal Code<input type="tel" autocomplete="postal-code" x-autocompletetype="postal-code"
pattern="^\d{5}([\-]\d{4})?$" required="" title="Postal Code (required)" name="PostalCode" value="" maxlength="10">
</label><label class="at-text City" id="NVContributionForm2054297-ContactInformation-City">City<input type="text" autocomplete="address-level2" x-autocompletetype="locality" required="" title="City (required)" name="City" value=""
maxlength="25">
</label><label class="at-select StateProvince" id="NVContributionForm2054297-ContactInformation-StateProvince">State<select required="" autocomplete="address-level1" x-autocompletetype="administrative-area" title="State" name="StateProvince"
class=" required" id="NVContributionForm2054297-ContactInformation-StateProvince-select">
<option value="" disabled="">- State -</option>
<option value="AK">AK</option>
<option value="AL">AL</option>
<option value="AR">AR</option>
<option value="AZ">AZ</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="GA">GA</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NC">NC</option>
<option value="ND">ND</option>
<option value="NE">NE</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VA">VA</option>
<option value="VT">VT</option>
<option value="WA">WA</option>
<option value="WI">WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
<option value="AS">AS</option>
<option value="FM">FM</option>
<option value="GU">GU</option>
<option value="MH">MH</option>
<option value="MP">MP</option>
<option value="PR">PR</option>
<option value="PW">PW</option>
<option value="VI">VI</option>
<option value="AA">AA</option>
<option value="AE">AE</option>
<option value="AP">AP</option>
</select>
</label></div>
<div class="at-row EmailAddress MobilePhone"><label class="at-text EmailAddress" id="NVContributionForm2054297-ContactInformation-EmailAddress">Email<input type="email" autocomplete="email" x-autocompletetype="email"
pattern="^([\w!#$%&'*+\-\/=?\^`\{\|\}~]+\.)*[\w!#$%&'*+\-\/=?\^`\{\|\}~]+@((((([a-zA-Z0-9]{1}[a-zA-Z0-9\-]{0,62}[a-zA-Z0-9]{1})|[a-zA-Z])\.)+[a-zA-Z]{2,62})|(\d{1,3}\.){3}\d{1,3}(:\d{1,5})?)$" required="" title="Email (required)"
name="EmailAddress" value="" maxlength="100" placeholder="email@email.com">
</label><label class="at-text MobilePhone" id="NVContributionForm2054297-ContactInformation-MobilePhone">Mobile Phone <small>(Optional)</small><input type="tel" autocomplete="mobile tel-national"
pattern="^(?:\+?1[\-. ]?)?(?:\(?([2-9]\d{2})\)?)[\-. ]?([2-9]\d{2})[\-. ]?(\d{4})(?:\s{0,2}(?:ext(?:ension)?|ex|x)\.?\s?(\d{1,5}))*$" false="" title="Mobile Phone" name="MobilePhone" value="" maxlength="">
</label></div>
<div class="at-row at-row-solo at-row-full SmsSubscribeMobilePhone"><label class="at-check SmsSubscribeMobilePhone" id="NVContributionForm2054297-ContactInformation-SmsSubscribeMobilePhone"><input type="checkbox"
name="SmsSubscribeMobilePhone"> <span class="at-checkbox-title-container"><span class="at-checkbox-title" id="NVContributionForm2054297-ContactInformation-SmsSubscribeMobilePhone-label">Sign me up for SMS messages.</span></span>
</label></div>
<div class="at-row at-row-solo at-row-full SmsLegalDisclaimer at-indented">
<div class="at-markup SmsLegalDisclaimer at-legal" id="NVContributionForm2054297-ContactInformation-SmsLegalDisclaimer">
<p>By submitting your cell phone number you are agreeing to receive periodic text messages from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages.</p>
</div>
</div>
<div class="at-row at-row-solo at-row-full YesSignMeUpForUpdatesForBinder"><label class="at-check YesSignMeUpForUpdatesForBinder" id="NVContributionForm2054297-ContactInformation-YesSignMeUpForUpdatesForBinder"><input type="checkbox"
checked="" name="YesSignMeUpForUpdatesForBinder"> <span class="at-checkbox-title-container"><span class="at-checkbox-title" id="NVContributionForm2054297-ContactInformation-YesSignMeUpForUpdatesForBinder-label">Yes, sign me up for email
updates.</span></span>
</label></div>
<div class="at-row "><label class="at-text PersonalUrl" id="NVContributionForm2054297-ContactInformation-PersonalUrl"> <small>(Optional)</small><input type="text" autocomplete="on" false="" title="" name="PersonalUrl" value="" maxlength="">
</label></div>
<div class="at-row "><input id="SocialNetworkTrackingId_Value" type="hidden" name="SocialNetworkTrackingId.Value"></div>
<div class="at-row "><input id="SocialNetwork_Value" type="hidden" name="SocialNetwork.Value"></div>
<div class="at-row ">
<div class="at-markup TrackingPixel" id="NVContributionForm2054297-ContactInformation-TrackingPixel" style="display: none;"><img alt=""
src="https://secure.everyaction.com/v1/Track/-s2gGo2bjEu_I1WtWbOBaw2?ms=MVTHeadquarters&formSessionId=eb1d4dbb-cdd3-4ec7-b210-d8b5a5df04d2&bName=chrome&dType=desktop&formVersion=12/12/2024 9:21:45 PM|12/11/2024 10:03:34 PM&fUrl=aHR0cHM6Ly9hY3Rpb24ubWVhbHNvbndoZWVsc2FtZXJpY2Eub3JnL2EvbXYtdHJhbnNwb3J0YXRpb24%2FbXM9TVZUSGVhZHF1YXJ0ZXJz&fRef="
style="display:none"></div>
</div>
</div>
</fieldset>
<fieldset class="at-fieldset PaymentInformation hideStep" id="NVContributionForm2054297-PaymentInformation" style="display: block;">
<legend class="at-legend">Payment</legend>
<div class="at-row">
<div class="at-payment-method-buttons" id="NVContributionForm2054297-PaymentInformation-PaymentMethod">
<div class="at-radio-set at-radio-set-buttons at-radio-set-button-wrap-styling">
<div class="at-btn-radio-wrapper at-credit-card-button-wrapper">
<input id="creditcard_radio_2054297" type="radio" name="PaymentMethod" value="creditcard">
<label for="creditcard_radio_2054297" class="at-btn-radio large" tabindex="0"> Pay with Card </label>
</div>
<div class="at-btn-radio-wrapper at-eft-button-wrapper">
<input id="eft_radio_2054297" type="radio" name="PaymentMethod" value="eft">
<label for="eft_radio_2054297" class="at-btn-radio large" tabindex="0"> Pay with Bank Account </label>
</div>
</div>
</div>
</div>
<div class="at-fields">
<div class="at-row "><label class="at-text at-cc-number" id="NVContributionForm2054297-PaymentInformation-Account">Card Number<div class="cc-type-wrapper vgs-loading-placeholder" style="display: none;">
<div class="cc-type unknown"></div>
<input type="tel" autocomplete="cc-number" title="Credit Card Number" placeholder="•••• •••• •••• ••••" readonly="true">
</div>
<div id="vgs-Account-2054297" class="vgs-cc-iframe-wrapper vgs-input-container vgs-collect-container__empty vgs-collect-container__invalid isEmpty" tabindex="-1"><iframe title="Secure card number input frame"
src="https://js.verygoodvault.com/vgs-collect/2.18.4/lib/index.html#name=Account&placeholder=%E2%80%A2%E2%80%A2%E2%80%A2%E2%80%A2%20%E2%80%A2%E2%80%A2%E2%80%A2%E2%80%A2%20%E2%80%A2%E2%80%A2%E2%80%A2%E2%80%A2%20%E2%80%A2%E2%80%A2%E2%80%A2%E2%80%A2&type=card-number&validations%5B0%5D=validCardNumber&validations%5B1%5D=required&autoComplete=cc-number&formId=randomId1903155696781517279&fieldId=randomId1909446828155863232&createdAt=1734645436555&tnt=dG50dzFwem5sYW0%3D&env=bGl2ZQ%3D%3D&logLevel=default&satellitePort=&vgsCollectSessionId=c57ce7c5-9f6b-41f2-aecd-a5fa91a5a725&css%5BfontSize%5D=.875rem&css%5BfontFamily%5D=monospace&css%5BlineHeight%5D=1&css%5BbackgroundColor%5D=%23fff&css%5B%26%3A%3Aplaceholder%5D%5Bcolor%5D=%23ced4da&css%5B%26%3A%3Aplaceholder%5D%5BfontWeight%5D=bold"
frameborder="0" scrolling="0" allowtransparency="true" id="randomId1909446828155863232" form-id="randomId1903155696781517279"></iframe></div>
</label><label class="at-text at-cc-expiration" id="NVContributionForm2054297-PaymentInformation-ExpirationDate">Expiration Date<div class="vgs-loading-placeholder" style="display: none;">
<input type="tel" autocomplete="cc-exp" title="Expiration Date (MM / YY)" placeholder="MM / YY" readonly="true">
</div>
<div id="vgs-ExpirationDate-2054297" class="vgs-ccexpiration-iframe-wrapper vgs-input-container vgs-collect-container__empty vgs-collect-container__invalid isEmpty"><iframe title="Secure card expiration date input frame"
src="https://js.verygoodvault.com/vgs-collect/2.18.4/lib/index.html#name=ExpirationDate&placeholder=MM%20%2F%20YY&type=card-expiration-date&serializers=W3sibmFtZSI6InNlcGFyYXRlIiwib3B0aW9ucyI6eyJtb250aE5hbWUiOiJFeHBpcmF0aW9uTW9udGgiLCJ5ZWFyTmFtZSI6IkV4cGlyYXRpb25ZZWFyIn19XQ%3D%3D&validations%5B0%5D=validCardExpirationDate&validations%5B1%5D=required&autoComplete=cc-exp&formId=randomId1903155696781517279&fieldId=randomId19042484477619820393&createdAt=1734645436556&tnt=dG50dzFwem5sYW0%3D&env=bGl2ZQ%3D%3D&logLevel=default&satellitePort=&vgsCollectSessionId=c57ce7c5-9f6b-41f2-aecd-a5fa91a5a725&css%5BfontSize%5D=.875rem&css%5BfontFamily%5D=monospace&css%5BlineHeight%5D=1&css%5BbackgroundColor%5D=%23fff&css%5B%26%3A%3Aplaceholder%5D%5Bcolor%5D=%23ced4da&css%5B%26%3A%3Aplaceholder%5D%5BfontWeight%5D=bold"
frameborder="0" scrolling="0" allowtransparency="true" id="randomId19042484477619820393" form-id="randomId1903155696781517279"></iframe></div>
</label><label class="at-text at-cc-csc" id="NVContributionForm2054297-PaymentInformation-SecurityCode">Security Code<div class="vgs-cvv-iframe-wrapper vgs-input-container">
<div class="cvc-type-wrapper">
<div class="cvc-type"></div>
<input type="tel" autocomplete="cc-csc" placeholder="•••" readonly="true" class="vgs-loading-placeholder" style="display: none;">
<div id="vgs-SecurityCode-2054297" class="vgs-collect-container__empty vgs-collect-container__invalid isEmpty"><iframe title="Secure card security code input frame"
src="https://js.verygoodvault.com/vgs-collect/2.18.4/lib/index.html#name=SecurityCode&placeholder=%E2%80%A2%E2%80%A2%E2%80%A2&type=card-security-code&validations%5B0%5D=validCardSecurityCode&validations%5B1%5D=required&autoComplete=cc-csc&formId=randomId1903155696781517279&fieldId=randomId1908428980460675972&createdAt=1734645436557&tnt=dG50dzFwem5sYW0%3D&env=bGl2ZQ%3D%3D&logLevel=default&satellitePort=&vgsCollectSessionId=c57ce7c5-9f6b-41f2-aecd-a5fa91a5a725&css%5BfontSize%5D=.875rem&css%5BfontFamily%5D=monospace&css%5BlineHeight%5D=1&css%5BbackgroundColor%5D=%23fff&css%5B%26%3A%3Aplaceholder%5D%5Bcolor%5D=%23ced4da&css%5B%26%3A%3Aplaceholder%5D%5BfontWeight%5D=bold"
frameborder="0" scrolling="0" allowtransparency="true" id="randomId1908428980460675972" form-id="randomId1903155696781517279" name="vgs-collect-cvv-field"></iframe></div>
</div>
</div>
</label></div>
<div class="at-row ">
<div class="at-markup UpdateMyProfile at-mode-person-only" id="NVContributionForm2054297-PaymentInformation-UpdateMyProfile">
<div class="updateMyProfileSection" style=""><label style="display:inline;"><input type="checkbox" name="updateMyProfile" checked="checked"><span><span class="text">Remember me so that I can use <i>Fast</i><b>Action</b> next
time.</span></span></label></div>
</div>
</div>
<div class="at-row">
<div class="at-eft-accepted-here" style="display: none;">
<label class="account-type-label">Account Type <select title="Account Type" name="bankAccountType" id="bankAccountType" style="width:50%;" class="eft-input">
<option value="Checking">Checking</option>
<option value="Savings">Savings</option>
</select>
</label>
<label class="routing-number-label at-row-half">Routing Number <a class="at-whatsthis" tabindex="0">What's This?</a>
<input type="tel" name="routingNumber" id="routingNumber" placeholder="•••••••••" style="width:100%;" maxlength="9" class="eft-input">
</label>
<label class="account-number-label at-row-half">Account Number <a class="at-whatsthis" tabindex="0">What's This?</a>
<input type="tel" name="bankAccountNumber" id="bankAccountNumber" placeholder="•••••••••••••••••" style="width:100%;" maxlength="17" class="eft-input">
</label>
<label class="confirm-account-number-label at-row-half">Confirm Account Number <input type="tel" name="confirmBankAccountNumber" id="confirmBankAccountNumber" placeholder="•••••••••••••••••" style="width:100%;" maxlength="17"
class="eft-input">
</label>
<label class="at-check authorize-payment-label">
<input type="checkbox" name="authorizePayment" id="authorizePayment" class="eft-input">
<span>I authorize the use of my bank account as a payment method and authorize this organization to debit my bank account via the Automated Clearing House system to fulfill my donation commitment. This authority will remain in effect
until revoked in writing by the account holder.</span>
</label>
</div>
</div>
</div>
</fieldset>
<style>
.at .at-steps li {
width: 33.233333333333334%
}
</style>
<div class="at-form-submit clearfix">
<div class="step-prevNext clearfix">
<div class="prevNext next">
<button class="submitStep btn-at btn-at-primary" style="display: none;">Contribute $103.75</button>
<a tabindex="0" role="button" class="nextStep btn-at btn-at-primary">Next</a>
</div>
<div class="prevNext prev">
<a tabindex="0" role="button" class="prevStep btn-at btn-at-link" style="display: none;">Back</a>
</div>
<div class="at-markup secure-processing-div" style="display: none;">
<label class="secure-processing-label at-text"> Your donation will be securely processed.<div class="glyphicons glyphicons-lock" aria-hidden="true"></div>
</label>
</div>
</div> <input type="submit" value="Contribute $103.75" class="at-submit btn-at btn-at-primary" style="visibility: hidden; position: absolute;">
<div class="at-markup secure-processing-single-step-div">
<label class="secure-processing-label at-text"> Your donation will be securely processed.<div class="glyphicons glyphicons-lock" aria-hidden="true"></div>
</label>
</div>
<footer class="at-markup FooterHtml clearfix" style="display: none;">
<p>To donate by phone, call the Development team at 703.548.5558</p>
<p>
<a href="https://www.mealsonwheelsamerica.org/privacy-policy" target="_blank">Privacy Policy and Donation Guidelines</a> | <a href="https://www.mealsonwheelsamerica.org/take-action/donate/individual-giving/give-stock" target="_blank">Donate Stock</a>
</p>
<p>If you prefer to donate by mail, please send payment to:<br> Meals on Wheels America, P.O. Box 791568, Baltimore, MD 21279-1568</p>
<p>Questions? Contact us at <a href="mailto:development@mealsonwheelsamerica.org">development@mealsonwheelsamerica.org</a>.</p>
<p>Meals on Wheels America is a registered 501(c)(3) private, nonprofit organization.<br> All donations are tax-deductible to the fullest extent of the law.<br> Federal identification number: 23-7447812</p>
<p><img alt="" src="https://nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/112108/images/aC-seal-vertical-w-url.png" style="width: 57px; height: 100px;"> <img alt=""
src="https://nvlupin.blob.core.windows.net/images/van/MOWA/MOWA/1/112108/images/4Star%2B125x125.jpg" style="width: 100px; height: 100px;"></p>
</footer>
</div>
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MV Transportation AMERICA'S SENIORS NEED YOU Your gift will help us support the local programs that keep seniors safe and living independently nationwide. ? Take future action with a single click. Log in or Sign up for FastAction 1. Amount 2. Details 3. Payment Amount One-Time Monthly Consider giving monthly $20 $50 $100 $250 $500 Other $ I'd like to help cover the transaction fees for my donation. My total amount will be $103.75. I'd like to make this contribution in honor or in memory of someone Is this an Honorary or Memorial Gift? In honor of In memory of Honoree Name I'd like to notify someone of this contribution Who would you like to notify? Please choose either email or mail to notify the recipient. 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To donate by phone, call the Development team at 703.548.5558 Privacy Policy and Donation Guidelines | Donate Stock If you prefer to donate by mail, please send payment to: Meals on Wheels America, P.O. Box 791568, Baltimore, MD 21279-1568 Questions? Contact us at development@mealsonwheelsamerica.org. Meals on Wheels America is a registered 501(c)(3) private, nonprofit organization. All donations are tax-deductible to the fullest extent of the law. Federal identification number: 23-7447812 SHOW YOUR SUPPORT WITH A SINGLE CLICK Autofill forms quickly and securely with FastAction Sign up with your email address Already have a FastAction account? Log in By clicking "Log in," I confirm that I agree with the FastAction terms of service and privacy policy. × SHOW YOUR SUPPORT WITH A SINGLE CLICK Autofill forms quickly and securely with FastAction Log in with your email address Don't have a FastAction account yet? Sign up By clicking "Sign up," I confirm that I agree with the FastAction terms of service and privacy policy. × SHOW YOUR SUPPORT WITH A SINGLE CLICK Autofill forms quickly and securely with FastAction Sign up with your email address Already have a FastAction account? Log in By clicking "Log in," I confirm that I agree with the FastAction terms of service and privacy policy. × SHOW YOUR SUPPORT WITH A SINGLE CLICK Autofill forms quickly and securely with FastAction Log in with your email address Don't have a FastAction account yet? Sign up By clicking "Sign up," I confirm that I agree with the FastAction terms of service and privacy policy. × To donate by phone, call the Development team at 703.548.5558 Privacy Policy and Donation Guidelines | Donate Stock If you prefer to donate by mail, please send payment to: Meals on Wheels America, P.O. Box 791568, Baltimore, MD 21279-1568 Questions? Send an email to our Development team. . Meals on Wheels America is a registered 501(c)(3) private, nonprofit organization. All donations are tax-deductible to the fullest extent of the law. Federal identification number: 23-7447812 Preview ×