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Submission: On October 25 via api from US — Scanned from IT
Submission: On October 25 via api from US — Scanned from IT
Form analysis 1 forms found in the DOM
<form class="pt-4">
<div class="grid grid-cols-1 sm:grid-cols-1 md:grid-cols-2 gap-6 lg:gap-8">
<div class="sm:col-span-2">
<div class="mb-4"><select class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName">
<option value="" disabled="" selected="">Select Campaign</option>
<option value="John">In support of Infrastructure at Chinmaya University</option>
<option value="Jane">Chinmaya Sankaram 2024</option>
<option value="Doe">In support of General Funding of Chinmaya University</option>
<option value="Jane">In support of Scholarships at Chinmaya University</option>
<option value="Doe">In support of Chinmaya Naada Bindu General Funding</option>
<option value="Jane">In support of Crowdfunding</option>
<option value="Doe">In Gratitude for the VTFL App</option>
</select></div>
</div>
</div>
<div class="grid grid-cols-1 md:grid-cols-2 gap-6 lg:gap-8 pt-4">
<div>
<div class="text-[#2a2d60]">First name</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName" placeholder="Your first name...">
</div>
<div>
<div class="text-[#2a2d60]">Last Name</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder="Your Last name...">
</div>
<div>
<div class="text-[#2a2d60]">Gender</div> <select class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName">
<option value="" disabled="" selected="">Gender</option>
<option value="John">Male</option>
<option value="Jane">Female</option>
<option value="Doe">Other</option>
</select>
</div>
<div>
<div class="text-[#2a2d60]">Nationality</div> <select class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName">
<option value="" disabled="" selected="">Nationality</option>
<option value="v1">US</option>
<option value="v2">UK</option>
<option value="v3">India</option>
<option value="v4">EU</option>
<option value="v5">Australia</option>
<option value="v6">New Zealand</option>
<option value="v7">Singapore</option>
<option value="v8">Others</option>
</select>
</div>
</div>
<div class="grid grid-cols-1 gap-6 lg:gap-8 pt-6">
<div class="sm:col-span-2">
<div class="text-[#2a2d60]">Select Currency</div>
<div class="text-xs pt-2">(Even though you will specify a USD amount here, your credit card will be billed in the currency depending on the country of issue e.g. US$ for US cards, GBP for UK cards, Dinars for UAE, etc)</div>
<div class="flex items-center pt-2"><input type="checkbox" id="currency" name="currency" value="v1"> <label for="currency" class="text-sm pl-2">US dollar</label></div>
</div>
</div>
<div class="grid grid-cols-1 md:grid-cols-2 gap-6 lg:gap-8 pt-4">
<div>
<div class="text-[#2a2d60]">Address</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName" placeholder="Address Line 1...">
</div>
<div>
<div class="text-[#2a2d60] pb-6"></div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder="Address Line 2...">
</div>
<div>
<div class="text-[#2a2d60]">City</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName" placeholder="city">
</div>
<div>
<div class="text-[#2a2d60]">State</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder="state">
</div>
<div>
<div class="text-[#2a2d60]">Country</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName" placeholder="country">
</div>
<div>
<div class="text-[#2a2d60]">Zipcode</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder="Zipcode">
</div>
<div>
<div class="text-[#2a2d60]">Phone Number</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName" placeholder="Phone Number">
</div>
<div>
<div class="text-[#2a2d60]">Email</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder="email">
</div>
<div>
<div class="text-[#2a2d60]">Who Referred you to this donation site?</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName"
placeholder="">
<div class="text-xs pt-1">(By sharing their name and email, you will give us a chance to thank them)</div>
</div>
<div>
<div class="text-[#2a2d60]">Email of the person who referred you</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName"
placeholder="">
</div>
<div>
<div class="text-[#2a2d60]">Chinmaya Center</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formFirstName" placeholder="">
</div>
<div>
<div class="text-[#2a2d60]">Remarks</div> <input type="text" class="block w-full text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder="">
</div>
</div>
<div class="grid grid-cols-1 gap-6 lg:gap-8 pt-6">
<div class="sm:col-span-2">
<div class="text-[#2a2d60] flex items-center">Amount <input type="text" class="block w-36 text-sm py-2 px-4 border-b border-[#24245A] focus:outline-none focus:border-b focus:ring-transparent" id="formLastName" placeholder=""></div>
<div class="text-xs pt-4">$ USD (Even though you will specify a USD amount here, your credit card will be billed in the currency depending on the country of issue e.g. US$ for US cards, GBP for UK cards, Dinars for UAE, etc)</div>
</div>
</div>
<div class="mt-8 flex justify-center"><button type="submit" class="py-3 px-10 rounded-md text-baseitems-center justify-center bg-[#24245A] text-white text-sm bg-blu-200 hover:bg-blu-100 transition-all duration-500 font-medium">Proceed to
payment</button></div>
</form>Text Content
* Home Thank you for your interest in making a donation JOIN THE MOVEMENT Donations on this page will be remitted to Chinmaya Education Foundation, Inc. Attn: Tina Smith, 5206 Gateway Center, Ste. 100, Flint, MI 48507 We are legally required to collect some data from all donors. These fields are marked with an asterix and are mandatory before we can process your donation Select CampaignIn support of Infrastructure at Chinmaya UniversityChinmaya Sankaram 2024In support of General Funding of Chinmaya UniversityIn support of Scholarships at Chinmaya UniversityIn support of Chinmaya Naada Bindu General FundingIn support of CrowdfundingIn Gratitude for the VTFL App First name Last Name Gender GenderMaleFemaleOther Nationality NationalityUSUKIndiaEUAustraliaNew ZealandSingaporeOthers Select Currency (Even though you will specify a USD amount here, your credit card will be billed in the currency depending on the country of issue e.g. US$ for US cards, GBP for UK cards, Dinars for UAE, etc) US dollar Address City State Country Zipcode Phone Number Email Who Referred you to this donation site? (By sharing their name and email, you will give us a chance to thank them) Email of the person who referred you Chinmaya Center Remarks Amount $ USD (Even though you will specify a USD amount here, your credit card will be billed in the currency depending on the country of issue e.g. US$ for US cards, GBP for UK cards, Dinars for UAE, etc) Proceed to payment Welcome and open yourself to your truest love this year with us! with the release process. * * * CONTACT US * Adi Sankara Nilayam, Adi Sankara Marg, Veliyanad, PO, Arakkunnam, Kerala 682313 * cuglobal@cvv.ac.in * Tel: +91 7720839000 * www.cvv.ac.in Privacy Policy | Terms of Services | Sitemap © 2024 Chinmaya Vishwa Vidyapeeth. Designed By Teknika Solutions