secure.animalhumanesociety.org
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74.123.152.207
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Submitted URL: https://secure.animalhumanesociety.org/site/R?i=iS4fyocvrd-QyH6N9uAhTU_q-C3ljdk0DNEKUwRgNqbOw9X0O6LUjg
Effective URL: https://secure.animalhumanesociety.org/site/Donation2?df_id=6175&mfc_pref=T&6175.donation=form1
Submission: On December 17 via api from US — Scanned from IL
Effective URL: https://secure.animalhumanesociety.org/site/Donation2?df_id=6175&mfc_pref=T&6175.donation=form1
Submission: On December 17 via api from US — Scanned from IL
Form analysis 1 forms found in the DOM
Name: process — POST https://secure.animalhumanesociety.org/site/Donation2
<form name="process" id="ProcessForm" action="https://secure.animalhumanesociety.org/site/Donation2" method="post" onsubmit="return checkDoubleClick();">
<div class="donation-form-container responsive">
<script type="text/javascript">
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function reloadPage() {
window.location.reload(true);
}
function testAjax() {
var xmlHttp = null;
// Opera 8.0+, Firefox, Chrome, Safari
try {
xmlHttp = new XMLHttpRequest();
} catch (e) {
// Internet Explorer Browsers
try {
xmlHttp = new ActiveXObject("Msxml2.XMLHTTP");
} catch (e) {
try {
xmlHttp = new ActiveXObject("Microsoft.XMLHTTP");
} catch (e) {
return false;
}
}
}
xmlHttp.open('POST', 'AjaxHelper;jsessionid=00000000.app20030a?NONCE_TOKEN=97FA40D11B75E245C24F4B5A9EF9DBAC', true);
xmlHttp.send();
}
addOnLoadHandler(testAjax);
//
-->
</script>
<div class="donation-form-content">
<script>
document.body.addEventListener("keypress", function(event) {
if (event.keyCode === 13) {
event.preventDefault();
var button = document.getElementById("pstep_finish");
if (!button) {
button = document.getElementById("pstep_next");
}
if (!button) {
button = document.getElementById("pstep_finish_validate");
}
if (button) {
button.click();
}
}
});
</script>
<input type="hidden" name="user_donation_amt" id="user_donation_amt" value="">
<input type="hidden" name="company_min_matching_amt" id="company_min_matching_amt" value="">
<input type="hidden" name="currency_locale" id="currency_locale" value="en_US">
<input type="hidden" name="user_additional_amount" id="user_additional_amount" value="">
<input type="hidden" name="cc_available" id="cc_available" value="false">
<input type="hidden" name="debit_available" id="debit_available" value="false">
<input type="hidden" name="paypal_available" id="paypal_available" value="false">
<input type="hidden" name="wallets_available" id="wallets_available" value="false">
<input type="hidden" name="primary_color" id="primary_color" value="">
<input type="hidden" name="application_name" id="application_name" value="Luminate">
<input type="hidden" name="secondary_color" id="secondary_color" value="">
<input type="hidden" name="font_color" id="font_color" value="">
<input type="hidden" name="font_family" id="font_family" value="">
<input type="hidden" name="secure_url" id="secure_url" value="https://secure.animalhumanesociety.org/site/">
<input type="hidden" name="is_admin_app" id="is_admin_app" value="F">
<input type="hidden" name="environment_id" id="environment_id" value="">
<input type="hidden" name="merchant_account_configuration_id" id="merchant_account_configuration_id" value="">
<input type="hidden" name="pco_javascript_location" id="pco_javascript_location" value="">
<input type="hidden" name="pco_language_locale" id="pco_language_locale" value="en_US">
<input type="hidden" name="pco_environment_zone" id="pco_environment_zone" value="p-usa01">
<div class="form-row">
<div class="html-caption-container">
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<p>
</p>
<p><img id="photo" class="dog-desktop" style="width: 100%; padding-left: 0px;" src="..//images/content/pagebuilder/CYE24_webAssets_donationFormHeader.png" border="0" alt="Donate"> <img class="dog-mobile" src="..//images/content/pagebuilder/CYE24_webAssets_donationFormHeader.png
" border="0" alt="Mobile Image"></p>
<p>Animal Humane Society provides expert medical and behavioral care to thousands of dogs, cats, and critters in the Twin Cities area each year. With your support, we can help every animal find their second chance — no matter the challenges
they face.</p>
<p>This December, your love can provide twice the hope, comfort, and critical care for local animals in need.</p>
<p><strong>All gifts will be DOUBLED, dollar-for-dollar, up to $25,000, thanks to the generosity of Bill Nesheim.</strong></p>
<p>Please consider making a gift today. Your support brings hope to the vulnerable animals in our care.</p>
<p></p>
<h2 class="section-header-container">Your donation</h2>
</div>
</div>
<div id="level_standard_row" style="display: block;">
<div class="form-row">
<p id="giving-frequencies"><span id="rwd-line"><input type="radio" name="giving-frequency" id="giving-frequency-monthly" value="monthly"> <label for="giving-frequency-monthly">Make a monthly sustaining donation</label></span><span
id="rwd-line"><input type="radio" name="giving-frequency" id="giving-frequency-once" value="once"> <label for="giving-frequency-once">Make a one-time donation</label></span></p>
</div>
<div class="don-standard-levels form-row">
<div class="levels-label">
</div>
<div id="level_standard_row" class="form-row form-donation-level" style="display: block;">
<div class="form-content">
<span class="field-required"></span> <span class="aural-only">Field Is Required</span>
<span class="FormLabelText">Select gift amount</span>
<div class="donation-level-general-ask">
</div>
<div class="donation-levels">
<div class="donation-level-container one-time" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8785" value="8785" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8785');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8785" onclick="">
<div class="donation-level-label-container"> $50 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8785expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8784" value="8784" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8784');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8784" onclick="">
<div class="donation-level-label-container"> $100 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8784expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8782" value="8782" onclick="evalMatchingGift('$250.00');
updateDonorCoverAmount('$250.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8782');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$250.00');
updateDonorCoverAmount('$250.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8782" onclick="">
<div class="donation-level-label-container"> $250 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8782expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8780" value="8780" onclick="evalMatchingGift('$500.00');
updateDonorCoverAmount('$500.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8780');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$500.00');
updateDonorCoverAmount('$500.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8780" onclick="">
<div class="donation-level-label-container"> $500 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8780expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8783" value="8783" onclick="evalMatchingGift('$1,000.00');
updateDonorCoverAmount('$1,000.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8783');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$1,000.00');
updateDonorCoverAmount('$1,000.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8783" onclick="">
<div class="donation-level-label-container"> $1,000 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8783expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8778" value="8778" onclick="evalMatchingGift('$10.00');
updateDonorCoverAmount('$10.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8778');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$10.00');
updateDonorCoverAmount('$10.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8778" onclick="">
<div class="donation-level-label-container"> $10 monthly </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8778expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8779" value="8779" onclick="evalMatchingGift('$25.00');
updateDonorCoverAmount('$25.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8779');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$25.00');
updateDonorCoverAmount('$25.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8779" onclick="">
<div class="donation-level-label-container"> $25 monthly </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8779expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8781" value="8781" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8781');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8781" onclick="">
<div class="donation-level-label-container"> $50 monthly </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8781expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8776" value="8776" onclick="evalMatchingGift('$75.00');
updateDonorCoverAmount('$75.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8776');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$75.00');
updateDonorCoverAmount('$75.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8776" onclick="">
<div class="donation-level-label-container"> $75 monthly </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8776expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8777" value="8777" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8777');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');
});
}
});
</script>
</div>
<label for="level_standardexpanded8777" onclick="">
<div class="donation-level-label-container"> $100 monthly </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8777expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container monthly user-entered-monthly">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8788" value="8788" onclick="evalMatchingGift(document.getElementById('level_standardexpanded8788amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded8788amount').value);">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8788');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift(document.getElementById('level_standardexpanded8788amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded8788amount').value);
});
}
});
</script>
</div>
<label for="level_standardexpanded8788" onclick="">
<div class="donation-level-label-container"></div>
</label>
<div class="donation-level-user-entered">
<label for="level_standardexpanded8788amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded8788amount" id="level_standardexpanded8788amount" value="" size="12" maxlength="50"
onfocus="var el = document.getElementById ('level_standardexpanded8788');if (el) el.click(); fire_obs_comp_event('level_standardexpanded8788amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded8788amount', this, event);evalMatchingGift(value);updateDonorCoverAmount(value);"
onkeyup="fire_obs_comp_event('level_standardexpanded8788amount', this, event);evalMatchingGift(value);updateDonorCoverAmount(value);"
onblur="fire_obs_comp_event('level_standardexpanded8788amount', this);updateDonorCoverAmount(value);" placeholder="Enter amount">
</div>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8788expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container one-time user-entered-one-time" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded8787" value="8787" onclick="evalMatchingGift(document.getElementById('level_standardexpanded8787amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded8787amount').value);">
<script type="text/javascript">
document.addEventListener('DOMContentLoaded', function() {
var radio = document.getElementById('level_standardexpanded8787');
if (radio && radio.checked) {
Y.use('jquery-noconflict', function() {
evalMatchingGift(document.getElementById('level_standardexpanded8787amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded8787amount').value);
});
}
});
</script>
</div>
<label for="level_standardexpanded8787" onclick="">
<div class="donation-level-label-container"></div>
</label>
<div class="donation-level-user-entered">
<label for="level_standardexpanded8787amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded8787amount" id="level_standardexpanded8787amount" value="" size="12" maxlength="50"
onfocus="var el = document.getElementById ('level_standardexpanded8787');if (el) el.click(); fire_obs_comp_event('level_standardexpanded8787amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded8787amount', this, event);evalMatchingGift(value);updateDonorCoverAmount(value);"
onkeyup="fire_obs_comp_event('level_standardexpanded8787amount', this, event);evalMatchingGift(value);updateDonorCoverAmount(value);"
onblur="fire_obs_comp_event('level_standardexpanded8787amount', this);updateDonorCoverAmount(value);" placeholder="Enter amount">
</div>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_8787expandedsubmit" value="true">
</div>
</div>
</div>
</div>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observables
jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
var syncAction = function(obj) {
if (obj.is(':checked')) {
obj.closest('div.donation-level-container').addClass('selected');
} else {
obj.closest('div.donation-level-container').removeClass('selected');
};
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('div.donation-level-container').removeClass('selected');
syncAction(jQuery(this));
});
});
});
});
</script><noscript> </noscript>
</div>
<div class="levels-gift-aid">
</div>
<input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true">
<script type="text/javascript">
function updateDonorCoverAmount(gift) {
var currencyLocale = getLevelCurrencyLocale();
var tempGift = parseCurrency(gift, currencyLocale) / 100;
if (currencyLocale !== 'fr_CA') {
gift = tempGift;
}
if (isNaN(tempGift) || tempGift === 0) {
gift = '';
}
var amountHidden = document.getElementById('user_donation_amt');
if (amountHidden !== null) {
amountHidden.value = gift;
}
jQuery('#level_standardname').val(gift);
jQuery('#user_donation_amt').val(gift);
if (typeof updateAmount !== "undefined") {
updateAmount(gift);
}
};
function getLevelCurrencyLocale() {
var element = document.getElementById('currency_locale');
if (element) {
return element.value;
}
return 'en_US';
}
function evalMatchingGift(gift) {}
</script><noscript> </noscript>
</div>
<div class="donation-level-container-generic-repeat form-input" style="display: none;">
<div class="generic-repeat-label-checkbox-container">
<input type="checkbox" name="level_standardauto_repeatname" id="level_standardauto_repeatname" onclick="fire_obs_comp_event('level_standardauto_repeat', this);" onkeypress="fire_obs_comp_event('level_standardauto_repeat', this);">
<input type="hidden" name="recurring_checkbox_name" id="recurring_checkbox_name" value="level_standardauto_repeatname">
<label for="level_standardauto_repeatname"> Yes, automatically repeat this gift every month. </label>
</div>
<input type="hidden" name="level_standardauto_repeatsubmit" id="level_standardauto_repeatsubmit" value="true">
</div>
<script type="text/javascript">
// subscribe listeners to make an ajax call to the server to calculate the total amount
Y.use('jquery-noconflict', function() {
var fetchAmountFunc = function() {
// find all the select, textarea, input, etc... and format them into key=val pairs.
var params = jQuery('#level_standard_row :input').serialize();
// parse the path and append the key/value pairs above to the url
var url = 'https://secure.animalhumanesociety.org/site/Donation2?idb=1149447918&level_standardajaxfetch=true&df_id=6175&mfc_pref=T&6175.donation=form1&level_standardtotalcalculateBtn=true';
var index = url.indexOf("?");
var path = url.substring(0, index);
var args = url.substring(index + 1, url.length);
args += '&' + params;
var recurringGiftTermsContainer = jQuery('#recurring_gift_terms_acceptance_message_container');
if (recurringGiftTermsContainer && recurringGiftTermsContainer.length > 0) {
jQuery.ajax(path, {
data: args,
success: function(data) {
jQuery('#recurring_gift_terms_acceptance_message_container').trigger("recurringTermsChange");
}
});
}
};
jQuery('#level_standard_row :input[type=text]').blur(function() {
fetchAmountFunc();
});
jQuery('#level_standard_row input:checkbox, #level_standard_row input:radio').click(function() {
fetchAmountFunc();
});
jQuery('#level_standard_row select').change(function() {
fetchAmountFunc();
});
// call it on page load
fetchAmountFunc();
});
</script><noscript> </noscript>
</div>
<div class="custom-field-container form-row ">
<div class="form-content">
<div class="form-input-label-block">
<label for="cover_fee_dropdown">Cover Fee</label>
</div>
<input type="checkbox" name="cover_fee_checkbox" id="cover_fee_checkbox_Yes" value="Yes"><label for="cover_fee_checkbox">Cover the <span class="fee-amt"></span> processing fee so Animal Humane Society gets my full donation.</label>
<fieldset>
<div class="radio-button-container">
<input type="radio" name="cover_fee_radio" id="cover_fee_radio_Yes" value="Yes">
<div class="form-input-label-block">
<label for="cover_fee_radio_Yes">Yes</label>
</div>
</div>
</fieldset>
<input type="hidden" name="cover_feesubmit" id="cover_feesubmit" value="true">
</div>
</div>
<h2 class="section-header-container"> Your information </h2>
<div id="billing_first_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name:</label>
<input type="text" name="billing_first_namename" id="billing_first_namename" value="" maxlength="50">
<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_last_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name:</label>
<input type="text" name="billing_last_namename" id="billing_last_namename" value="" maxlength="50">
<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street1_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street 1:</label>
<input type="text" name="billing_addr_street1name" id="billing_addr_street1name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street1_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_city_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City:</label>
<input type="text" name="billing_addr_cityname" id="billing_addr_cityname" value="" maxlength="50">
<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_city_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_state_row" class="form-row form-selectlist">
<div class="form-content">
<span class="field-required"></span>
<label class="" for="billing_addr_state">State/Province:</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" onchange="fire_obs_comp_event('billing_addr_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option selected="selected" value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_state', src);
}
}
var el = document.getElementById('billing_addr_state');
if (el) {
Utils.addEvent(el, 'change', billing_addr_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_zip_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">ZIP/Postal Code:</label>
<input type="text" name="billing_addr_zipname" id="billing_addr_zipname" value="" maxlength="50">
<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_zip_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_country_row" class="form-row form-selectlist">
<div class="form-content">
<label class="" for="billing_addr_country">Country:</label>
<select name="billing_addr_country" id="billing_addr_country" size="1" onchange="fire_obs_comp_event('billing_addr_country', this)">
<option></option>
<option selected="selected" value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivarian Republic of Venezuela">Bolivarian Republic of Venezuela</option>
<option value="Bonaire, Sint Eustatios and Saba">Bonaire, Sint Eustatios and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Democratic People's Republic of Korea">Democratic People's Republic of Korea</option>
<option value="The Democratic Republic of the Congo">The Democratic Republic of the Congo</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="The Former Yugoslav Republic of Macedonia">The Former Yugoslav Republic of Macedonia</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Islamic Republic of Iran">Islamic Republic of Iran</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos People's Democratic Republic">Laos People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Plurinational State of Bolivia">Plurinational State of Bolivia</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Korea">Republic of Korea</option>
<option value="Republic of Moldova">Republic of Moldova</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French)">Saint Martin (French)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls.</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch)">Sint Maarten (Dutch)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United Republic of Tanzania">United Republic of Tanzania</option>
<option value="Uruguay">Uruguay</option>
<option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_countrysubmit" id="billing_addr_countrysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_country_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_country', src);
}
}
var el = document.getElementById('billing_addr_country');
if (el) {
Utils.addEvent(el, 'change', billing_addr_country_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_email_address_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">Email Address:</label>
<input type="text" name="donor_email_addressname" id="donor_email_addressname" value="" maxlength="255">
<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_address', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_address_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div class="form-row form-checkbox" id="donor_email_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="hidden" name="donor_email_opt_inname" id="donor_email_opt_inname" value="implicit">
<span class="auto-opt-in-warning-message">If you complete a donation and have not already unsubscribed from email, you will receive periodic updates and communications from Animal Humane Society.</span>
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_opt_in', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_opt_in_Row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_email_opt_inname')) {
document.getElementById('donor_email_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_email_opt_inname')) return document.getElementById('donor_email_opt_inname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row ">
<div class="form-content">
<div class="form-input-label-block">
<label for="mobile_phone_number_input">Mobile phone number</label>
</div>
<input type="text" name="mobile_phone_number_input" id="mobile_phone_number_input" value="" maxlength="255">
<input type="hidden" name="mobile_phone_numbersubmit" id="mobile_phone_numbersubmit" value="true">
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<p style="font-size: 16px; margin-block-start: 0em;">By providing your mobile number, you agree to receive text messages about Animal Humane Society and opportunities to help animals in need.</p>
</div>
</div>
<h2 class="section-header-container"> Honor and memorial gifts </h2>
<div id="tribute_show_honor_fields_row" class="form-row form-checkbox">
<div class="form-content">
<input type="checkbox" name="tribute_show_honor_fieldsname" id="tribute_show_honor_fieldsname" onclick="fire_obs_comp_event('tribute_show_honor_fields', this);">
<label for="tribute_show_honor_fieldsname">Yes, this gift is being made in honor of a person or a pet.</label>
<input type="hidden" name="tribute_show_honor_fieldssubmit" id="tribute_show_honor_fieldssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_show_honor_fields', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_show_honor_fields_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('tribute_show_honor_fieldsname')) {
document.getElementById('tribute_show_honor_fieldsname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('tribute_show_honor_fieldsname')) {
return document.getElementById('tribute_show_honor_fieldsname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div class="custom-field-container form-row " style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<label for="this_gift_is_from_input">This donation is from:</label>
</div>
<input type="text" name="this_gift_is_from_input" id="this_gift_is_from_input" value="" maxlength="255">
<input type="hidden" name="this_gift_is_fromsubmit" id="this_gift_is_fromsubmit" value="true">
</div>
</div>
<div class="custom-field-container form-row " style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<label for="this_donation_is_for_a_dropdown">This donation is </label>
</div>
<fieldset>
<div class="radio-button-container">
<input type="radio" name="this_donation_is_for_a_radio" id="this_donation_is_for_a_radio_In memory of a person" value="In memory of a person">
<div class="form-input-label-block">
<label for="this_donation_is_for_a_radio_In memory of a person">In memory of a person</label>
</div>
</div>
<div class="radio-button-container">
<input type="radio" name="this_donation_is_for_a_radio" id="this_donation_is_for_a_radio_In memory of a pet" value="In memory of a pet">
<div class="form-input-label-block">
<label for="this_donation_is_for_a_radio_In memory of a pet">In memory of a pet</label>
</div>
</div>
<div class="radio-button-container">
<input type="radio" name="this_donation_is_for_a_radio" id="this_donation_is_for_a_radio_In honor of a person" value="In honor of a person">
<div class="form-input-label-block">
<label for="this_donation_is_for_a_radio_In honor of a person">In honor of a person</label>
</div>
</div>
<div class="radio-button-container">
<input type="radio" name="this_donation_is_for_a_radio" id="this_donation_is_for_a_radio_In honor of a pet" value="In honor of a pet">
<div class="form-input-label-block">
<label for="this_donation_is_for_a_radio_In honor of a pet">In honor of a pet</label>
</div>
</div>
</fieldset>
<input type="hidden" name="this_donation_is_for_asubmit" id="this_donation_is_for_asubmit" value="true">
</div>
</div>
<div id="tribute_honoree_name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_honoree_namename">Honoree Name:</label>
<input type="text" name="tribute_honoree_namename" id="tribute_honoree_namename" value="" maxlength="50">
<input type="hidden" name="tribute_honoree_namesubmit_skip" id="tribute_honoree_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_honoree_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_honoree_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_honoree_name'));
</script><noscript> </noscript>
</div>
</div>
<div class="custom-field-container form-row " style="display: none;">
<div class="form-content">
<div class="form-input-label-block">
<label for="gift_notification_method_dropdown">Would you like to send an ecard or postcard?</label>
</div>
<select name="gift_notification_method_dropdown" id="gift_notification_method_dropdown" size="1">
<option value="None">No thanks (do not send an eCard or postal card)</option>
<option value="postal">Have AHS send a postal card (minimum 10 business days for delivery)</option>
<option value="ecard">Send an ecard (schedule for today or at a future date)</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('gift_notification_method_dropdown', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('gift_notification_method_dropdown_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="gift_notification_methodsubmit" id="gift_notification_methodsubmit" value="true">
</div>
</div>
<h2 class="section-header-container" style="display: none;"> Send a Postal Card </h2>
<div id="tribute_notify_recip_name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_namename">Recipient Name:</label>
<input type="text" name="tribute_notify_recip_namename" id="tribute_notify_recip_namename" value="" maxlength="70">
<input type="hidden" name="tribute_notify_recip_namesubmit_skip" id="tribute_notify_recip_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_street1_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_street1name">Recipient Street 1:</label>
<input type="text" name="tribute_notify_recip_street1name" id="tribute_notify_recip_street1name" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_street1submit_skip" id="tribute_notify_recip_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_street1_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_street1'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_street2_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_street2name">Recipient Street 2:</label>
<input type="text" name="tribute_notify_recip_street2name" id="tribute_notify_recip_street2name" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_street2submit_skip" id="tribute_notify_recip_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_street2_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_street2'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_city_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_cityname">Recipient City:</label>
<input type="text" name="tribute_notify_recip_cityname" id="tribute_notify_recip_cityname" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_citysubmit_skip" id="tribute_notify_recip_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_city_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_city'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_state_row" class="form-row form-selectlist" style="display: none;">
<div class="form-content">
<label class="" for="tribute_notify_recip_state">Recipient State/Province:</label>
<select name="tribute_notify_recip_state" id="tribute_notify_recip_state" size="1" onchange="fire_obs_comp_event('tribute_notify_recip_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="tribute_notify_recip_statesubmit_skip" id="tribute_notify_recip_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_state_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_state'));
function tribute_notify_recip_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_notify_recip_state', src);
}
}
var el = document.getElementById('tribute_notify_recip_state');
if (el) {
Utils.addEvent(el, 'change', tribute_notify_recip_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_zip_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_notify_recip_zipname">Recipient ZIP/Postal Code:</label>
<input type="text" name="tribute_notify_recip_zipname" id="tribute_notify_recip_zipname" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_zipsubmit_skip" id="tribute_notify_recip_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_zip_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_zip'));
</script><noscript> </noscript>
</div>
</div>
<h2 class="section-header-container" style="display: none;"> Send an Ecard </h2>
<div id="send_ecard_row" class="form-row form-checkbox" style="display: none;">
<div class="form-content">
<span class="check-box-form-label-text">Yes, Send an eCard</span>
<input type="checkbox" name="send_ecardname" id="send_ecardname" onclick="fire_obs_comp_event('send_ecard', this);">
<label for="send_ecardname">Yes, I would like to send an eCard.</label>
<input type="hidden" name="send_ecardsubmit" id="send_ecardsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('send_ecard', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('send_ecard_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('send_ecardname')) {
document.getElementById('send_ecardname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('send_ecardname')) {
return document.getElementById('send_ecardname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div id="ecard_send_date_row" class="form-row form-date" style="display: none;">
<div class="form-content">
<label for="ecard_send_date_MONTH">
<span class="label-text">Send eCard on:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="ecard_send_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<label for="ecard_send_date_MONTH"><span style="display:none;">Month</span></label>
<label for="ecard_send_date_DAY"><span style="display:none;">Day</span></label>
<label for="ecard_send_date_YEAR"><span style="display:none;">Year</span></label>
<select name="ecard_send_date_MONTH" id="ecard_send_date_MONTH" title="Month">
<option value="1">Jan</option>
<option value="2">Feb</option>
<option value="3">Mar</option>
<option value="4">Apr</option>
<option value="5">May</option>
<option value="6">Jun</option>
<option value="7">Jul</option>
<option value="8">Aug</option>
<option value="9">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12" selected="selected">Dec</option>
</select>
<select name="ecard_send_date_DAY" id="ecard_send_date_DAY" title="Day">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17" selected="selected">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<select name="ecard_send_date_YEAR" id="ecard_send_date_YEAR" title="Year">
<option value="2034">2034</option>
<option value="2033">2033</option>
<option value="2032">2032</option>
<option value="2031">2031</option>
<option value="2030">2030</option>
<option value="2029">2029</option>
<option value="2028">2028</option>
<option value="2027">2027</option>
<option value="2026">2026</option>
<option value="2025">2025</option>
<option value="2024" selected="selected">2024</option>
</select>
</div>
<input type="hidden" name="ecard_send_datesubmit" id="ecard_send_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('ecard_send_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('ecard_send_date_row', _display);
disable_submit_flag('ecard_send_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('ecard_send_date_MONTH', _disabled);
disable_element('ecard_send_date_DAY', _disabled);
disable_element('ecard_send_date_YEAR', _disabled);
disable_element('ecard_send_date_HOUR12', _disabled);
disable_element('ecard_send_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('ecard_send_date_MINUTE', _disabled);
disable_element('ecard_send_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="ecard_recpients_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="ecard_recpientsname">Recipient email addresses:</label>
<textarea cols="60" rows="4" name="ecard_recpientsname" id="ecard_recpientsname"></textarea>
<input type="hidden" name="ecard_recpientssubmit" id="ecard_recpientssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('ecard_recpients', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('ecard_recpients_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_ecard_subject_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_ecard_subjectname">eCard Subject:</label>
<input type="text" name="tribute_ecard_subjectname" id="tribute_ecard_subjectname" value="A donation was made to Animal Humane Society" maxlength="50">
<input type="hidden" name="tribute_ecard_subjectsubmit" id="tribute_ecard_subjectsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_ecard_subject', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_ecard_subject_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_ecard_message_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="tribute_ecard_messagename">Message body (limit 255 characters):</label>
<textarea cols="60" rows="4" name="tribute_ecard_messagename" id="tribute_ecard_messagename" maxlength="255"></textarea>
<input type="hidden" name="tribute_ecard_messagesubmit" id="tribute_ecard_messagesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_ecard_message', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_ecard_message_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="select_grid_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<label for="select_gridname">Select an eCard:</label>
<input type="hidden" name="stationery_layout_chooser" id="stationery_layout_chooser" value="true">
<div class="layout-chooser-container clearfix">
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_8228">
<img src="../images/stationery/layout_thumbnail_8228.1131503490.custom.jpg" alt="Cat ecard" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_8228" value="8228">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_8226">
<img src="../images/stationery/layout_thumbnail_8226.1722458418.custom.jpg" alt="Happy dog ecard" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_8226" value="8226">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_8227">
<img src="../images/stationery/layout_thumbnail_8227.700890420.custom.jpg" alt="Kittens ecard" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_8227" value="8227">
</div>
<div class="layout-choice-thumbnail-container">
<label class="layout-choice-thumbnail-label" for="stationery_layout_id_8225">
<img src="../images/stationery/layout_thumbnail_8225.1969236810.custom.jpg" alt="Two puppies ecard" border="0">
</label>
<input type="radio" name="stationery_layout_id" id="stationery_layout_id_8225" value="8225">
</div>
</div>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('select_grid', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('select_grid_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
<input type="hidden" name="select_gridsubmit" id="select_gridsubmit" value="true">
</div>
</div>
<div id="preview_button_row" class="form-row" style="display: none;">
<label for="preview_buttonname"></label>
<div id="null_row" class="form-row form-button">
<div class="form-content">
<button class="step-button action-button" type="submit" name="nullbtn" id="nullbtn" value="eCard Preview" title="Reloads page. "> eCard Preview </button>
<input type="hidden" name="nullsubmit" id="nullsubmit" value="true">
</div>
</div>
<input type="hidden" name="preview_buttonsubmit" id="preview_buttonsubmit" value="true">
</div>
<h2 class="section-header-container"> Payment information </h2>
<div class="payment-type-element-container">
<div class="payment-type-selection-container payment-field-container">
<h3>Payment Method:</h3>
<div id="responsive_payment_typepay_typeradio_row" class="form-row">
<div class="form-content">
<div class="payment-type-selections" id="responsive_payment_typepay_typeradio_payment_types">
<span class="internal-payment"><span class="payment-type-option selected"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiocredit" value="credit" checked="checked"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiocredit"><a href="javascript:void(0);" class="payment-type-label">Credit Card</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span><span class="payment-type-option"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradioach" value="ach"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradioach"><a href="javascript:void(0);" class="payment-type-label">Checking Account</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span></span>
<span class="external-payment"><span class="payment-type-option"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiopaypal" value="paypal"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiopaypal"><a href="javascript:void(0);" class="payment-type-label"><img src="../images/payment/paypal-logo.png" alt="Pay with Paypal"></a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span></span>
</div>
<input type="hidden" name="responsive_payment_typepay_typeradiosubmit" id="responsive_payment_typepay_typeradiosubmit" value="true">
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observable for payment type options
jQuery('.payment-type-option').each(function() {
var syncAction = function(obj) {
if (obj.hasClass('selected')) {
var radioGroupName = obj.find('input').attr('name');
obj.find('input').prop('checked', true);
fire_obs_comp_event(radioGroupName, obj.find('input').get());
}
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('.payment-type-option').removeClass('selected');
jQuery(this).addClass('selected');
syncAction(jQuery(this));
var selectedValue = jQuery(this).find('input').val();
if (selectedValue == 'paypal' || selectedValue == 'amazon') {
// open up a boxinator dialog
jQuery(document).trigger('redirect-external');
jQuery('#btn_next').click();
}
});
});
});
});
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typepay_typeradio_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_cc_container" class="payment-field-container">
<h3>Credit Card Information:</h3>
<div id="responsive_payment_typecc_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/diners_sm.gif" alt="Diners Club" name="responsive_payment_typecc_type_Diners_Club" id="responsive_payment_typecc_type_Diners_Club">
</li>
<li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="responsive_payment_typecc_type_Discover" id="responsive_payment_typecc_type_Discover">
</li>
<li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="responsive_payment_typecc_type_American_Express" id="responsive_payment_typecc_type_American_Express">
</li>
<li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="responsive_payment_typecc_type_MasterCard" id="responsive_payment_typecc_type_MasterCard">
</li>
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="responsive_payment_typecc_type_Visa" id="responsive_payment_typecc_type_Visa">
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_typesubmit" id="responsive_payment_typecc_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typecc_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
<input type="hidden" name="recurring_options_name_install_plan" id="recurring_options_name_install_plan" value="responsive_payment_typecc_type">
</div>
</div>
<div id="responsive_payment_typecc_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_numbername">Credit Card Number:</label>
<input type="text" name="responsive_payment_typecc_numbername" id="responsive_payment_typecc_numbername" value="" maxlength="22" autocomplete="off">
<input type="hidden" name="responsive_payment_typecc_numbersubmit" id="responsive_payment_typecc_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_number_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typecc_number'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_exp_date_row" class="form-row form-date">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_exp_date_MONTH">
<span class="label-text">Expiration Date:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="responsive_payment_typecc_exp_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<fieldset class="cardExpGroup">
<select name="responsive_payment_typecc_exp_date_MONTH" id="responsive_payment_typecc_exp_date_MONTH" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_MONTH', this)">
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12" selected="selected">12</option>
</select>
<select name="responsive_payment_typecc_exp_date_YEAR" id="responsive_payment_typecc_exp_date_YEAR" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_YEAR', this)">
<option value="2024" selected="selected">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>
</select>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_exp_date_DAY" id="responsive_payment_typecc_exp_date_DAY" value="1">
<script type="text/javascript">
<!--
var comp1 = new ObservableComponent('responsive_payment_typecc_exp_date_MONTH', '');
comp1.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
var comp2 = new ObservableComponent('responsive_payment_typecc_exp_date_YEAR', '');
comp2.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
</div>
<input type="hidden" name="responsive_payment_typecc_exp_datesubmit" id="responsive_payment_typecc_exp_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_exp_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_row', _display);
disable_submit_flag('responsive_payment_typecc_exp_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('responsive_payment_typecc_exp_date_MONTH', _disabled);
disable_element('responsive_payment_typecc_exp_date_DAY', _disabled);
disable_element('responsive_payment_typecc_exp_date_YEAR', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR12', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('responsive_payment_typecc_exp_date_MINUTE', _disabled);
disable_element('responsive_payment_typecc_exp_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_cvv_row" class="form-row form-text cvv-input">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_cvvname">
<span class="FormLabelText">CVV Number:</span>
</label>
<a href="http://help.convio.net/site/PageServer?s_site=ahs&pagename=user_donation_cvv" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typecc_cvvname" id="responsive_payment_typecc_cvvname" value="" maxlength="4" autocomplete="cc-csc">
<input type="hidden" name="responsive_payment_typecc_cvvsubmit" id="responsive_payment_typecc_cvvsubmit" value="true">
<script type="text/javascript">
//chrome is mapping cvv as card name
if (/CriOS/.test(navigator.userAgent) || (/Chrome/.test(navigator.userAgent) && /Google Inc/.test(navigator.vendor))) {
document.getElementById('responsive_payment_typecc_cvvname').autocomplete = 'cc-csc';
}
var comp = new ObservableComponent('responsive_payment_typecc_cvv', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_cvv_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_bank_container" class="payment-field-container" style="display: none;">
<h3>Checking Account Information:</h3>
<div id="responsive_payment_typerouting_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typerouting_numbername">Bank Routing Number:</label>
<a href="http://help.convio.net/site/PageServer?s_site=ahs&pagename=User_Donation_ACH" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typerouting_numbername" id="responsive_payment_typerouting_numbername" value="" size="20" maxlength="20" onchange="fire_obs_comp_event('responsive_payment_typerouting_number', this);"
autocomplete="off">
<input type="hidden" name="responsive_payment_typerouting_numbersubmit" id="responsive_payment_typerouting_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typerouting_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typerouting_number_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typebank_account_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typebank_accountname">Bank Account Number:</label>
<input type="text" name="responsive_payment_typebank_accountname" id="responsive_payment_typebank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typebank_accountsubmit" id="responsive_payment_typebank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typebank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typebank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typebank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeverify_bank_account_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typeverify_bank_accountname">Verify Bank Account Number:</label>
<input type="text" name="responsive_payment_typeverify_bank_accountname" id="responsive_payment_typeverify_bank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typeverify_bank_accountsubmit" id="responsive_payment_typeverify_bank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeverify_bank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeverify_bank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typeverify_bank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_type.account_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend><span class="field-required"></span> Account Type:</legend>
<ul class="radio-array-list">
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking" value="CHECKING"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking">Checking</label>
</span>
</li>
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings" value="SAVINGS"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings">Savings</label>
</span>
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_type.account_typesubmit" id="responsive_payment_type.account_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_type.account_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_type.account_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
<input type="hidden" name="recurring_options_name_install_plan" id="recurring_options_name_install_plan" value="responsive_payment_type.account_type">
</div>
</div>
<div id="responsive_payment_typeach_confirm_row" class="form-row form-checkbox">
<div class="form-content">
<span class="field-required"></span>
<input type="checkbox" name="responsive_payment_typeach_confirmname" id="responsive_payment_typeach_confirmname" onclick="fire_obs_comp_event('responsive_payment_typeach_confirm', this);">
<label for="responsive_payment_typeach_confirmname">By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.</label>
<input type="hidden" name="responsive_payment_typeach_confirmsubmit" id="responsive_payment_typeach_confirmsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeach_confirm', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeach_confirm_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
document.getElementById('responsive_payment_typeach_confirmname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
return document.getElementById('responsive_payment_typeach_confirmname').checked;
}
}
comp.clear = function() {
this.set(false);
}
observe_component('null', new ComponentEnabler('responsive_payment_typeach_confirm'));
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_check_container" class="payment-field-container" style="display: none;">
<h3>Check Information</h3>
</div>
<script>
document.addEventListener("DOMContentLoaded", function() {
addHiddenInputIfNotExist("currency_locale", "currency_locale", "en_US");
addHiddenInputIfNotExist("cc_available", "cc_available", "null");
addHiddenInputIfNotExist("debit_available", "debit_available", "null");
addHiddenInputIfNotExist("paypal_available", "paypal_available", "null");
addHiddenInputIfNotExist("wallets_available", "wallets_available", "null");
addHiddenInputIfNotExist("secure_url", "secure_url", "https://secure.animalhumanesociety.org/site/");
addHiddenInputIfNotExist("is_admin_app", "is_admin_app", "F");
addHiddenInputIfNotExist("environment_id", "environment_id", "");
addHiddenInputIfNotExist("merchant_account_configuration_id", "merchant_account_configuration_id", "");
addHiddenInputIfNotExist("pco_javascript_location", "pco_javascript_location", "");
addHiddenInputIfNotExist("primary_color", "primary_color", "null");
addHiddenInputIfNotExist("application_name", "application_name", "TeamRaiser");
addHiddenInputIfNotExist("pco_language_locale", "pco_language_locale", "en_US");
addHiddenInputIfNotExist("pco_environment_zone", "pco_environment_zone", "p-usa01");
});
</script>
<input type="hidden" name="responsive_payment_typesubmit" id="responsive_payment_typesubmit" value="true">
<script type="text/javascript">
function PaymentObserver() {
this.observe = function(_event) {
var sVal = _event.component.get();
switch (sVal) {
case 'check':
hide_element('payment_cc_container');
hide_element('payment_bank_container');
show_element('payment_check_container');
break;
case 'credit':
hide_element('payment_bank_container');
hide_element('payment_check_container');
show_element('payment_cc_container');
break;
case 'ach':
hide_element('payment_cc_container');
hide_element('payment_check_container');
show_element('payment_bank_container');
break;
case 'paypal':
case 'amazon':
case 'mobilepay':
default:
// hide all
hide_element('payment_bank_container');
hide_element('payment_cc_container');
hide_element('payment_check_container');
break;
}
}
}
// Set the observer to show/hide the relevant fields
observe_component('responsive_payment_typepay_typeradio', new PaymentObserver());
</script><noscript> </noscript>
</div>
<div class="button-container clearfix">
<div class="button-sub-container">
<button id="modal-submit-button" class="step-button action-button finish-step" type="button" name="modal-submit-button" value="Submit Monthly Gift" data-target="#monthlyModal">Submit Monthly Gift</button><button
class="step-button action-button finish-step hide-true-submit" type="submit" id="pstep_finish" name="pstep_finish" value="Submit donation" disabled="disabled" style="display: none;">Submit Monthly Gift</button>
</div>
</div>
<input type="hidden" name="idb" id="idb" value="1149447918">
<input type="hidden" name="df_id" id="df_id" value="6175">
<input type="hidden" name="mfc_pref" id="mfc_pref" value="T">
<div class="form-row">
<div class="html-caption-container">
<p></p>
<div style="float: left; padding-top: 30px;">
<p style="font-size: 90%;line-height: 22px;"><strong>The information you submit on this page is sent over a secure connection.</strong> Your contribution is tax-deductible to the fullest extent of the law.</p>
<p style="font-size: 90%; line-height: 22px;"><strong>Need assistance?</strong> Contact our donor services team at <a href="tel:763-489-2210">763-489-2210</a> or
<a href="https://www.animalhumanesociety.org/about/contact-us">complete our contact form</a>.</p>
</div>
<div style="float: left; padding-right: 60px; padding-top: 30px;">
<a href="https://www.charitynavigator.org/index.cfm?bay=search.summary&orgid=5328" target="_blank"><img src="../images/content/pagebuilder/charity-navigator_120x90.png " border="0" alt="meetsstandards.gif" width="70" height="70">
</a>
</div>
</div>
<p></p>
</div>
</div>
<input type="hidden" name="monthly_ask_popup_conversionhidden" id="monthly_ask_popup_conversionhidden" value="">
<input type="hidden" name="monthly_ask_popup_orig_amounthidden" id="monthly_ask_popup_orig_amounthidden" value="">
<input type="hidden" name="monthly_ask_popup_monthly_amthidden" id="monthly_ask_popup_monthly_amthidden" value="">
</div>
<input type="hidden" name="6175.donation" id="6175.donation" value="form1">
</form>Text Content
Animal Humane Society provides expert medical and behavioral care to thousands of dogs, cats, and critters in the Twin Cities area each year. With your support, we can help every animal find their second chance — no matter the challenges they face. This December, your love can provide twice the hope, comfort, and critical care for local animals in need. All gifts will be DOUBLED, dollar-for-dollar, up to $25,000, thanks to the generosity of Bill Nesheim. Please consider making a gift today. Your support brings hope to the vulnerable animals in our care. YOUR DONATION Make a monthly sustaining donation Make a one-time donation Field Is Required Select gift amount $50 $100 $250 $500 $1,000 $10 monthly $25 monthly $50 monthly $75 monthly $100 monthly Enter amount Enter amount Yes, automatically repeat this gift every month. Cover Fee Cover the processing fee so Animal Humane Society gets my full donation. 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Send eCard on:Select month of credit card Select Expiration Year Month Day Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2034 2033 2032 2031 2030 2029 2028 2027 2026 2025 2024 Recipient email addresses: eCard Subject: Message body (limit 255 characters): Select an eCard: eCard Preview PAYMENT INFORMATION PAYMENT METHOD: Credit Card Checking Account CREDIT CARD INFORMATION: Credit Card Type: * * * * * Credit Card Number: Expiration Date:Select month of credit card Select Expiration Year 01 02 03 04 05 06 07 08 09 10 11 12 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 CVV Number: What is this? CHECKING ACCOUNT INFORMATION: Bank Routing Number: What is this? Bank Account Number: Verify Bank Account Number: Account Type: * Checking * Savings By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment. CHECK INFORMATION Submit Monthly GiftSubmit Monthly Gift The information you submit on this page is sent over a secure connection. Your contribution is tax-deductible to the fullest extent of the law. Need assistance? Contact our donor services team at 763-489-2210 or complete our contact form. Contact Us • Hours & Locations • Careers • Privacy Policy • © 2022 Animal Humane Society. All rights reserved. × Thank you for supporting Animal Humane Society! By switching your one-time gift to a monthly gift, you can provide immediate care for the animals currently in our shelters while making an ongoing difference for every animal who will come to us for a second chance in the future. Make it a monthly gift instead Keep my one-time gift.