jewishmuseummilwaukee.org
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141.193.213.21
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Submitted URL: https://click.icptrack.com/icp/relay.php?r=31642938&msgid=270898&act=zhst&c=1270334&pid=1266690&destination=https%3a%2f%2fj...
Effective URL: https://jewishmuseummilwaukee.org/donate/
Submission: On March 30 via api from US — Scanned from DE
Effective URL: https://jewishmuseummilwaukee.org/donate/
Submission: On March 30 via api from US — Scanned from DE
Form analysis 4 forms found in the DOM
GET https://jewishmuseummilwaukee.org/
<form method="get" id="searchform" action="https://jewishmuseummilwaukee.org/">
<input type="text" value="" name="s" id="s" placeholder="Search">
<input name="nds-pmd" type="hidden"
value="{"jvqtrgQngn":{"oq":"1600:1200:1600:1200:1600:1200","wfi":"flap-1","ji":"2.3.1","oc":"q400qo6n8n86q525","fe":"1200k1600 24","qvqgm":"0","jxe":222371,"syi":"snyfr","si":"si,btt,zc4,jroz","sn":"sn,zcrt,btt,jni","us":"1259r9317n207q09","cy":"Jva32","sg":"{\"zgc\":0,\"gf\":snyfr,\"gr\":snyfr}","sp":"{\"gp\":gehr,\"ap\":gehr}","sf":"gehr","jt":"n46p01n68sp5740r","sz":"9r58r1074ro06610","vce":"apvc,0,6424s86o,2,1;fg,0,f,0,vachg_3_7,0,vachg_3_8,0,vachg_3_10,0,vachg_3_9,0,vachg_3_11_1,0,vachg_3_11_2,0,vachg_3_11_3,0,vachg_3_11_4,0,vachg_3_11_5,0,vachg_3_12,5,vachg_2_1,0,vachg_2_3,0,vachg_2_4,0;","vp":"0,qr;"},"jg":"1.j-952168.1.2.Uh6SMgV8E0p6cbeqmX5Myj,,.XAJ8KabpWvXjiros27YubysNC995k-ZllKZ-JSpf1CC8TaSf9ZGH4cw20fig0O_dgzorb8sxH-7PjnuzFYxQKDRkCaXzKXRJYN9CLa_KTOpHnkR3SI8rq0xigkaT8zGEuxSvhHjuO6L2sr_EMo1agpKqtehAfukORMkrY9C3MHKXqenwwn45d-36vxGguzrO2Ye6jbSgG-sl0qgapTwOvleYkdwZvjuGa3ZJoaIiUud3chfHHHcSiFEu7sz5Mr3n"}">
</form>https://jewishmuseummilwaukee.org/
<form action="https://jewishmuseummilwaukee.org/" class="rmp-search-form" role="search">
<input type="search" name="s" title="Search" placeholder="Search" class="rmp-search-box">
<input name="nds-pmd" type="hidden"
value="{"jvqtrgQngn":{"oq":"1600:1200:1600:1200:1600:1200","wfi":"flap-1","ji":"2.3.1","oc":"q400qo6n8n86q525","fe":"1200k1600 24","qvqgm":"0","jxe":222371,"syi":"snyfr","si":"si,btt,zc4,jroz","sn":"sn,zcrt,btt,jni","us":"1259r9317n207q09","cy":"Jva32","sg":"{\"zgc\":0,\"gf\":snyfr,\"gr\":snyfr}","sp":"{\"gp\":gehr,\"ap\":gehr}","sf":"gehr","jt":"n46p01n68sp5740r","sz":"9r58r1074ro06610","vce":"apvc,0,6424s86o,2,1;fg,0,f,0,vachg_3_7,0,vachg_3_8,0,vachg_3_10,0,vachg_3_9,0,vachg_3_11_1,0,vachg_3_11_2,0,vachg_3_11_3,0,vachg_3_11_4,0,vachg_3_11_5,0,vachg_3_12,5,vachg_2_1,0,vachg_2_3,0,vachg_2_4,0;","vp":"0,qr;"},"jg":"1.j-952168.1.2.Uh6SMgV8E0p6cbeqmX5Myj,,.XAJ8KabpWvXjiros27YubysNC995k-ZllKZ-JSpf1CC8TaSf9ZGH4cw20fig0O_dgzorb8sxH-7PjnuzFYxQKDRkCaXzKXRJYN9CLa_KTOpHnkR3SI8rq0xigkaT8zGEuxSvhHjuO6L2sr_EMo1agpKqtehAfukORMkrY9C3MHKXqenwwn45d-36vxGguzrO2Ye6jbSgG-sl0qgapTwOvleYkdwZvjuGa3ZJoaIiUud3chfHHHcSiFEu7sz5Mr3n"}">
</form>POST /donate/
<form method="post" enctype="multipart/form-data" id="gform_3" action="/donate/" data-formid="3" novalidate="" class="recaptcha-v3-initialized">
<div class="gf_invisible ginput_recaptchav3" data-sitekey="6LfOgEUhAAAAAFg-XqlYApw24rkUCqqrNmtIOLim" data-tabindex="0"><input id="input_caf731380c5ac593521ecdbabc01632a" class="gfield_recaptcha_response" type="hidden"
name="input_caf731380c5ac593521ecdbabc01632a" value=""></div>
<div class="gform-body gform_body">
<div id="gform_fields_3" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_3_16" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_16">
<h3 class="gsection_title">DONATION FORM</h3>
</div>
<div id="field_3_17" class="gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_17"><label
class="gfield_label gform-field-label" for="input_3_17">Type of Gift<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_17" id="input_3_17" class="large gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Please Select</option>
<option value="General Donation">General Donation</option>
<option value="Sponsorship">Sponsorship</option>
<option value="Tribute">Tribute</option>
<option value="Memorial">Memorial</option>
<option value="Contribute to Planned Gift Funds">Contribute to Planned Gift Funds</option>
<option value="Make a New Planned Gift Fund">Make a New Planned Gift Fund</option>
</select></div>
</div>
<fieldset id="field_3_14"
class="gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-full amount-radio gfield_price gfield_price_3_14 gfield_product_3_14 gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_14" style="display: none;">
<legend class="gfield_label gform-field-label">Donation Amount<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_3_14">
<div class="gchoice gchoice_3_14_0">
<input class="gfield-choice-input" name="input_14" type="radio" value="$100|100" id="choice_3_14_0" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_14_0" id="label_3_14_0" class="gform-field-label gform-field-label--type-inline">$100</label>
</div>
<div class="gchoice gchoice_3_14_1">
<input class="gfield-choice-input" name="input_14" type="radio" value="$250|250" id="choice_3_14_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_14_1" id="label_3_14_1" class="gform-field-label gform-field-label--type-inline">$250</label>
</div>
<div class="gchoice gchoice_3_14_2">
<input class="gfield-choice-input" name="input_14" type="radio" value="$500|500" id="choice_3_14_2" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_14_2" id="label_3_14_2" class="gform-field-label gform-field-label--type-inline">$500</label>
</div>
<div class="gchoice gchoice_3_14_3">
<input class="gfield-choice-input" name="input_14" type="radio" value="Other|0" id="choice_3_14_3" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_14_3" id="label_3_14_3" class="gform-field-label gform-field-label--type-inline">Other</label>
</div>
</div>
</div>
</fieldset>
<div id="field_3_29"
class="gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_3_29 gfield_product_3_29 field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_29" style="display: none;"><label class="gfield_label gform-field-label" for="input_3_29">Custom Donation Amount</label>
<div class="ginput_container ginput_container_product_price">
<input name="input_29" id="input_3_29" type="text" value="" class="large ginput_amount" aria-invalid="false" disabled="disabled">
</div>
</div>
<fieldset id="field_3_34" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_34" style="display: none;">
<legend class="gfield_label gform-field-label">Would you like to cover the transaction fees?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_3_34">
<div class="gchoice gchoice_3_34_0">
<input class="gfield-choice-input" name="input_34" type="radio" value="Yes" id="choice_3_34_0" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_34_0" id="label_3_34_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_3_34_1">
<input class="gfield-choice-input" name="input_34" type="radio" value="No" id="choice_3_34_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_34_1" id="label_3_34_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_3_31"
class="gfield gfield--type-product gfield--input-type-calculation gfield--width-full gfield_price gfield_price_3_31 gfield_product_3_31 gfield_calculation field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_31" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_3_31_1">Processing fee</label>
<div class="ginput_container ginput_container_product_calculation">
<input type="hidden" name="input_31.1" value="Processing fee" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_3_31" class="ginput_product_price_wrapper">
<span class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</span>
<span class="gform-field-label gform-field-label--type-sub-large ginput_product_price" id="input_3_31">$0.00</span>
</div>
<input type="hidden" name="input_31.2" id="ginput_base_price_3_31" class="gform_hidden" value="$0.00" disabled="disabled">
<input type="hidden" name="input_31.3" value="1" class="ginput_quantity_3_31 gform_hidden" disabled="disabled">
</div>
</div>
<fieldset id="field_3_35" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_35" style="display: none;">
<legend class="gfield_label gform-field-label">Would you like to cover the transaction fees?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_3_35">
<div class="gchoice gchoice_3_35_0">
<input class="gfield-choice-input" name="input_35" type="radio" value="Yes" id="choice_3_35_0" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_35_0" id="label_3_35_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_3_35_1">
<input class="gfield-choice-input" name="input_35" type="radio" value="No" id="choice_3_35_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_35_1" id="label_3_35_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_3_32"
class="gfield gfield--type-product gfield--input-type-calculation gfield--width-full gfield_price gfield_price_3_32 gfield_product_3_32 gfield_calculation field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_32" style="display: none;"><label class="gfield_label gform-field-label gfield_label_before_complex" for="input_3_32_1">Processing fee</label>
<div class="ginput_container ginput_container_product_calculation">
<input type="hidden" name="input_32.1" value="Processing fee" class="gform_hidden" disabled="disabled">
<div id="ginput_product_price_3_32" class="ginput_product_price_wrapper">
<span class="gform-field-label gform-field-label--type-sub-large ginput_product_price_label">Price:</span>
<span class="gform-field-label gform-field-label--type-sub-large ginput_product_price" id="input_3_32">$0.00</span>
</div>
<input type="hidden" name="input_32.2" id="ginput_base_price_3_32" class="gform_hidden" value="$0.00" disabled="disabled">
<input type="hidden" name="input_32.3" value="1" class="ginput_quantity_3_32 gform_hidden" disabled="disabled">
</div>
</div>
<div id="field_3_15" class="gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_15"><label
class="gfield_label gform-field-label" for="input_3_15">Would you like to make your donation a recurring gift?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_15" id="input_3_15" class="large gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Plese select</option>
<option value="One Time">One Time</option>
<option value="Monthly">Monthly</option>
<option value="Annually">Annually</option>
</select></div>
</div>
<fieldset id="field_3_18" class="gfield gfield--type-list gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_18" style="display: none;">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Tribute Honoree(s)</legend>
<div class="ginput_container ginput_container_list ginput_list ginput_container_list--columns">
<div class="gfield_list gfield_list_container">
<div class="gfield_list_header gform-grid-row">
<div class="gform-field-label gfield_header_item gform-grid-col">Name of honoree</div>
<div class="gform-field-label gfield_header_item gform-grid-col">Address of honoree</div>
<div class="gform-field-label gfield_header_item gform-grid-col">Message to honoree</div>
<div class="gfield_header_item gfield_header_item--icons gform-grid-col"> </div>
</div>
<div class="gfield_list_groups">
<div class="gfield_list_row_odd gfield_list_group gform-grid-row">
<div class="gfield_list_group_item gfield_list_cell gfield_list_18_cell1 gform-grid-col" data-label="Name of honoree"><input aria-invalid="false" aria-label="Name of honoree, Row 1" data-aria-label-template="Name of honoree, Row {0}"
type="text" name="input_18[]" value="" disabled="disabled"></div>
<div class="gfield_list_group_item gfield_list_cell gfield_list_18_cell2 gform-grid-col" data-label="Address of honoree"><input aria-invalid="false" aria-label="Address of honoree, Row 1"
data-aria-label-template="Address of honoree, Row {0}" type="text" name="input_18[]" value="" disabled="disabled"></div>
<div class="gfield_list_group_item gfield_list_cell gfield_list_18_cell3 gform-grid-col" data-label="Message to honoree"><input aria-invalid="false" aria-label="Message to honoree, Row 1"
data-aria-label-template="Message to honoree, Row {0}" type="text" name="input_18[]" value="" disabled="disabled"></div>
<div class="gfield_list_icons gform-grid-col"> <button type="button" class="add_list_item " aria-label="Add another row" onclick="gformAddListItem(this, 50)" disabled="disabled">Add</button> <button type="button"
class="delete_list_item" aria-label="Remove row 1" data-aria-label-template="Remove row {0}" onclick="gformDeleteListItem(this, 50)" style="visibility:hidden;" disabled="disabled">Remove</button></div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset id="field_3_36" class="gfield gfield--type-list gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_36" style="display: none;">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Memorial Information</legend>
<div class="ginput_container ginput_container_list ginput_list ginput_container_list--columns">
<div class="gfield_list gfield_list_container">
<div class="gfield_list_header gform-grid-row">
<div class="gform-field-label gfield_header_item gform-grid-col">Name of honoree</div>
<div class="gform-field-label gfield_header_item gform-grid-col">Name of Recipient</div>
<div class="gform-field-label gfield_header_item gform-grid-col">Address of Recipient</div>
<div class="gform-field-label gfield_header_item gform-grid-col">Message to Recipient</div>
<div class="gfield_header_item gfield_header_item--icons gform-grid-col"> </div>
</div>
<div class="gfield_list_groups">
<div class="gfield_list_row_odd gfield_list_group gform-grid-row">
<div class="gfield_list_group_item gfield_list_cell gfield_list_36_cell1 gform-grid-col" data-label="Name of honoree"><input aria-invalid="false" aria-label="Name of honoree, Row 1" data-aria-label-template="Name of honoree, Row {0}"
type="text" name="input_36[]" value="" disabled="disabled"></div>
<div class="gfield_list_group_item gfield_list_cell gfield_list_36_cell2 gform-grid-col" data-label="Name of Recipient"><input aria-invalid="false" aria-label="Name of Recipient, Row 1"
data-aria-label-template="Name of Recipient, Row {0}" type="text" name="input_36[]" value="" disabled="disabled"></div>
<div class="gfield_list_group_item gfield_list_cell gfield_list_36_cell3 gform-grid-col" data-label="Address of Recipient"><input aria-invalid="false" aria-label="Address of Recipient, Row 1"
data-aria-label-template="Address of Recipient, Row {0}" type="text" name="input_36[]" value="" disabled="disabled"></div>
<div class="gfield_list_group_item gfield_list_cell gfield_list_36_cell4 gform-grid-col" data-label="Message to Recipient"><input aria-invalid="false" aria-label="Message to Recipient, Row 1"
data-aria-label-template="Message to Recipient, Row {0}" type="text" name="input_36[]" value="" disabled="disabled"></div>
<div class="gfield_list_icons gform-grid-col"> <button type="button" class="add_list_item " aria-label="Add another row" onclick="gformAddListItem(this, 50)" disabled="disabled">Add</button> <button type="button"
class="delete_list_item" aria-label="Remove row 1" data-aria-label-template="Remove row {0}" onclick="gformDeleteListItem(this, 50)" style="visibility:hidden;" disabled="disabled">Remove</button></div>
</div>
</div>
</div>
</div>
</fieldset>
<div id="field_3_24"
class="gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_3_24 gfield_product_3_24 field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_24" style="display: none;"><label class="gfield_label gform-field-label" for="input_3_24">Donation Amount</label>
<div class="ginput_container ginput_container_product_price">
<input name="input_24" id="input_3_24" type="text" value="" class="large ginput_amount" aria-invalid="false" disabled="disabled">
</div>
</div>
<fieldset id="field_3_19" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_19"
style="display: none;">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Which would you like to sponsor?</legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_3_19">
<div class="gchoice gchoice_3_19_1">
<input class="gfield-choice-input" name="input_19.1" type="checkbox" value="Special Exhibit" id="choice_3_19_1" disabled="disabled">
<label for="choice_3_19_1" id="label_3_19_1" class="gform-field-label gform-field-label--type-inline">Special Exhibit</label>
</div>
<div class="gchoice gchoice_3_19_2">
<input class="gfield-choice-input" name="input_19.2" type="checkbox" value="Program Series" id="choice_3_19_2" disabled="disabled">
<label for="choice_3_19_2" id="label_3_19_2" class="gform-field-label gform-field-label--type-inline">Program Series</label>
</div>
<div class="gchoice gchoice_3_19_3">
<input class="gfield-choice-input" name="input_19.3" type="checkbox" value="Learning Opportunity for Schools" id="choice_3_19_3" disabled="disabled">
<label for="choice_3_19_3" id="label_3_19_3" class="gform-field-label gform-field-label--type-inline">Learning Opportunity for Schools</label>
</div>
</div>
</div>
</fieldset>
<div id="field_3_25"
class="gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_3_25 gfield_product_3_25 field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_25" style="display: none;"><label class="gfield_label gform-field-label" for="input_3_25">Sponsorship Amount</label>
<div class="ginput_container ginput_container_product_price">
<input name="input_25" id="input_3_25" type="text" value="" class="large ginput_amount" aria-invalid="false" disabled="disabled">
</div>
</div>
<div id="field_3_20" class="gfield gfield--type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_20" style="display: none;"><label
class="gfield_label gform-field-label" for="input_3_20">How would you like to apply your gift?</label>
<div class="ginput_container ginput_container_select"><select name="input_20" id="input_3_20" class="large gfield_select" aria-invalid="false" disabled="disabled">
<option value="Barbara & Stephen Becker Curatorial Endowment Fund">Barbara & Stephen Becker Curatorial Endowment Fund</option>
<option value="Beverly Greenberg Education Fund">Beverly Greenberg Education Fund</option>
<option value="Beverly Greenberg Education Fund">Beverly Greenberg Education Fund</option>
<option value="Herbert L. Gronik Oral History Fund">Herbert L. Gronik Oral History Fund</option>
<option value="Jacob Bernheim Endowment Fund">Jacob Bernheim Endowment Fund</option>
<option value="Kathleen E. Bernstein Executive Director's Discretionary Fund">Kathleen E. Bernstein Executive Director's Discretionary Fund</option>
<option value="Marianne Lubar Programming Fund">Marianne Lubar Programming Fund</option>
<option value="Michael J. Spector Endowment Fund">Michael J. Spector Endowment Fund</option>
<option value="Michael Reynard, M.D. Endowment Fund">Michael Reynard, M.D. Endowment Fund</option>
<option value="Morton Komisar Refurnishing Fund">Morton Komisar Refurnishing Fund</option>
<option value="Neena and Richard Florsheim Wish List Fund">Neena and Richard Florsheim Wish List Fund</option>
<option value="Paul and Betty Jacobs Archives Program Endowment Fund">Paul and Betty Jacobs Archives Program Endowment Fund</option>
<option value="Steve Solochek Memorial Lecture Fund">Steve Solochek Memorial Lecture Fund</option>
<option value="Sally Waters Exhibit Endowment Fund">Sally Waters Exhibit Endowment Fund</option>
</select></div>
</div>
<div id="field_3_21"
class="gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_3_21 gfield_product_3_21 field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_21" style="display: none;"><label class="gfield_label gform-field-label" for="input_3_21">Donation Amount</label>
<div class="ginput_container ginput_container_product_price">
<input name="input_21" id="input_3_21" type="text" value="" class="large ginput_amount" aria-invalid="false" disabled="disabled">
</div>
</div>
<fieldset id="field_3_22" class="gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_22" style="display: none;">
<legend class="gfield_label gform-field-label">How would you like to be recognized for your gift?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_3_22">
<div class="gchoice gchoice_3_22_0">
<input class="gfield-choice-input" name="input_22" type="radio" value="Your Name" id="choice_3_22_0" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_22_0" id="label_3_22_0" class="gform-field-label gform-field-label--type-inline">Your Name</label>
</div>
<div class="gchoice gchoice_3_22_1">
<input class="gfield-choice-input" name="input_22" type="radio" value="Remain Anonymous" id="choice_3_22_1" onchange="gformToggleRadioOther( this )" disabled="disabled">
<label for="choice_3_22_1" id="label_3_22_1" class="gform-field-label gform-field-label--type-inline">Remain Anonymous</label>
</div>
</div>
</div>
</fieldset>
<div id="field_3_23" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_23">
<h3 class="gsection_title"></h3>
</div>
<div id="field_3_26" class="gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_26">
<h4>BILLING INFORMATION</h4>
</div>
<div id="field_3_7" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_7"><label
class="gfield_label gform-field-label" for="input_3_7">First Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_7" id="input_3_7" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_3_8" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_8"><label
class="gfield_label gform-field-label" for="input_3_8">Last Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_8" id="input_3_8" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_3_10" class="gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_10"><label
class="gfield_label gform-field-label" for="input_3_10">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_10" id="input_3_10" type="email" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</div>
<div id="field_3_9" class="gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_9"><label
class="gfield_label gform-field-label" for="input_3_9">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_9" id="input_3_9" type="tel" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
<fieldset id="field_3_11" class="gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_11">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row" id="input_3_11">
<span class="ginput_full address_line_1 ginput_address_line_1 gform-grid-col" id="input_3_11_1_container">
<label for="input_3_11_1" id="input_3_11_1_label" class="gform-field-label gform-field-label--type-sub ">Street Address</label>
<input type="text" name="input_11.1" id="input_3_11_1" value="" aria-required="true">
</span><span class="ginput_full address_line_2 ginput_address_line_2 gform-grid-col" id="input_3_11_2_container">
<label for="input_3_11_2" id="input_3_11_2_label" class="gform-field-label gform-field-label--type-sub ">Address Line 2</label>
<input type="text" name="input_11.2" id="input_3_11_2" value="" aria-required="false">
</span><span class="ginput_left address_city ginput_address_city gform-grid-col" id="input_3_11_3_container">
<label for="input_3_11_3" id="input_3_11_3_label" class="gform-field-label gform-field-label--type-sub ">City</label>
<input type="text" name="input_11.3" id="input_3_11_3" value="" aria-required="true">
</span><span class="ginput_right address_state ginput_address_state gform-grid-col" id="input_3_11_4_container">
<label for="input_3_11_4" id="input_3_11_4_label" class="gform-field-label gform-field-label--type-sub ">State / Province / Region</label>
<input type="text" name="input_11.4" id="input_3_11_4" value="" aria-required="true">
</span><span class="ginput_left address_zip ginput_address_zip gform-grid-col" id="input_3_11_5_container">
<label for="input_3_11_5" id="input_3_11_5_label" class="gform-field-label gform-field-label--type-sub ">ZIP / Postal Code</label>
<input type="text" name="input_11.5" id="input_3_11_5" value="" aria-required="true">
</span><span class="ginput_right address_country ginput_address_country gform-grid-col" id="input_3_11_6_container">
<label for="input_3_11_6" id="input_3_11_6_label" class="gform-field-label gform-field-label--type-sub ">Country</label>
<select name="input_11.6" id="input_3_11_6" aria-required="true">
<option value=""></option>
<option value="Afghanistan">Afghanistan</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="Bolivia">Bolivia</option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius 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="Cabo Verde">Cabo Verde</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</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 Islands">Cocos Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, Democratic Republic of the">Congo, Democratic Republic of the</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czechia">Czechia</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</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="Eswatini">Eswatini</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands">Falkland Islands</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</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">Holy See</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="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</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="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao 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="Micronesia">Micronesia</option>
<option value="Moldova">Moldova</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="North Macedonia">North Macedonia</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="Palestine, State of">Palestine, State of</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="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Réunion">Réunion</option>
<option value="Saint Barthélemy">Saint Barthélemy</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">Saint Martin</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="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten">Sint Maarten</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 Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</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="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria Arab Republic">Syria Arab Republic</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, the United Republic of">Tanzania, the United Republic of</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="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Türkiye">Türkiye</option>
<option value="US Minor Outlying Islands">US Minor Outlying Islands</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 States" selected="selected">United States</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela">Venezuela</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</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>
<option value="Åland Islands">Åland Islands</option>
</select>
</span>
<div class="gf_clear gf_clear_complex"></div>
</div>
</fieldset>
<div id="field_3_12" class="gfield gfield--type-total gfield--width-full gfield_price gfield_price_3_ gfield_total gfield_total_3_ field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" aria-atomic="true"
aria-live="polite" data-js-reload="field_3_12"><label class="gfield_label gform-field-label" for="input_3_12">Donation Amount</label>
<div class="ginput_container ginput_container_total">
<input type="text" readonly="" name="input_12" id="input_3_12" value="$0.00" class="gform-text-input-reset ginput_total ginput_total_3">
</div>
</div>
<fieldset id="field_3_27" class="gfield gfield--type-square_creditcard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_3_27">
<legend class="gfield_label gfield_label_before_complex gform-field-label">Credit Card<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container_square_card gform-grid-row single-element SqPaymentForm--invalid" id="input_3_27" style="display: none;">
<div class="ginput_full gform-grid-col" id="input_3_27_1_container">
<div class="sq-input-container sq-cardholder-container"><input class="sq-input" type="text" name="input_27.3" id="input_3_27_3" value="" placeholder="Cardholder Name"><label for="input_3_27_3" id="input_3_27_3_label"
class="gform-field-label gform-field-label--type-sub">Cardholder Name</label></div>
</div>
<div class="ginput_full gform-grid-col" id="input_3_27_3_container">
<div id="input_3_27_1" class="square-single-form" style="visibility: hidden;">
<div id="single-card-wrapper-997b8cbd-da3b-400d-8952-22de8eb60f3d" class="sq-card-wrapper">
<div class="sq-card-iframe-container gform-theme-field-control" style="height: 97px;"><iframe frameborder="0" height="97px" name="single-card-997b8cbd-da3b-400d-8952-22de8eb60f3d" scrolling="no"
src="https://web.squarecdn.com/1.47.0/single-card-element-iframe.html" width="100%" class="sq-card-component"></iframe></div><span class="sq-card-message"></span>
</div>
</div><label for="input_3_27_1" id="input_3_27_1_label" class="gform-field-label gform-field-label--type-sub">Card Details</label>
</div>
</div>
<div class="gfield_description validation_message gfield_validation_message">
<div class="generic">The credit card field will initiate once the payment condition is met.</div>
</div>
</fieldset>
<div id="field_3_28" class="gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_3_28"><strong>Google reCAPTCHA</strong> - <a href="https://www.google.com/intl/en/policies/privacy/" target="_blank">Privacy</a> - <a href="https://www.google.com/intl/en/policies/terms/" target="_blank">Terms</a></div>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_3" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_3"]){return false;} if( !jQuery("#gform_3")[0].checkValidity || jQuery("#gform_3")[0].checkValidity()){window["gf_submitting_3"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_3"]){return false;} if( !jQuery("#gform_3")[0].checkValidity || jQuery("#gform_3")[0].checkValidity()){window["gf_submitting_3"]=true;} jQuery("#gform_3").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_3" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="3">
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