supportgaza.efe.org
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20.57.32.38
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URL:
https://supportgaza.efe.org/
Submission: On March 23 via api from US — Scanned from US
Submission: On March 23 via api from US — Scanned from US
Form analysis 3 forms found in the DOM
Name: wf-form-Email — GET
<form id="wf-form-Email" name="wf-form-Email" data-name="Email" method="get" data-wf-page-id="64e46aa877b1c2da838ced1c" data-wf-element-id="7a85152c-0880-9285-74b7-590cf7aa2364" aria-label="Email"><input type="email"
class="c_form_input popup w-input" maxlength="256" name="Email" data-name="Email" placeholder="Enter your Email" id="Email-4" required=""><input type="submit" value="Sign Up" data-wait="Please wait..." class="button-primary pop w-button"></form>POST https://www.tfaforms.com/api_v2/workflow/processor
<form method="post" action="https://www.tfaforms.com/api_v2/workflow/processor" class="hintsBelow labelsAbove" id="4981255" role="form" aria-label="Form">
<div class="oneField field-container-D wf-acl-hidden" id="tfa_3320-D">
<label id="tfa_3320-L" class="label preField " for="tfa_3320">Initiative ID</label><br>
<div class="inputWrapper"><input type="text" id="tfa_3320" name="tfa_3320" value="701Rg000008QPW3IAO" title="Initiative ID" class=""></div>
</div>
<div id="tfa_2579" class="section group">
<div id="tfa_2602" class="section inline group" style="margin-bottom:20px;"><label for="name-4" class="pay-section-label first">Choose Interval</label>
<div class="htmlSection" id="tfa_3230">
<div class="htmlContent" id="tfa_3230-HTML"> </div>
</div>
<div id="tfa_2610" class="section group">
<div class="htmlSection" id="tfa_2609">
<div class="htmlContent" id="tfa_2609-HTML">
<div align="right"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><b></b></span>
</div>
</div>
</div>
</div>
<div class="oneField field-container-D labelsRemoved " id="tfa_2576-D" role="radiogroup" aria-labelledby="tfa_2576-L" data-tfa-labelledby="-L tfa_2576-L">
<div class="inputWrapper">
<table id="tfa_2576" class="choices columns2 required ms-pill-wrap">
<tbody>
<tr>
<td><span class="oneChoice maskControl"><input type="radio" value="tfa_2577" class="" checked="" data-default-value="true" id="tfa_2577" name="tfa_2576" aria-required="true" data-conditionals="#tfa_3235" aria-labelledby="tfa_2577-L"
data-tfa-labelledby="tfa_2576-L tfa_2577-L" data-tfa-parent-id="tfa_2576"><label class="label postField" id="tfa_2577-L" for="tfa_2577"><span class="input-radio-faux"></span><span style=""
class="ms-pill-label w-form-label">One-Time</span></label></span></td>
<td><span class="oneChoice maskControl"><input type="radio" value="tfa_2578" class="" id="tfa_2578" name="tfa_2576" aria-required="true" data-conditionals="#tfa_3233" aria-labelledby="tfa_2578-L"
data-tfa-labelledby="tfa_2576-L tfa_2578-L" data-tfa-parent-id="tfa_2576"><label class="label postField" id="tfa_2578-L" for="tfa_2578"><span class="input-radio-faux"></span><span style=""
class="ms-pill-label w-form-label">Monthly</span></label></span></td>
</tr>
</tbody>
</table>
</div>
</div>
<div id="tfa_2597" class="section inline group">
<div class="oneField field-container-D labelsRemoved " id="tfa_3235-D">
<div class="inputWrapper">
<div class="delimiter delimiterBefore" id="tfa_3235-DB"><span style="font-weight: 700;"><span style="font-size: 25pt; line-height: 35.6667px; font-family: "Italia Std Medium", serif; color: rgb(153, 28, 13);"></span></span>
</div>
<input aria-required="true" type="text" id="tfa_3235" name="tfa_3235" value="" min="1" max="999999999" data-condition="`#tfa_2577`" title="Dollar Amount Once" class="validate-integer calc-USDSingle required c_form_input pay w-input"
placeholder="Please enter an amount (USD)">
<div class="delimiter delimiterAfter" id="tfa_3235-DA"></div>
</div>
</div>
<div class="oneField field-container-D labelsRemoved offstate" id="tfa_3233-D">
<div class="inputWrapper">
<div class="delimiter delimiterBefore" id="tfa_3233-DB"><span style="font-weight: 700;"><span style="font-size: 25pt; line-height: 35.6667px; font-family: "Italia Std Medium", serif; color: rgb(153, 28, 13);"></span></span>
</div>
<input aria-required="true" type="text" id="tfa_3233" name="tfa_3233" value="" min="1" max="999999999" data-condition="`#tfa_2578`" title="Dollar Amount Monthly" class="validate-integer calc-USDMonthly required c_form_input pay w-input"
placeholder="Please enter an amount (USD)" disabled="">
<div class="delimiter delimiterAfter" id="tfa_3233-DA"></div>
</div>
</div>
</div>
</div>
<div class="" id="tfa_3252">
<div class="htmlContent" id="tfa_3252-HTML">
<p class="MsoNormal"><span class="MsoHyperlink"><span><a target="_blank" href="Euro.php"><span style="margin-top:5px;">Click here to give in Euros</span></a></span></span></p>
</div>
</div>
</div>
<fieldset id="tfa_2232" class="section">
<label for="tfa_2238" class="pay-section-label">Your Details</label>
<div class="oneField field-container-D labelsAbove " id="tfa_2238-D">
<label id="tfa_2238-L" class="label preField reqMark" for="tfa_2238"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2238" name="tfa_2238" value="" title="First name" class="calc-FIRST required c_form_input pay w-input" placeholder="First name"></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2239-D">
<label id="tfa_2239-L" class="label preField reqMark" for="tfa_2239"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2239" name="tfa_2239" value="" title="Last name" class="calc-LAST required c_form_input pay w-input" placeholder="Last name"></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2241-D">
<label id="tfa_2241-L" class="label preField reqMark" for="tfa_2241"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2241" name="tfa_2241" value="" title="Email" class="validate-email required c_form_input pay w-input" placeholder="Email"></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2242-D">
<label id="tfa_2242-L" class="label preField reqMark" for="tfa_2242"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span>
</label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2242" name="tfa_2242" value="" title="Address " class="required c_form_input pay w-input" placeholder="Address"></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2243-D">
<label id="tfa_2243-L" class="label preField " for="tfa_2243"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span><span
style="box-sizing: border-box; font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; color: rgb(150, 137, 137); user-select: auto;"></span><span
style="font-family: "Fira Sans", sans-serif; font-size: 16px; color: rgb(150, 137, 137); user-select: auto;"></span></label><br>
<div class="inputWrapper"><input type="text" id="tfa_2243" name="tfa_2243" value="" title="Apartment/Suite # (Optional)" class="c_form_input pay w-input" placeholder="Apartment/Suite # (Optional)"></div>
</div>
<div id="tfa_2559" class="section ">
<div class="oneField field-container-D labelsAbove " id="tfa_2244-D">
<div class="oneField field-container-D " id="tfa_2245-D">
<label id="tfa_2245-L" class="label preField reqMark" for="tfa_2245"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><select aria-required="true" id="tfa_2245" name="tfa_2245" title="Country" class="required c_form_input pay w-input">
<option value="">Country</option>
<option value="tfa_2469" id="tfa_2469" class="">United States</option>
<option value="tfa_2283" id="tfa_2283" class="">Canada</option>
<option value="tfa_2246" id="tfa_2246" class="">Afghanistan</option>
<option value="tfa_2247" id="tfa_2247" class="">Albania</option>
<option value="tfa_2248" id="tfa_2248" class="">Algeria</option>
<option value="tfa_2249" id="tfa_2249" class="">American Samoa</option>
<option value="tfa_2250" id="tfa_2250" class="">Andorra</option>
<option value="tfa_2251" id="tfa_2251" class="">Angola</option>
<option value="tfa_2252" id="tfa_2252" class="">Anguilla</option>
<option value="tfa_2253" id="tfa_2253" class="">Antarctica</option>
<option value="tfa_2254" id="tfa_2254" class="">Antigua and Barbuda</option>
<option value="tfa_2255" id="tfa_2255" class="">Argentina</option>
<option value="tfa_2256" id="tfa_2256" class="">Armenia</option>
<option value="tfa_2257" id="tfa_2257" class="">Aruba</option>
<option value="tfa_2258" id="tfa_2258" class="">Australia</option>
<option value="tfa_2259" id="tfa_2259" class="">Austria</option>
<option value="tfa_2260" id="tfa_2260" class="">Azerbaijan</option>
<option value="tfa_2261" id="tfa_2261" class="">Bahamas</option>
<option value="tfa_2262" id="tfa_2262" class="">Bahrain</option>
<option value="tfa_2263" id="tfa_2263" class="">Bangladesh</option>
<option value="tfa_2264" id="tfa_2264" class="">Barbados</option>
<option value="tfa_2265" id="tfa_2265" class="">Belarus</option>
<option value="tfa_2266" id="tfa_2266" class="">Belgium</option>
<option value="tfa_2267" id="tfa_2267" class="">Belize</option>
<option value="tfa_2268" id="tfa_2268" class="">Benin</option>
<option value="tfa_2269" id="tfa_2269" class="">Bermuda</option>
<option value="tfa_2270" id="tfa_2270" class="">Bhutan</option>
<option value="tfa_2271" id="tfa_2271" class="">Bolivia</option>
<option value="tfa_2272" id="tfa_2272" class="">Bosnia and Herzegovina</option>
<option value="tfa_2273" id="tfa_2273" class="">Botswana</option>
<option value="tfa_2274" id="tfa_2274" class="">Bouvet Island</option>
<option value="tfa_2275" id="tfa_2275" class="">Brazil</option>
<option value="tfa_2276" id="tfa_2276" class="">British Indian Ocean Territory</option>
<option value="tfa_2277" id="tfa_2277" class="">Brunei</option>
<option value="tfa_2278" id="tfa_2278" class="">Bulgaria</option>
<option value="tfa_2279" id="tfa_2279" class="">Burkina Faso</option>
<option value="tfa_2280" id="tfa_2280" class="">Burundi</option>
<option value="tfa_2281" id="tfa_2281" class="">Cambodia</option>
<option value="tfa_2282" id="tfa_2282" class="">Cameroon</option>
<option value="tfa_2284" id="tfa_2284" class="">Cape Verde</option>
<option value="tfa_2285" id="tfa_2285" class="">Cayman Islands</option>
<option value="tfa_2286" id="tfa_2286" class="">Central African Republic</option>
<option value="tfa_2287" id="tfa_2287" class="">Chad</option>
<option value="tfa_2288" id="tfa_2288" class="">Chile</option>
<option value="tfa_2289" id="tfa_2289" class="">China</option>
<option value="tfa_2290" id="tfa_2290" class="">Christmas Island</option>
<option value="tfa_2291" id="tfa_2291" class="">Cocos ( Keeling ) Islands</option>
<option value="tfa_2292" id="tfa_2292" class="">Colombia</option>
<option value="tfa_2293" id="tfa_2293" class="">Comoros</option>
<option value="tfa_2294" id="tfa_2294" class="">Congo</option>
<option value="tfa_2295" id="tfa_2295" class="">Cook Islands</option>
<option value="tfa_2296" id="tfa_2296" class="">Costa Rica</option>
<option value="tfa_2297" id="tfa_2297" class="">Côte d ' Ivoire</option>
<option value="tfa_2298" id="tfa_2298" class="">Croatia ( Hrvatska )</option>
<option value="tfa_2299" id="tfa_2299" class="">Cuba</option>
<option value="tfa_2300" id="tfa_2300" class="">Cyprus</option>
<option value="tfa_2301" id="tfa_2301" class="">Czech Republic</option>
<option value="tfa_2302" id="tfa_2302" class="">Congo ( DRC )</option>
<option value="tfa_2303" id="tfa_2303" class="">Denmark</option>
<option value="tfa_2304" id="tfa_2304" class="">Djibouti</option>
<option value="tfa_2305" id="tfa_2305" class="">Dominica</option>
<option value="tfa_2306" id="tfa_2306" class="">Dominican Republic</option>
<option value="tfa_2307" id="tfa_2307" class="">East Timor</option>
<option value="tfa_2308" id="tfa_2308" class="">Ecuador</option>
<option value="tfa_2309" id="tfa_2309" class="">Egypt</option>
<option value="tfa_2310" id="tfa_2310" class="">El Salvador</option>
<option value="tfa_2311" id="tfa_2311" class="">Equatorial Guinea</option>
<option value="tfa_2312" id="tfa_2312" class="">Eritrea</option>
<option value="tfa_2313" id="tfa_2313" class="">Estonia</option>
<option value="tfa_2314" id="tfa_2314" class="">Ethiopia</option>
<option value="tfa_2315" id="tfa_2315" class="">Falkland Islands ( Islas Malvinas )</option>
<option value="tfa_2316" id="tfa_2316" class="">Faroe Islands</option>
<option value="tfa_2317" id="tfa_2317" class="">Fiji Islands</option>
<option value="tfa_2318" id="tfa_2318" class="">Finland</option>
<option value="tfa_2319" id="tfa_2319" class="">France</option>
<option value="tfa_2320" id="tfa_2320" class="">French Guiana</option>
<option value="tfa_2321" id="tfa_2321" class="">French Polynesia</option>
<option value="tfa_2322" id="tfa_2322" class="">French Southern and Antarctic Lands</option>
<option value="tfa_2323" id="tfa_2323" class="">Gabon</option>
<option value="tfa_2324" id="tfa_2324" class="">Gambia</option>
<option value="tfa_2325" id="tfa_2325" class="">Georgia</option>
<option value="tfa_2326" id="tfa_2326" class="">Germany</option>
<option value="tfa_2327" id="tfa_2327" class="">Ghana</option>
<option value="tfa_2328" id="tfa_2328" class="">Gibraltar</option>
<option value="tfa_2329" id="tfa_2329" class="">Greece</option>
<option value="tfa_2330" id="tfa_2330" class="">Greenland</option>
<option value="tfa_2331" id="tfa_2331" class="">Grenada</option>
<option value="tfa_2332" id="tfa_2332" class="">Guadeloupe</option>
<option value="tfa_2333" id="tfa_2333" class="">Guam</option>
<option value="tfa_2334" id="tfa_2334" class="">Guatemala</option>
<option value="tfa_2335" id="tfa_2335" class="">Guinea</option>
<option value="tfa_2336" id="tfa_2336" class="">Guinea-Bissau</option>
<option value="tfa_2337" id="tfa_2337" class="">Guyana</option>
<option value="tfa_2338" id="tfa_2338" class="">Haiti</option>
<option value="tfa_2339" id="tfa_2339" class="">Heard Island and McDonald Islands</option>
<option value="tfa_2340" id="tfa_2340" class="">Honduras</option>
<option value="tfa_2341" id="tfa_2341" class="">Hong Kong SAR</option>
<option value="tfa_2342" id="tfa_2342" class="">Hungary</option>
<option value="tfa_2343" id="tfa_2343" class="">Iceland</option>
<option value="tfa_2344" id="tfa_2344" class="">India</option>
<option value="tfa_2345" id="tfa_2345" class="">Indonesia</option>
<option value="tfa_2346" id="tfa_2346" class="">Iran</option>
<option value="tfa_2347" id="tfa_2347" class="">Iraq</option>
<option value="tfa_2348" id="tfa_2348" class="">Ireland</option>
<option value="tfa_2349" id="tfa_2349" class="">Israel</option>
<option value="tfa_2350" id="tfa_2350" class="">Italy</option>
<option value="tfa_2351" id="tfa_2351" class="">Jamaica</option>
<option value="tfa_2352" id="tfa_2352" class="">Japan</option>
<option value="tfa_2353" id="tfa_2353" class="">Jordan</option>
<option value="tfa_2354" id="tfa_2354" class="">Kazakhstan</option>
<option value="tfa_2355" id="tfa_2355" class="">Kenya</option>
<option value="tfa_2356" id="tfa_2356" class="">Kiribati</option>
<option value="tfa_2357" id="tfa_2357" class="">Korea</option>
<option value="tfa_2358" id="tfa_2358" class="">Kuwait</option>
<option value="tfa_2359" id="tfa_2359" class="">Kyrgyzstan</option>
<option value="tfa_2360" id="tfa_2360" class="">Laos</option>
<option value="tfa_2361" id="tfa_2361" class="">Latvia</option>
<option value="tfa_2362" id="tfa_2362" class="">Lebanon</option>
<option value="tfa_2363" id="tfa_2363" class="">Lesotho</option>
<option value="tfa_2364" id="tfa_2364" class="">Liberia</option>
<option value="tfa_2365" id="tfa_2365" class="">Libya</option>
<option value="tfa_2366" id="tfa_2366" class="">Liechtenstein</option>
<option value="tfa_2367" id="tfa_2367" class="">Lithuania</option>
<option value="tfa_2368" id="tfa_2368" class="">Luxembourg</option>
<option value="tfa_2369" id="tfa_2369" class="">Macao SAR</option>
<option value="tfa_2370" id="tfa_2370" class="">Macedonia, Former Yugoslav Republic of</option>
<option value="tfa_2371" id="tfa_2371" class="">Madagascar</option>
<option value="tfa_2372" id="tfa_2372" class="">Malawi</option>
<option value="tfa_2373" id="tfa_2373" class="">Malaysia</option>
<option value="tfa_2374" id="tfa_2374" class="">Maldives</option>
<option value="tfa_2375" id="tfa_2375" class="">Mali</option>
<option value="tfa_2376" id="tfa_2376" class="">Malta</option>
<option value="tfa_2377" id="tfa_2377" class="">Marshall Islands</option>
<option value="tfa_2378" id="tfa_2378" class="">Martinique</option>
<option value="tfa_2379" id="tfa_2379" class="">Mauritania</option>
<option value="tfa_2380" id="tfa_2380" class="">Mauritius</option>
<option value="tfa_2381" id="tfa_2381" class="">Mayotte</option>
<option value="tfa_2382" id="tfa_2382" class="">Mexico</option>
<option value="tfa_2383" id="tfa_2383" class="">Micronesia</option>
<option value="tfa_2384" id="tfa_2384" class="">Moldova</option>
<option value="tfa_2385" id="tfa_2385" class="">Monaco</option>
<option value="tfa_2386" id="tfa_2386" class="">Mongolia</option>
<option value="tfa_2387" id="tfa_2387" class="">Montserrat</option>
<option value="tfa_2388" id="tfa_2388" class="">Morocco</option>
<option value="tfa_2389" id="tfa_2389" class="">Mozambique</option>
<option value="tfa_2390" id="tfa_2390" class="">Myanmar</option>
<option value="tfa_2391" id="tfa_2391" class="">Namibia</option>
<option value="tfa_2392" id="tfa_2392" class="">Nauru</option>
<option value="tfa_2393" id="tfa_2393" class="">Nepal</option>
<option value="tfa_2394" id="tfa_2394" class="">Netherlands</option>
<option value="tfa_2395" id="tfa_2395" class="">Netherlands Antilles</option>
<option value="tfa_2396" id="tfa_2396" class="">New Caledonia</option>
<option value="tfa_2397" id="tfa_2397" class="">New Zealand</option>
<option value="tfa_2398" id="tfa_2398" class="">Nicaragua</option>
<option value="tfa_2399" id="tfa_2399" class="">Niger</option>
<option value="tfa_2400" id="tfa_2400" class="">Nigeria</option>
<option value="tfa_2401" id="tfa_2401" class="">Niue</option>
<option value="tfa_2402" id="tfa_2402" class="">Norfolk Island</option>
<option value="tfa_2403" id="tfa_2403" class="">North Korea</option>
<option value="tfa_2404" id="tfa_2404" class="">Northern Mariana Islands</option>
<option value="tfa_2405" id="tfa_2405" class="">Norway</option>
<option value="tfa_2406" id="tfa_2406" class="">Oman</option>
<option value="tfa_2407" id="tfa_2407" class="">Pakistan</option>
<option value="tfa_2408" id="tfa_2408" class="">Palau</option>
<option value="tfa_2409" id="tfa_2409" class="">Panama</option>
<option value="tfa_2410" id="tfa_2410" class="">Papua New Guinea</option>
<option value="tfa_2411" id="tfa_2411" class="">Paraguay</option>
<option value="tfa_2412" id="tfa_2412" class="">Peru</option>
<option value="tfa_2413" id="tfa_2413" class="">Philippines</option>
<option value="tfa_2414" id="tfa_2414" class="">Pitcairn Islands</option>
<option value="tfa_2415" id="tfa_2415" class="">Poland</option>
<option value="tfa_2416" id="tfa_2416" class="">Portugal</option>
<option value="tfa_2417" id="tfa_2417" class="">Puerto Rico</option>
<option value="tfa_2418" id="tfa_2418" class="">Qatar</option>
<option value="tfa_2419" id="tfa_2419" class="">Reunion</option>
<option value="tfa_2420" id="tfa_2420" class="">Romania</option>
<option value="tfa_2421" id="tfa_2421" class="">Russia</option>
<option value="tfa_2422" id="tfa_2422" class="">Rwanda</option>
<option value="tfa_2423" id="tfa_2423" class="">Samoa</option>
<option value="tfa_2424" id="tfa_2424" class="">San Marino</option>
<option value="tfa_2425" id="tfa_2425" class="">São Tomé and Prìncipe</option>
<option value="tfa_2426" id="tfa_2426" class="">Saudi Arabia</option>
<option value="tfa_2427" id="tfa_2427" class="">Senegal</option>
<option value="tfa_2428" id="tfa_2428" class="">Serbia and Montenegro</option>
<option value="tfa_2429" id="tfa_2429" class="">Seychelles</option>
<option value="tfa_2430" id="tfa_2430" class="">Sierra Leone</option>
<option value="tfa_2431" id="tfa_2431" class="">Singapore</option>
<option value="tfa_2432" id="tfa_2432" class="">Slovakia</option>
<option value="tfa_2433" id="tfa_2433" class="">Slovenia</option>
<option value="tfa_2434" id="tfa_2434" class="">Solomon Islands</option>
<option value="tfa_2435" id="tfa_2435" class="">Somalia</option>
<option value="tfa_2436" id="tfa_2436" class="">South Africa</option>
<option value="tfa_2437" id="tfa_2437" class="">South Georgia and the South Sandwich Islands</option>
<option value="tfa_2438" id="tfa_2438" class="">Spain</option>
<option value="tfa_2439" id="tfa_2439" class="">Sri Lanka</option>
<option value="tfa_2440" id="tfa_2440" class="">St. Helena</option>
<option value="tfa_2441" id="tfa_2441" class="">St. Kitts and Nevis</option>
<option value="tfa_2442" id="tfa_2442" class="">St. Lucia</option>
<option value="tfa_2443" id="tfa_2443" class="">St. Pierre and Miquelon</option>
<option value="tfa_2444" id="tfa_2444" class="">St. Vincent and the Grenadines</option>
<option value="tfa_2445" id="tfa_2445" class="">Sudan</option>
<option value="tfa_2446" id="tfa_2446" class="">Suriname</option>
<option value="tfa_2447" id="tfa_2447" class="">Svalbard and Jan Mayen</option>
<option value="tfa_2448" id="tfa_2448" class="">Swaziland</option>
<option value="tfa_2449" id="tfa_2449" class="">Sweden</option>
<option value="tfa_2450" id="tfa_2450" class="">Switzerland</option>
<option value="tfa_2451" id="tfa_2451" class="">Syria</option>
<option value="tfa_2452" id="tfa_2452" class="">Taiwan</option>
<option value="tfa_2453" id="tfa_2453" class="">Tajikistan</option>
<option value="tfa_2454" id="tfa_2454" class="">Tanzania</option>
<option value="tfa_2455" id="tfa_2455" class="">Thailand</option>
<option value="tfa_2456" id="tfa_2456" class="">Togo</option>
<option value="tfa_2457" id="tfa_2457" class="">Tokelau</option>
<option value="tfa_2458" id="tfa_2458" class="">Tonga</option>
<option value="tfa_2459" id="tfa_2459" class="">Trinidad and Tobago</option>
<option value="tfa_2460" id="tfa_2460" class="">Tunisia</option>
<option value="tfa_2461" id="tfa_2461" class="">Turkey</option>
<option value="tfa_2462" id="tfa_2462" class="">Turkmenistan</option>
<option value="tfa_2463" id="tfa_2463" class="">Turks and Caicos Islands</option>
<option value="tfa_2464" id="tfa_2464" class="">Tuvalu</option>
<option value="tfa_2465" id="tfa_2465" class="">Uganda</option>
<option value="tfa_2466" id="tfa_2466" class="">Ukraine</option>
<option value="tfa_2467" id="tfa_2467" class="">United Arab Emirates</option>
<option value="tfa_2468" id="tfa_2468" class="">United Kingdom</option>
<option value="tfa_2470" id="tfa_2470" class="">United States Minor Outlying Islands</option>
<option value="tfa_2471" id="tfa_2471" class="">Uruguay</option>
<option value="tfa_2472" id="tfa_2472" class="">Uzbekistan</option>
<option value="tfa_2473" id="tfa_2473" class="">Vanuatu</option>
<option value="tfa_2474" id="tfa_2474" class="">Vatican City</option>
<option value="tfa_2475" id="tfa_2475" class="">Venezuela</option>
<option value="tfa_2476" id="tfa_2476" class="">Viet Nam</option>
<option value="tfa_2477" id="tfa_2477" class="">Virgin Islands ( British )</option>
<option value="tfa_2478" id="tfa_2478" class="">Virgin Islands</option>
<option value="tfa_2479" id="tfa_2479" class="">Wallis and Futuna</option>
<option value="tfa_2480" id="tfa_2480" class="">Yemen</option>
<option value="tfa_2481" id="tfa_2481" class="">Zambia</option>
<option value="tfa_2482" id="tfa_2482" class="">Zimbabwe</option>
</select></div>
</div>
<div class="oneField field-container-D " id="tfa_2483-D">
<label id="tfa_2483-L" class="label preField " for="tfa_2483"><span style=""></span></label><br>
<div class="inputWrapper"><select id="tfa_2483" name="tfa_2483" title="State/Province" class="c_form_input pay w-input" placeholder="">
<option value="">State/Province</option>
<option value="tfa_2484" id="tfa_2484" class="">Alabama</option>
<option value="tfa_2485" id="tfa_2485" class="">Alaska</option>
<option value="tfa_2486" id="tfa_2486" class="">Arizona</option>
<option value="tfa_2487" id="tfa_2487" class="">Arkansas</option>
<option value="tfa_2488" id="tfa_2488" class="">California</option>
<option value="tfa_2489" id="tfa_2489" class="">Colorado</option>
<option value="tfa_2490" id="tfa_2490" class="">Connecticut</option>
<option value="tfa_2491" id="tfa_2491" class="">Delaware</option>
<option value="tfa_2492" id="tfa_2492" class="">District Of Columbia</option>
<option value="tfa_2493" id="tfa_2493" class="">Florida</option>
<option value="tfa_2494" id="tfa_2494" class="">Georgia</option>
<option value="tfa_2495" id="tfa_2495" class="">Hawaii</option>
<option value="tfa_2496" id="tfa_2496" class="">Idaho</option>
<option value="tfa_2497" id="tfa_2497" class="">Illinois</option>
<option value="tfa_2498" id="tfa_2498" class="">Indiana</option>
<option value="tfa_2499" id="tfa_2499" class="">Iowa</option>
<option value="tfa_2500" id="tfa_2500" class="">Kansas</option>
<option value="tfa_2501" id="tfa_2501" class="">Kentucky</option>
<option value="tfa_2502" id="tfa_2502" class="">Louisiana</option>
<option value="tfa_2503" id="tfa_2503" class="">Maine</option>
<option value="tfa_2504" id="tfa_2504" class="">Maryland</option>
<option value="tfa_2505" id="tfa_2505" class="">Massachusetts</option>
<option value="tfa_2506" id="tfa_2506" class="">Michigan</option>
<option value="tfa_2507" id="tfa_2507" class="">Minnesota</option>
<option value="tfa_2508" id="tfa_2508" class="">Mississippi</option>
<option value="tfa_2509" id="tfa_2509" class="">Missouri</option>
<option value="tfa_2510" id="tfa_2510" class="">Montana</option>
<option value="tfa_2511" id="tfa_2511" class="">Nebraska</option>
<option value="tfa_2512" id="tfa_2512" class="">Nevada</option>
<option value="tfa_2513" id="tfa_2513" class="">New Hampshire</option>
<option value="tfa_2514" id="tfa_2514" class="">New Jersey</option>
<option value="tfa_2515" id="tfa_2515" class="">New Mexico</option>
<option value="tfa_2516" id="tfa_2516" class="">New York</option>
<option value="tfa_2517" id="tfa_2517" class="">North Carolina</option>
<option value="tfa_2518" id="tfa_2518" class="">North Dakota</option>
<option value="tfa_2519" id="tfa_2519" class="">Ohio</option>
<option value="tfa_2520" id="tfa_2520" class="">Oklahoma</option>
<option value="tfa_2521" id="tfa_2521" class="">Oregon</option>
<option value="tfa_2522" id="tfa_2522" class="">Pennsylvania</option>
<option value="tfa_2523" id="tfa_2523" class="">Rhode Island</option>
<option value="tfa_2524" id="tfa_2524" class="">South Carolina</option>
<option value="tfa_2525" id="tfa_2525" class="">South Dakota</option>
<option value="tfa_2526" id="tfa_2526" class="">Tennessee</option>
<option value="tfa_2527" id="tfa_2527" class="">Texas</option>
<option value="tfa_2528" id="tfa_2528" class="">Utah</option>
<option value="tfa_2529" id="tfa_2529" class="">Vermont</option>
<option value="tfa_2530" id="tfa_2530" class="">Virginia</option>
<option value="tfa_2531" id="tfa_2531" class="">Washington</option>
<option value="tfa_2532" id="tfa_2532" class="">West Virginia</option>
<option value="tfa_2533" id="tfa_2533" class="">Wisconsin</option>
<option value="tfa_2534" id="tfa_2534" class="">Wyoming</option>
<option value="tfa_2535" id="tfa_2535" class="">Puerto Rico</option>
<option value="tfa_2536" id="tfa_2536" class="">Virgin Island</option>
<option value="tfa_2537" id="tfa_2537" class="">Northern Mariana Islands</option>
<option value="tfa_2538" id="tfa_2538" class="">Guam</option>
<option value="tfa_2539" id="tfa_2539" class="">American Samoa</option>
<option value="tfa_2540" id="tfa_2540" class="">Palau</option>
<option value="tfa_3255" id="tfa_3255" class="">Alberta</option>
<option value="tfa_3256" id="tfa_3256" class="">British Columbia</option>
<option value="tfa_3257" id="tfa_3257" class="">Manitoba</option>
<option value="tfa_3258" id="tfa_3258" class="">New Brunswick</option>
<option value="tfa_3259" id="tfa_3259" class="">Newfoundland and Labrador</option>
<option value="tfa_3260" id="tfa_3260" class="">Northwest Territories</option>
<option value="tfa_3261" id="tfa_3261" class="">Nova Scotia</option>
<option value="tfa_3262" id="tfa_3262" class="">Nunavut</option>
<option value="tfa_3263" id="tfa_3263" class="">Ontario</option>
<option value="tfa_3264" id="tfa_3264" class="">Prince Edward Island</option>
<option value="tfa_3265" id="tfa_3265" class="">Quebec</option>
<option value="tfa_3266" id="tfa_3266" class="">Saskatchewan</option>
<option value="tfa_3267" id="tfa_3267" class="">Yukon</option>
</select></div>
</div>
<label id="tfa_2244-L" class="label preField reqMark" for="tfa_2244"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2244" name="tfa_2244" value="" title="City" class="required c_form_input pay w-input" placeholder="City"></div>
</div>
<div class="oneField field-container-D " id="tfa_3283-D">
<label id="tfa_3283-L" class="label preField " for="tfa_3283"><span style="color: rgb(33, 37, 41); font-size: 16px;"></span></label><br>
<div class="inputWrapper"><input type="text" id="tfa_3283" name="tfa_3283" value="" title="ZIP/Postal Code" class="c_form_input pay w-input" placeholder="ZIP/Postal Code"></div>
</div>
</div>
</fieldset>
<div class="oneField field-container-D ms-pill-wrap leb" id="tfa_3223-D" role="radiogroup" aria-labelledby="tfa_3223-L" data-tfa-labelledby="-L tfa_3223-L">
<label id="tfa_3223-L" class="label preField ms-pill-item w-radio" data-tfa-check-label-for="tfa_3223"><span style="">Is this also your billing address?</span></label>
<div class="inputWrapper"><span id="tfa_3223" class="choices horizontal "><span class="oneChoice"><input type="radio" value="tfa_3224" class="" checked="" data-default-value="true" id="tfa_3224" name="tfa_3223" aria-labelledby="tfa_3224-L"
data-tfa-labelledby="tfa_3223-L tfa_3224-L" data-tfa-parent-id="tfa_3223"><label class="label postField ms-pill-item w-radio" id="tfa_3224-L" for="tfa_3224"><span class="input-radio-faux"></span><span style=""
class="ms-pill-label w-form-label">Yes</span></label></span><span class="oneChoice"><input type="radio" value="tfa_3225" class="" id="tfa_3225" name="tfa_3223" data-conditionals="#tfa_2917" aria-labelledby="tfa_3225-L"
data-tfa-labelledby="tfa_3223-L tfa_3225-L" data-tfa-parent-id="tfa_3223"><label class="label postField" id="tfa_3225-L" for="tfa_3225"><span class="input-radio-faux"></span><span
class="ms-pill-label w-form-label">No</span></label></span></span></div>
</div>
<fieldset id="tfa_2917" class="section offstate" data-condition="`#tfa_3225`">
<legend id="tfa_2917-L">
<b><span style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Billing Information</span></b>
</legend>
<div class="oneField field-container-D labelsAbove " id="tfa_2918-D">
<label id="tfa_2918-L" class="label preField reqMark" for="tfa_2918"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2918" name="tfa_2918" value="" title="First name" class="calc-FIRST required c_form_input pay w-input" placeholder="First name" disabled=""></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2919-D">
<label id="tfa_2919-L" class="label preField reqMark" for="tfa_2919"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2919" name="tfa_2919" value="" title="Last name" class="calc-LAST required c_form_input pay w-input" placeholder="Last name" disabled=""></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2922-D">
<label id="tfa_2922-L" class="label preField reqMark" for="tfa_2922"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span>
</label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2922" name="tfa_2922" value="" title="Address " class="required c_form_input pay w-input" placeholder="Address" disabled=""></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2923-D">
<label id="tfa_2923-L" class="label preField " for="tfa_2923"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span><span
style="box-sizing: border-box; font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; color: rgb(150, 137, 137); user-select: auto;"></span><span
style="font-family: "Fira Sans", sans-serif; font-size: 16px; color: rgb(150, 137, 137); user-select: auto;"></span></label><br>
<div class="inputWrapper"><input type="text" id="tfa_2923" name="tfa_2923" value="" title="Apartment/Suite # (Optional)" class="c_form_input pay w-input" placeholder="Apartment/Suite # (Optional)" disabled=""></div>
</div>
<div id="tfa_2924" class="section inline group">
<div class="oneField field-container-D " id="tfa_2985-D">
<label id="tfa_2985-L" class="label preField reqMark" for="tfa_2985"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><select aria-required="true" id="tfa_2985" name="tfa_2985" title="Country" class="required c_form_input pay w-input" disabled="">
<option value="">Country</option>
<option value="tfa_2986" id="tfa_2986" class="">Afghanistan</option>
<option value="tfa_2987" id="tfa_2987" class="">Albania</option>
<option value="tfa_2988" id="tfa_2988" class="">Algeria</option>
<option value="tfa_2989" id="tfa_2989" class="">American Samoa</option>
<option value="tfa_2990" id="tfa_2990" class="">Andorra</option>
<option value="tfa_2991" id="tfa_2991" class="">Angola</option>
<option value="tfa_2992" id="tfa_2992" class="">Anguilla</option>
<option value="tfa_2993" id="tfa_2993" class="">Antarctica</option>
<option value="tfa_2994" id="tfa_2994" class="">Antigua and Barbuda</option>
<option value="tfa_2995" id="tfa_2995" class="">Argentina</option>
<option value="tfa_2996" id="tfa_2996" class="">Armenia</option>
<option value="tfa_2997" id="tfa_2997" class="">Aruba</option>
<option value="tfa_2998" id="tfa_2998" class="">Australia</option>
<option value="tfa_2999" id="tfa_2999" class="">Austria</option>
<option value="tfa_3000" id="tfa_3000" class="">Azerbaijan</option>
<option value="tfa_3001" id="tfa_3001" class="">Bahamas</option>
<option value="tfa_3002" id="tfa_3002" class="">Bahrain</option>
<option value="tfa_3003" id="tfa_3003" class="">Bangladesh</option>
<option value="tfa_3004" id="tfa_3004" class="">Barbados</option>
<option value="tfa_3005" id="tfa_3005" class="">Belarus</option>
<option value="tfa_3006" id="tfa_3006" class="">Belgium</option>
<option value="tfa_3007" id="tfa_3007" class="">Belize</option>
<option value="tfa_3008" id="tfa_3008" class="">Benin</option>
<option value="tfa_3009" id="tfa_3009" class="">Bermuda</option>
<option value="tfa_3010" id="tfa_3010" class="">Bhutan</option>
<option value="tfa_3011" id="tfa_3011" class="">Bolivia</option>
<option value="tfa_3012" id="tfa_3012" class="">Bosnia and Herzegovina</option>
<option value="tfa_3013" id="tfa_3013" class="">Botswana</option>
<option value="tfa_3014" id="tfa_3014" class="">Bouvet Island</option>
<option value="tfa_3015" id="tfa_3015" class="">Brazil</option>
<option value="tfa_3016" id="tfa_3016" class="">British Indian Ocean Territory</option>
<option value="tfa_3017" id="tfa_3017" class="">Brunei</option>
<option value="tfa_3018" id="tfa_3018" class="">Bulgaria</option>
<option value="tfa_3019" id="tfa_3019" class="">Burkina Faso</option>
<option value="tfa_3020" id="tfa_3020" class="">Burundi</option>
<option value="tfa_3021" id="tfa_3021" class="">Cambodia</option>
<option value="tfa_3022" id="tfa_3022" class="">Cameroon</option>
<option value="tfa_3023" id="tfa_3023" class="">Canada</option>
<option value="tfa_3024" id="tfa_3024" class="">Cape Verde</option>
<option value="tfa_3025" id="tfa_3025" class="">Cayman Islands</option>
<option value="tfa_3026" id="tfa_3026" class="">Central African Republic</option>
<option value="tfa_3027" id="tfa_3027" class="">Chad</option>
<option value="tfa_3028" id="tfa_3028" class="">Chile</option>
<option value="tfa_3029" id="tfa_3029" class="">China</option>
<option value="tfa_3030" id="tfa_3030" class="">Christmas Island</option>
<option value="tfa_3031" id="tfa_3031" class="">Cocos ( Keeling ) Islands</option>
<option value="tfa_3032" id="tfa_3032" class="">Colombia</option>
<option value="tfa_3033" id="tfa_3033" class="">Comoros</option>
<option value="tfa_3034" id="tfa_3034" class="">Congo</option>
<option value="tfa_3035" id="tfa_3035" class="">Cook Islands</option>
<option value="tfa_3036" id="tfa_3036" class="">Costa Rica</option>
<option value="tfa_3037" id="tfa_3037" class="">Côte d ' Ivoire</option>
<option value="tfa_3038" id="tfa_3038" class="">Croatia ( Hrvatska )</option>
<option value="tfa_3039" id="tfa_3039" class="">Cuba</option>
<option value="tfa_3040" id="tfa_3040" class="">Cyprus</option>
<option value="tfa_3041" id="tfa_3041" class="">Czech Republic</option>
<option value="tfa_3042" id="tfa_3042" class="">Congo ( DRC )</option>
<option value="tfa_3043" id="tfa_3043" class="">Denmark</option>
<option value="tfa_3044" id="tfa_3044" class="">Djibouti</option>
<option value="tfa_3045" id="tfa_3045" class="">Dominica</option>
<option value="tfa_3046" id="tfa_3046" class="">Dominican Republic</option>
<option value="tfa_3047" id="tfa_3047" class="">East Timor</option>
<option value="tfa_3048" id="tfa_3048" class="">Ecuador</option>
<option value="tfa_3049" id="tfa_3049" class="">Egypt</option>
<option value="tfa_3050" id="tfa_3050" class="">El Salvador</option>
<option value="tfa_3051" id="tfa_3051" class="">Equatorial Guinea</option>
<option value="tfa_3052" id="tfa_3052" class="">Eritrea</option>
<option value="tfa_3053" id="tfa_3053" class="">Estonia</option>
<option value="tfa_3054" id="tfa_3054" class="">Ethiopia</option>
<option value="tfa_3055" id="tfa_3055" class="">Falkland Islands ( Islas Malvinas )</option>
<option value="tfa_3056" id="tfa_3056" class="">Faroe Islands</option>
<option value="tfa_3057" id="tfa_3057" class="">Fiji Islands</option>
<option value="tfa_3058" id="tfa_3058" class="">Finland</option>
<option value="tfa_3059" id="tfa_3059" class="">France</option>
<option value="tfa_3060" id="tfa_3060" class="">French Guiana</option>
<option value="tfa_3061" id="tfa_3061" class="">French Polynesia</option>
<option value="tfa_3062" id="tfa_3062" class="">French Southern and Antarctic Lands</option>
<option value="tfa_3063" id="tfa_3063" class="">Gabon</option>
<option value="tfa_3064" id="tfa_3064" class="">Gambia</option>
<option value="tfa_3065" id="tfa_3065" class="">Georgia</option>
<option value="tfa_3066" id="tfa_3066" class="">Germany</option>
<option value="tfa_3067" id="tfa_3067" class="">Ghana</option>
<option value="tfa_3068" id="tfa_3068" class="">Gibraltar</option>
<option value="tfa_3069" id="tfa_3069" class="">Greece</option>
<option value="tfa_3070" id="tfa_3070" class="">Greenland</option>
<option value="tfa_3071" id="tfa_3071" class="">Grenada</option>
<option value="tfa_3072" id="tfa_3072" class="">Guadeloupe</option>
<option value="tfa_3073" id="tfa_3073" class="">Guam</option>
<option value="tfa_3074" id="tfa_3074" class="">Guatemala</option>
<option value="tfa_3075" id="tfa_3075" class="">Guinea</option>
<option value="tfa_3076" id="tfa_3076" class="">Guinea-Bissau</option>
<option value="tfa_3077" id="tfa_3077" class="">Guyana</option>
<option value="tfa_3078" id="tfa_3078" class="">Haiti</option>
<option value="tfa_3079" id="tfa_3079" class="">Heard Island and McDonald Islands</option>
<option value="tfa_3080" id="tfa_3080" class="">Honduras</option>
<option value="tfa_3081" id="tfa_3081" class="">Hong Kong SAR</option>
<option value="tfa_3082" id="tfa_3082" class="">Hungary</option>
<option value="tfa_3083" id="tfa_3083" class="">Iceland</option>
<option value="tfa_3084" id="tfa_3084" class="">India</option>
<option value="tfa_3085" id="tfa_3085" class="">Indonesia</option>
<option value="tfa_3086" id="tfa_3086" class="">Iran</option>
<option value="tfa_3087" id="tfa_3087" class="">Iraq</option>
<option value="tfa_3088" id="tfa_3088" class="">Ireland</option>
<option value="tfa_3089" id="tfa_3089" class="">Israel</option>
<option value="tfa_3090" id="tfa_3090" class="">Italy</option>
<option value="tfa_3091" id="tfa_3091" class="">Jamaica</option>
<option value="tfa_3092" id="tfa_3092" class="">Japan</option>
<option value="tfa_3093" id="tfa_3093" class="">Jordan</option>
<option value="tfa_3094" id="tfa_3094" class="">Kazakhstan</option>
<option value="tfa_3095" id="tfa_3095" class="">Kenya</option>
<option value="tfa_3096" id="tfa_3096" class="">Kiribati</option>
<option value="tfa_3097" id="tfa_3097" class="">Korea</option>
<option value="tfa_3098" id="tfa_3098" class="">Kuwait</option>
<option value="tfa_3099" id="tfa_3099" class="">Kyrgyzstan</option>
<option value="tfa_3100" id="tfa_3100" class="">Laos</option>
<option value="tfa_3101" id="tfa_3101" class="">Latvia</option>
<option value="tfa_3102" id="tfa_3102" class="">Lebanon</option>
<option value="tfa_3103" id="tfa_3103" class="">Lesotho</option>
<option value="tfa_3104" id="tfa_3104" class="">Liberia</option>
<option value="tfa_3105" id="tfa_3105" class="">Libya</option>
<option value="tfa_3106" id="tfa_3106" class="">Liechtenstein</option>
<option value="tfa_3107" id="tfa_3107" class="">Lithuania</option>
<option value="tfa_3108" id="tfa_3108" class="">Luxembourg</option>
<option value="tfa_3109" id="tfa_3109" class="">Macao SAR</option>
<option value="tfa_3110" id="tfa_3110" class="">Macedonia, Former Yugoslav Republic of</option>
<option value="tfa_3111" id="tfa_3111" class="">Madagascar</option>
<option value="tfa_3112" id="tfa_3112" class="">Malawi</option>
<option value="tfa_3113" id="tfa_3113" class="">Malaysia</option>
<option value="tfa_3114" id="tfa_3114" class="">Maldives</option>
<option value="tfa_3115" id="tfa_3115" class="">Mali</option>
<option value="tfa_3116" id="tfa_3116" class="">Malta</option>
<option value="tfa_3117" id="tfa_3117" class="">Marshall Islands</option>
<option value="tfa_3118" id="tfa_3118" class="">Martinique</option>
<option value="tfa_3119" id="tfa_3119" class="">Mauritania</option>
<option value="tfa_3120" id="tfa_3120" class="">Mauritius</option>
<option value="tfa_3121" id="tfa_3121" class="">Mayotte</option>
<option value="tfa_3122" id="tfa_3122" class="">Mexico</option>
<option value="tfa_3123" id="tfa_3123" class="">Micronesia</option>
<option value="tfa_3124" id="tfa_3124" class="">Moldova</option>
<option value="tfa_3125" id="tfa_3125" class="">Monaco</option>
<option value="tfa_3126" id="tfa_3126" class="">Mongolia</option>
<option value="tfa_3127" id="tfa_3127" class="">Montserrat</option>
<option value="tfa_3128" id="tfa_3128" class="">Morocco</option>
<option value="tfa_3129" id="tfa_3129" class="">Mozambique</option>
<option value="tfa_3130" id="tfa_3130" class="">Myanmar</option>
<option value="tfa_3131" id="tfa_3131" class="">Namibia</option>
<option value="tfa_3132" id="tfa_3132" class="">Nauru</option>
<option value="tfa_3133" id="tfa_3133" class="">Nepal</option>
<option value="tfa_3134" id="tfa_3134" class="">Netherlands</option>
<option value="tfa_3135" id="tfa_3135" class="">Netherlands Antilles</option>
<option value="tfa_3136" id="tfa_3136" class="">New Caledonia</option>
<option value="tfa_3137" id="tfa_3137" class="">New Zealand</option>
<option value="tfa_3138" id="tfa_3138" class="">Nicaragua</option>
<option value="tfa_3139" id="tfa_3139" class="">Niger</option>
<option value="tfa_3140" id="tfa_3140" class="">Nigeria</option>
<option value="tfa_3141" id="tfa_3141" class="">Niue</option>
<option value="tfa_3142" id="tfa_3142" class="">Norfolk Island</option>
<option value="tfa_3143" id="tfa_3143" class="">North Korea</option>
<option value="tfa_3144" id="tfa_3144" class="">Northern Mariana Islands</option>
<option value="tfa_3145" id="tfa_3145" class="">Norway</option>
<option value="tfa_3146" id="tfa_3146" class="">Oman</option>
<option value="tfa_3147" id="tfa_3147" class="">Pakistan</option>
<option value="tfa_3148" id="tfa_3148" class="">Palau</option>
<option value="tfa_3149" id="tfa_3149" class="">Panama</option>
<option value="tfa_3150" id="tfa_3150" class="">Papua New Guinea</option>
<option value="tfa_3151" id="tfa_3151" class="">Paraguay</option>
<option value="tfa_3152" id="tfa_3152" class="">Peru</option>
<option value="tfa_3153" id="tfa_3153" class="">Philippines</option>
<option value="tfa_3154" id="tfa_3154" class="">Pitcairn Islands</option>
<option value="tfa_3155" id="tfa_3155" class="">Poland</option>
<option value="tfa_3156" id="tfa_3156" class="">Portugal</option>
<option value="tfa_3157" id="tfa_3157" class="">Puerto Rico</option>
<option value="tfa_3158" id="tfa_3158" class="">Qatar</option>
<option value="tfa_3159" id="tfa_3159" class="">Reunion</option>
<option value="tfa_3160" id="tfa_3160" class="">Romania</option>
<option value="tfa_3161" id="tfa_3161" class="">Russia</option>
<option value="tfa_3162" id="tfa_3162" class="">Rwanda</option>
<option value="tfa_3163" id="tfa_3163" class="">Samoa</option>
<option value="tfa_3164" id="tfa_3164" class="">San Marino</option>
<option value="tfa_3165" id="tfa_3165" class="">São Tomé and Prìncipe</option>
<option value="tfa_3166" id="tfa_3166" class="">Saudi Arabia</option>
<option value="tfa_3167" id="tfa_3167" class="">Senegal</option>
<option value="tfa_3168" id="tfa_3168" class="">Serbia and Montenegro</option>
<option value="tfa_3169" id="tfa_3169" class="">Seychelles</option>
<option value="tfa_3170" id="tfa_3170" class="">Sierra Leone</option>
<option value="tfa_3171" id="tfa_3171" class="">Singapore</option>
<option value="tfa_3172" id="tfa_3172" class="">Slovakia</option>
<option value="tfa_3173" id="tfa_3173" class="">Slovenia</option>
<option value="tfa_3174" id="tfa_3174" class="">Solomon Islands</option>
<option value="tfa_3175" id="tfa_3175" class="">Somalia</option>
<option value="tfa_3176" id="tfa_3176" class="">South Africa</option>
<option value="tfa_3177" id="tfa_3177" class="">South Georgia and the South Sandwich Islands</option>
<option value="tfa_3178" id="tfa_3178" class="">Spain</option>
<option value="tfa_3179" id="tfa_3179" class="">Sri Lanka</option>
<option value="tfa_3180" id="tfa_3180" class="">St. Helena</option>
<option value="tfa_3181" id="tfa_3181" class="">St. Kitts and Nevis</option>
<option value="tfa_3182" id="tfa_3182" class="">St. Lucia</option>
<option value="tfa_3183" id="tfa_3183" class="">St. Pierre and Miquelon</option>
<option value="tfa_3184" id="tfa_3184" class="">St. Vincent and the Grenadines</option>
<option value="tfa_3185" id="tfa_3185" class="">Sudan</option>
<option value="tfa_3186" id="tfa_3186" class="">Suriname</option>
<option value="tfa_3187" id="tfa_3187" class="">Svalbard and Jan Mayen</option>
<option value="tfa_3188" id="tfa_3188" class="">Swaziland</option>
<option value="tfa_3189" id="tfa_3189" class="">Sweden</option>
<option value="tfa_3190" id="tfa_3190" class="">Switzerland</option>
<option value="tfa_3191" id="tfa_3191" class="">Syria</option>
<option value="tfa_3192" id="tfa_3192" class="">Taiwan</option>
<option value="tfa_3193" id="tfa_3193" class="">Tajikistan</option>
<option value="tfa_3194" id="tfa_3194" class="">Tanzania</option>
<option value="tfa_3195" id="tfa_3195" class="">Thailand</option>
<option value="tfa_3196" id="tfa_3196" class="">Togo</option>
<option value="tfa_3197" id="tfa_3197" class="">Tokelau</option>
<option value="tfa_3198" id="tfa_3198" class="">Tonga</option>
<option value="tfa_3199" id="tfa_3199" class="">Trinidad and Tobago</option>
<option value="tfa_3200" id="tfa_3200" class="">Tunisia</option>
<option value="tfa_3201" id="tfa_3201" class="">Turkey</option>
<option value="tfa_3202" id="tfa_3202" class="">Turkmenistan</option>
<option value="tfa_3203" id="tfa_3203" class="">Turks and Caicos Islands</option>
<option value="tfa_3204" id="tfa_3204" class="">Tuvalu</option>
<option value="tfa_3205" id="tfa_3205" class="">Uganda</option>
<option value="tfa_3206" id="tfa_3206" class="">Ukraine</option>
<option value="tfa_3207" id="tfa_3207" class="">United Arab Emirates</option>
<option value="tfa_3208" id="tfa_3208" class="">United Kingdom</option>
<option value="tfa_3209" id="tfa_3209" class="">United States</option>
<option value="tfa_3210" id="tfa_3210" class="">United States Minor Outlying Islands</option>
<option value="tfa_3211" id="tfa_3211" class="">Uruguay</option>
<option value="tfa_3212" id="tfa_3212" class="">Uzbekistan</option>
<option value="tfa_3213" id="tfa_3213" class="">Vanuatu</option>
<option value="tfa_3214" id="tfa_3214" class="">Vatican City</option>
<option value="tfa_3215" id="tfa_3215" class="">Venezuela</option>
<option value="tfa_3216" id="tfa_3216" class="">Viet Nam</option>
<option value="tfa_3217" id="tfa_3217" class="">Virgin Islands ( British )</option>
<option value="tfa_3218" id="tfa_3218" class="">Virgin Islands</option>
<option value="tfa_3219" id="tfa_3219" class="">Wallis and Futuna</option>
<option value="tfa_3220" id="tfa_3220" class="">Yemen</option>
<option value="tfa_3221" id="tfa_3221" class="">Zambia</option>
<option value="tfa_3222" id="tfa_3222" class="">Zimbabwe</option>
</select></div>
</div>
<div class="oneField field-container-D " id="tfa_2926-D">
<label id="tfa_2926-L" class="label preField " for="tfa_2926"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><select id="tfa_2926" name="tfa_2926" title="State/Province" class="c_form_input pay w-input" disabled="">
<option value="">State/Province</option>
<option value="tfa_2927" id="tfa_2927" class="">Alabama</option>
<option value="tfa_2928" id="tfa_2928" class="">Alaska</option>
<option value="tfa_2929" id="tfa_2929" class="">Arizona</option>
<option value="tfa_2930" id="tfa_2930" class="">Arkansas</option>
<option value="tfa_2931" id="tfa_2931" class="">California</option>
<option value="tfa_2932" id="tfa_2932" class="">Colorado</option>
<option value="tfa_2933" id="tfa_2933" class="">Connecticut</option>
<option value="tfa_2934" id="tfa_2934" class="">Delaware</option>
<option value="tfa_2935" id="tfa_2935" class="">District Of Columbia</option>
<option value="tfa_2936" id="tfa_2936" class="">Florida</option>
<option value="tfa_2937" id="tfa_2937" class="">Georgia</option>
<option value="tfa_2938" id="tfa_2938" class="">Hawaii</option>
<option value="tfa_2939" id="tfa_2939" class="">Idaho</option>
<option value="tfa_2940" id="tfa_2940" class="">Illinois</option>
<option value="tfa_2941" id="tfa_2941" class="">Indiana</option>
<option value="tfa_2942" id="tfa_2942" class="">Iowa</option>
<option value="tfa_2943" id="tfa_2943" class="">Kansas</option>
<option value="tfa_2944" id="tfa_2944" class="">Kentucky</option>
<option value="tfa_2945" id="tfa_2945" class="">Louisiana</option>
<option value="tfa_2946" id="tfa_2946" class="">Maine</option>
<option value="tfa_2947" id="tfa_2947" class="">Maryland</option>
<option value="tfa_2948" id="tfa_2948" class="">Massachusetts</option>
<option value="tfa_2949" id="tfa_2949" class="">Michigan</option>
<option value="tfa_2950" id="tfa_2950" class="">Minnesota</option>
<option value="tfa_2951" id="tfa_2951" class="">Mississippi</option>
<option value="tfa_2952" id="tfa_2952" class="">Missouri</option>
<option value="tfa_2953" id="tfa_2953" class="">Montana</option>
<option value="tfa_2954" id="tfa_2954" class="">Nebraska</option>
<option value="tfa_2955" id="tfa_2955" class="">Nevada</option>
<option value="tfa_2956" id="tfa_2956" class="">New Hampshire</option>
<option value="tfa_2957" id="tfa_2957" class="">New Jersey</option>
<option value="tfa_2958" id="tfa_2958" class="">New Mexico</option>
<option value="tfa_2959" id="tfa_2959" class="">New York</option>
<option value="tfa_2960" id="tfa_2960" class="">North Carolina</option>
<option value="tfa_2961" id="tfa_2961" class="">North Dakota</option>
<option value="tfa_2962" id="tfa_2962" class="">Ohio</option>
<option value="tfa_2963" id="tfa_2963" class="">Oklahoma</option>
<option value="tfa_2964" id="tfa_2964" class="">Oregon</option>
<option value="tfa_2965" id="tfa_2965" class="">Pennsylvania</option>
<option value="tfa_2966" id="tfa_2966" class="">Rhode Island</option>
<option value="tfa_2967" id="tfa_2967" class="">South Carolina</option>
<option value="tfa_2968" id="tfa_2968" class="">South Dakota</option>
<option value="tfa_2969" id="tfa_2969" class="">Tennessee</option>
<option value="tfa_2970" id="tfa_2970" class="">Texas</option>
<option value="tfa_2971" id="tfa_2971" class="">Utah</option>
<option value="tfa_2972" id="tfa_2972" class="">Vermont</option>
<option value="tfa_2973" id="tfa_2973" class="">Virginia</option>
<option value="tfa_2974" id="tfa_2974" class="">Washington</option>
<option value="tfa_2975" id="tfa_2975" class="">West Virginia</option>
<option value="tfa_2976" id="tfa_2976" class="">Wisconsin</option>
<option value="tfa_2977" id="tfa_2977" class="">Wyoming</option>
<option value="tfa_2978" id="tfa_2978" class="">Puerto Rico</option>
<option value="tfa_2979" id="tfa_2979" class="">Virgin Island</option>
<option value="tfa_2980" id="tfa_2980" class="">Northern Mariana Islands</option>
<option value="tfa_2981" id="tfa_2981" class="">Guam</option>
<option value="tfa_2982" id="tfa_2982" class="">American Samoa</option>
<option value="tfa_2983" id="tfa_2983" class="">Palau</option>
<option value="tfa_3268" id="tfa_3268" class="">Alberta</option>
<option value="tfa_3269" id="tfa_3269" class="">British Columbia</option>
<option value="tfa_3270" id="tfa_3270" class="">Manitoba</option>
<option value="tfa_3271" id="tfa_3271" class="">New Brunswick</option>
<option value="tfa_3272" id="tfa_3272" class="">Newfoundland and Labrador</option>
<option value="tfa_3273" id="tfa_3273" class="">Northwest Territories</option>
<option value="tfa_3274" id="tfa_3274" class="">Nova Scotia</option>
<option value="tfa_3275" id="tfa_3275" class="">Nunavut</option>
<option value="tfa_3276" id="tfa_3276" class="">Ontario</option>
<option value="tfa_3277" id="tfa_3277" class="">Prince Edward Island</option>
<option value="tfa_3278" id="tfa_3278" class="">Quebec</option>
<option value="tfa_3279" id="tfa_3279" class="">Saskatchewan</option>
<option value="tfa_3280" id="tfa_3280" class="">Yukon</option>
</select></div>
</div>
<div class="oneField field-container-D labelsAbove " id="tfa_2925-D">
<label id="tfa_2925-L" class="label preField reqMark" for="tfa_2925"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2925" name="tfa_2925" value="" title="City" class="required c_form_input pay w-input" placeholder="City" disabled=""></div>
</div>
<div class="oneField field-container-D " id="tfa_3281-D">
<label id="tfa_3281-L" class="label preField " for="tfa_3281"><span style="color: rgb(33, 37, 41); font-size: 16px;"></span></label><br>
<div class="inputWrapper"><input type="text" id="tfa_3281" name="tfa_3281" value="" title="ZIP/Postal Code" class="c_form_input pay w-input" placeholder="ZIP/Postal Code" disabled=""></div>
</div>
</div>
</fieldset>
<fieldset id="tfa_3291" class="section">
<legend id="tfa_3291-L"></legend>
<label for="tribute" class="pay-section-label">Tribute Information</label>
<div class="oneField field-container-D " id="tfa_3284-D">
<label id="tfa_3284-L" class="label preField " for="tfa_3284"><span style="color: rgb(33, 37, 41); font-size: 16px;"></span></label><br>
<div class="inputWrapper"><select id="tfa_3284" name="tfa_3284" title="Is this gift in tribute to a friend or loved one? (Optional)" class="c_form_input pay w-input">
<option value="">Is this gift in tribute to a friend or loved one? (Optional)</option>
<option value="tfa_3285" id="tfa_3285" data-conditionals="#tfa_3314,#tfa_3319" class="">In tribute</option>
<option value="tfa_3286" id="tfa_3286" data-conditionals="#tfa_3314,#tfa_3319" class="">In memory</option>
</select></div>
</div>
<div id="tfa_3314" class="section group offstate" data-condition="`#tfa_3285` OR `#tfa_3286`">
<div class="oneField field-container-D " id="tfa_3288-D">
<label id="tfa_3288-L" class="label preField reqMark" for="tfa_3288"><span style="color: rgb(33, 37, 41); font-size: 16px;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_3288" name="tfa_3288" value="" title="Honoree first name" class="required c_form_input pay w-input" placeholder="Honoree first name" disabled=""></div>
</div>
<div class="oneField field-container-D " id="tfa_3316-D">
<label id="tfa_3316-L" class="label preField reqMark" for="tfa_3316"><span style="color: rgb(33, 37, 41); font-size: 16px;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_3316" name="tfa_3316" value="" title="Honoree last name" class="required c_form_input pay w-input" placeholder="Honoree last name" disabled=""></div>
</div>
<div class="oneField field-container-D " id="tfa_3299-D">
<label id="tfa_3299-L" class="label preField reqMark" for="tfa_3299"><span style="color: rgb(33, 37, 41); font-size: 16px;"></span></label><br>
<div class="inputWrapper"><select aria-required="true" id="tfa_3299" name="tfa_3299" title="Would you like to notify someone of this gift?" class="required c_form_input pay w-input" disabled="">
<option value="">Would you like to notify someone of this gift?</option>
<option value="tfa_3300" id="tfa_3300" data-conditionals="#tfa_3319" class="">Yes</option>
<option value="tfa_3301" id="tfa_3301" class="">No</option>
</select></div>
</div>
<div id="tfa_3319" class="section group offstate" data-condition="(`#tfa_3300`) AND (`#tfa_3285` OR `#tfa_3286`)">
<div class="oneField field-container-D " id="tfa_3290-D">
<label id="tfa_3290-L" class="label preField reqMark" for="tfa_3290"><span style="font-size: 16px;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_3290" name="tfa_3290" value="" title="First name of person to notify" class="required c_form_input pay w-input" placeholder="First name of person to notify"
disabled=""></div>
</div>
<div class="oneField field-container-D " id="tfa_3318-D">
<label id="tfa_3318-L" class="label preField reqMark" for="tfa_3318"><span style="font-size: 16px;"></span></label><br>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_3318" name="tfa_3318" value="" title="Last name of person to notify" class="required c_form_input pay w-input" placeholder="Last name of person to notify"
disabled=""></div>
</div>
<div class="oneField field-container-D " id="tfa_3307-D">
<label id="tfa_3307-L" class="label preField reqMark" for="tfa_3307"><span style="font-size: 16px;"></span></label><br>
<div class="inputWrapper">
<div><input aria-required="true" type="text" id="tfa_3307" name="tfa_3307" value="" maxlength="40" title="Email address for notification" class="validate-email required c_form_input pay w-input"
placeholder="Email address for notification" disabled="">
<div class="lengthIndicator" aria-live="assertive" style="display: none; left: 100px;">40 characters left.</div>
</div>
</div>
</div>
<div class="oneField field-container-D " id="tfa_3313-D">
<label id="tfa_3313-L" class="label preField reqMark" for="tfa_3313"><span style="font-size: 16px;"></span></label><br>
<div class="inputWrapper">
<div><textarea aria-required="true" maxlength="10000" id="tfa_3313" name="tfa_3313" title="Notification message" class="required c_form_input pay w-input" placeholder="Notification message" disabled=""></textarea>
<div class="lengthIndicator" aria-live="assertive" style="display: none; left: 100px;">10000 characters left.</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset id="tfa_1" class="section inline highlighted" style="margin-bottom:20px;">
<legend id="tfa_1-L"></legend>
<label for="card-number" class="pay-section-label">Bank Details</label>
<div id="tfa_2589" class="section group">
<div class="oneField field-container-D ms-pill-wrap leb " id="tfa_2221-D" role="radiogroup" aria-labelledby="tfa_2221-L" data-tfa-labelledby="-L tfa_2221-L">
<label id="tfa_2221-L" class="label preField reqMark" data-tfa-check-label-for="tfa_2221"><span style="">Name on Card</span></label>
<div class="inputWrapper"><span id="tfa_2221" class="choices horizontal required"><span class="oneChoice"><input type="radio" value="tfa_2584" class="calc-NameAsAboveOrOther calcval-Same" checked="" data-default-value="true" id="tfa_2584"
name="tfa_2221" aria-required="true" aria-labelledby="tfa_2584-L" data-tfa-labelledby="tfa_2221-L tfa_2584-L" data-tfa-parent-id="tfa_2221"><label class="label postField" id="tfa_2584-L" for="tfa_2584"><span
class="input-radio-faux"></span><span style="" class="ms-pill-label w-form-label">Same As Above</span></label></span><span class="oneChoice"><input type="radio" value="tfa_2585" class="calc-NameAsAboveOrOther calcval-Other"
id="tfa_2585" name="tfa_2221" aria-required="true" data-conditionals="#tfa_2586" aria-labelledby="tfa_2585-L" data-tfa-labelledby="tfa_2221-L tfa_2585-L" data-tfa-parent-id="tfa_2221"><label class="label postField" id="tfa_2585-L"
for="tfa_2585"><span class="input-radio-faux"></span><span style="" class="ms-pill-label w-form-label">Other</span></label></span></span></div>
</div>
<div class="oneField field-container-D labelsRemoved offstate" id="tfa_2586-D">
<div class="inputWrapper"><input type="text" id="tfa_2586" name="tfa_2586" value="" data-condition="`#tfa_2585`" title="Other Name on Card" class="calc-OtherNameOnCard c_form_input pay w-input" placeholder="Other Name on Card" disabled="">
</div>
</div>
</div>
<div class="oneField field-container-D labelsLeftAligned " id="tfa_2222-D">
<label id="tfa_2222-L" class="label preField reqMark" for="tfa_2222"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(234, 234, 234); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></span></label>
<div class="inputWrapper">
<input aria-required="true" type="text" id="tfa_2222" name="tfa_2222" value="" autocomplete="off" placeholder="Card number ●●●●●●●●●●●●●●●●" title="Card Number" class="calc-CCNum required c_form_input pay w-input">
<div class="delimiter delimiterAfter" id="tfa_2222-DA"></div>
</div>
</div>
<div id="tfa_2599" class="section group">
<div id="tfa_2600" class="section inline group">
<div class="oneField field-container-D " id="tfa_2224-D">
<label id="tfa_2224-L" class="label preField reqMark" for="tfa_2224"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(234, 234, 234); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></span></label><br>
<div class="inputWrapper">
<div><input aria-required="true" type="text" id="tfa_2224" name="tfa_2224" value="" placeholder="MM" maxlength="2" min="01" max="12" title=" MM" class="validate-integer required c_form_input pay w-input">
<div class="lengthIndicator" aria-live="assertive" style="display: none; left: 701px;">2 characters left.</div>
</div>
</div>
</div>
<div class="oneField field-container-D " id="tfa_2225-D">
<label id="tfa_2225-L" class="label preField reqMark" for="tfa_2225"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(234, 234, 234); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></span></label><br>
<div class="inputWrapper">
<div><input aria-required="true" type="text" id="tfa_2225" name="tfa_2225" value="" placeholder="YY" maxlength="2" min="00" max="99" title=" YY" class="validate-integer required c_form_input pay w-input">
<div class="lengthIndicator" aria-live="assertive" style="display: none; left: 701px;">2 characters left.</div>
</div>
</div>
</div>
<div class="oneField field-container-D " id="tfa_2226-D">
<label id="tfa_2226-L" class="label preField reqMark" for="tfa_2226"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(234, 234, 234); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"><span
style="color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"></span></span></label><br>
<div class="inputWrapper">
<input aria-required="true" type="text" id="tfa_2226" name="tfa_2226" value="" autocomplete="off" placeholder="Security code ●●●" title="Security code" class="validate-custom /^[0-9]{3,4}$/ required c_form_input pay w-input">
<div class="delimiter delimiterAfter" id="tfa_2226-DA"></div>
</div>
</div>
<div id="tfa_3229" class="section group">
<div class="htmlSection" id="tfa_3228">
<div class="htmlContent" id="tfa_3228-HTML">
<center><span style="font-weight: bolder; color: rgb(33, 37, 41); font-family: "Fira Sans", sans-serif; font-size: 16px; text-align: center; user-select: auto;">Education For Employment (EFE) is an IRS-registered 501(c)(3) -
All Donations are 100% Tax Deductible</span></center>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<div id="tfa_3249" class="section group">
<div class="oneField field-container-D labelsRemoved " id="tfa_3226-D" role="group" aria-labelledby="tfa_3226-L" data-tfa-labelledby="-L tfa_3226-L">
<div class="inputWrapper"><span id="tfa_3226" class="choices vertical required"><span class="oneChoice"><input type="checkbox" value="tfa_3227" class="" id="tfa_3227" name="tfa_3227" aria-labelledby="tfa_3227-L"
data-tfa-labelledby="tfa_3226-L tfa_3227-L" data-tfa-parent-id="tfa_3226"><label class="label postField" id="tfa_3227-L" for="tfa_3227"><span class="input-checkbox-faux"></span><span style=""><strong>I consent to having EFE use my data
in accordance with EFE’s</strong></span><strong><span style=""> <span><a href="https://donate.efe.org/privacy.php">privacy policy</a></span>.</span></strong></label></span></span></div>
</div>
</div>
<fieldset id="tfa_2569" class="section inline wf-acl-hidden">
<legend id="tfa_2569-L">Hidden fields</legend>
<div class="htmlSection" id="tfa_2593">
<div class="htmlContent" id="tfa_2593-HTML">
<p class="MsoNormal"><b><span style="font-size:25.0pt;line-height:107%;
font-family:"Italia Std Medium",serif;color:#991C0D;mso-themecolor:accent1">$</span></b></p>
</div>
</div>
<div class="htmlSection" id="tfa_2607">
<div class="htmlContent" id="tfa_2607-HTML">
<p class="MsoNormal"><b><span style="font-size:25.0pt;line-height:107%;
font-family:"Italia Std Medium",serif;mso-bidi-font-family:Calibri;mso-bidi-theme-font:
minor-latin;color:#991C0D;mso-themecolor:accent1">€</span></b><b><span style="font-size:25.0pt;line-height:107%;font-family:"Italia Std Medium",serif;
color:#991C0D;mso-themecolor:accent1"></span></b></p>
</div>
</div>
<div class="oneField field-container-D " id="tfa_3237-D">
<label id="tfa_3237-L" class="label preField " for="tfa_3237">Final Donation Amount:</label><br>
<div class="inputWrapper"><input type="text" id="tfa_3237" name="tfa_3237" value="" autocomplete="off" readonly="" title="Final Donation Amount:" class="formula=USDSingle+USDMonthly readonly"></div>
</div>
<div class="oneField field-container-D " id="tfa_3231-D">
<label id="tfa_3231-L" class="label preField " for="tfa_3231">Credit Card Name</label><br>
<div class="inputWrapper"><input type="text" id="tfa_3231" name="tfa_3231" value="" readonly="" title="Credit Card Name" class="formula=if(NameAsAboveOrOther=="Same"){FIRST+"\u0020"+LAST}else{OtherNameOnCard}; readonly">
</div>
</div>
<fieldset id="tfa_3243" class="section">
<legend id="tfa_3243-L">Edit section title</legend>
<input type="hidden" id="STRIPE_CUSTOMER_493795" name="STRIPE_CUSTOMER_493795" value="" class=""><input type="hidden" id="STRIPE_CHARGE_493795" name="STRIPE_CHARGE_493795" value="" class=""><input type="hidden" id="STRIPE_SUBSCR_493795"
name="STRIPE_SUBSCR_493795" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_METHOD_493795" name="STRIPE_PAYMENT_METHOD_493795" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_INTENT_493795"
name="STRIPE_PAYMENT_INTENT_493795" value="" class=""><input type="hidden" id="STRIPE_SETUP_INTENT_493795" name="STRIPE_SETUP_INTENT_493795" value="" class="">
</fieldset>
<fieldset id="tfa_3244" class="section">
<legend id="tfa_3244-L">Edit section title</legend>
<input type="hidden" id="STRIPE_CUSTOMER_493797" name="STRIPE_CUSTOMER_493797" value="" class=""><input type="hidden" id="STRIPE_SUBSCR_493797" name="STRIPE_SUBSCR_493797" value="" class=""><input type="hidden" id="STRIPE_CHARGE_493797"
name="STRIPE_CHARGE_493797" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_METHOD_493797" name="STRIPE_PAYMENT_METHOD_493797" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_INTENT_493797"
name="STRIPE_PAYMENT_INTENT_493797" value="" class=""><input type="hidden" id="STRIPE_SETUP_INTENT_493797" name="STRIPE_SETUP_INTENT_493797" value="" class="">
</fieldset>
<fieldset id="tfa_3245" class="section">
<legend id="tfa_3245-L">Edit section title</legend>
<div id="tfa_3246" class="section inline group">
<input type="hidden" id="STRIPE_CUSTOMER_493277" name="STRIPE_CUSTOMER_493277" value="" class=""><input type="hidden" id="STRIPE_CHARGE_493277" name="STRIPE_CHARGE_493277" value="" class="">
</div>
<input type="hidden" id="STRIPE_SUBSCR_493277" name="STRIPE_SUBSCR_493277" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_METHOD_493277" name="STRIPE_PAYMENT_METHOD_493277" value="" class=""><input type="hidden"
id="STRIPE_PAYMENT_INTENT_493277" name="STRIPE_PAYMENT_INTENT_493277" value="" class=""><input type="hidden" id="STRIPE_SETUP_INTENT_493277" name="STRIPE_SETUP_INTENT_493277" value="" class="">
</fieldset>
<fieldset id="tfa_3247" class="section">
<legend id="tfa_3247-L">Edit section title</legend>
<input type="hidden" id="STRIPE_CUSTOMER_494287" name="STRIPE_CUSTOMER_494287" value="" class=""><input type="hidden" id="STRIPE_SUBSCR_494287" name="STRIPE_SUBSCR_494287" value="" class=""><input type="hidden" id="STRIPE_CHARGE_494287"
name="STRIPE_CHARGE_494287" value="" class="">
<div id="tfa_3248" class="section inline group">
<input type="hidden" id="STRIPE_PAYMENT_METHOD_494287" name="STRIPE_PAYMENT_METHOD_494287" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_INTENT_494287" name="STRIPE_PAYMENT_INTENT_494287" value="" class=""><input type="hidden"
id="STRIPE_SETUP_INTENT_494287" name="STRIPE_SETUP_INTENT_494287" value="" class="">
</div>
</fieldset>
</fieldset>
<input type="hidden" id="STRIPE_CUSTOMER_525927" name="STRIPE_CUSTOMER_525927" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_METHOD_525927" name="STRIPE_PAYMENT_METHOD_525927" value="" class=""><input type="hidden"
id="STRIPE_PAYMENT_INTENT_525927" name="STRIPE_PAYMENT_INTENT_525927" value="" class=""><input type="hidden" id="STRIPE_SETUP_INTENT_525927" name="STRIPE_SETUP_INTENT_525927" value="" class=""><input type="hidden" id="STRIPE_CUSTOMER_525928"
name="STRIPE_CUSTOMER_525928" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_METHOD_525928" name="STRIPE_PAYMENT_METHOD_525928" value="" class=""><input type="hidden" id="STRIPE_PAYMENT_INTENT_525928"
name="STRIPE_PAYMENT_INTENT_525928" value="" class=""><input type="hidden" id="STRIPE_SETUP_INTENT_525928" name="STRIPE_SETUP_INTENT_525928" value="" class=""><input type="hidden" id="STRIPE_SUBSCR_525928" name="STRIPE_SUBSCR_525928" value=""
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Our Work Our Tracks Pathway To A Job This track equips youth with the tools necessary for a successful job search and integration into the workforce through various programs. Job Placement This track prepares participants to succeed in any workplace based on employer demand. Entrepreneurship This track prepares young people to start their first business, as well as links youth to financing, mentoring and other services. More Work Mentorship This program supports recent graduates by connecting them with volunteer mentors sourced from corporate partners, local employer partners, and EFE alumni. Systems Change We partner with the public and private sectors to build their capacity to deliver market-relevant, demand-driven programming in order to address youth unemployment on a larger scale. Alumni Support Alumni engagement programs provide opportunities for continuing professional development, networking, and volunteering. About About Us Overview Get to know us Partners & Funders Discover our strong network of supporters Our Team Meet our people Join our Team Resource Library Impact Thought Leadership EFE Network News News All News Explore our engaging highlight page featuring Spotlight moments, breaking news, press releases, and inspiring campaigns that make a difference. EFE Updates Stay informed and up-to-date with the latest EFE Updates press Explore a curated collection of press mentions showcasing the impact and influence of EFE Spotlight Read Now No items found. New Campaign Take Action Take Action Work with us to bring a change Your actions have the power to change lives and make the world a better place. Take action today and make a difference. Make a Donation Invest in a brighter future for MENA youth, make a meaningful donation today. Become a partner Join us in our mission to create economic opportunity for youth in the MENA region. Become a mentor Inspire and guide youth from across the MENA region, join our mentorship program. Contact Us Get in Touch with EFE Our Work Our Tracks Pathway To A Job This track equips youth with the tools necessary for a successful job search and integration into the workforce through various programs. Job Placement This track prepares participants to succeed in any workplace based on employer demand. Entrepreneurship This track prepares young people to start their first business, as well as links youth to financing, mentoring and other services. More Work Mentorship This program supports recent graduates by connecting them with volunteer mentors sourced from corporate partners, local employer partners, and EFE alumni. Systems Change We partner with the public and private sectors to build their capacity to deliver market-relevant, demand-driven programming in order to address youth unemployment on a larger scale. Alumni Support Alumni engagement programs provide opportunities for continuing professional development, networking, and volunteering. About About Us Overview Get to know us Partners & Funders Discover our strong network of supporters Our Team Meet our people Join our Team Resource Library Impact Thought Leadership EFE Network News News All News Explore our engaging highlight page featuring Spotlight moments, breaking news, press releases, and inspiring campaigns that make a difference. EFE Updates Stay informed and up-to-date with the latest EFE Updates press Explore a curated collection of press mentions showcasing the impact and influence of EFE Spotlight Read Now No items found. New Campaign Take Action Take Action Work with us to bring a change Your actions have the power to change lives and make the world a better place. Take action today and make a difference. Make a Donation Invest in a brighter future for MENA youth, make a meaningful donation today. Become a partner Join us in our mission to create economic opportunity for youth in the MENA region. Become a mentor Inspire and guide youth from across the MENA region, join our mentorship program. Contact Us Get in Touch with EFE go back Get impact updates in your inbox Thank you! Your submission has been received! Oops! Something went wrong while submitting the form. Go Back PEOPLE IN GAZA URGENTLY NEED YOUR SUPPORT SUPPORT OUR TEAM ON THE GROUND TO PROVIDE LIFESAVING SKILLS AND KITS TO THOSE IN NEED: * $10,085 trains a full class of 20 people with Emergency Midwifery skills. * $4,185 trains a full class of 20 people with Emergency First Aid and Psychosocial Support skills. * $1,000 provides a Medicine Kit including adrenaline, inhalers, painkillers & more * $602 provides an Emergency Bag including syringes, cannulas, scalpels & more. * $250 provides an Infection Prevention Kit including sterile gauze, iodine, masks, sanitizer & more. * $50 provides a first aid kit, a hygiene kit for a displaced family, or a recreational kit for a displaced child. Please donate with confidence, knowing that we have received Charity Navigator and Transparency International’s highest ratings. 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