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Submitted URL: https://click.support.nyp.org/?qs=ba57cf7809d747b84befb3fd558825441dd5e13bfd28bb93becbc8c5355361687f045fd3ce4ad1bb66f003bc2d44...
Effective URL: https://give.nyp.org/give/583523?utm_source=tsm-dec2024-sfmc&utm_medium=tsm-email&utm_campaign=tsm-annualgiving-givin...
Submission: On December 04 via api from US — Scanned from US
Effective URL: https://give.nyp.org/give/583523?utm_source=tsm-dec2024-sfmc&utm_medium=tsm-email&utm_campaign=tsm-annualgiving-givin...
Submission: On December 04 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
Name: FORM —
<form name="FORM" novalidate="novalidate" data-ng-submit="submit()" class="donation-block_form ng-pristine ng-invalid ng-invalid-required ng-valid-email-address ng-valid-maxlength ng-valid-phone-number ng-valid-min ng-valid-max"
data-sc-broadcast-form-errors="">
<!-- Honeypot -->
<input type="hidden" data-ng-model="MODEL.z" autocomplete="off" class="ng-pristine ng-untouched ng-valid ng-empty ng-not-modified">
<!-- Components -->
<!-- ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-welcome ng-scope" data-ng-controller="frsDonationWelcomeCtrl">
<div data-sc-filler-text="{
fontBase: 16,
fontRatio: 14
}" data-title-container="'.donation-welcome_container'" data-parent-container="'.donation-welcome_container'" class="ng-isolate-scope">
<div class="donation-welcome_container">
<div class="sr-only">
<!-- ngIf: META.errorList.length -->
<!-- ngRepeat: error in META.errorList -->
</div>
<!-- ngIf: !editable && !isPreview() -->
<h1 class="donation-welcome_title ng-binding ng-scope" data-ng-if="!editable && !isPreview()" data-ng-bind-html="trustedBlockHeadlineHtml">
<p style="font-size: 40px;"><strong>GivingTuesday was a celebration of hope!</strong></p>
</h1><!-- end ngIf: !editable && !isPreview() -->
<!-- ngIf: !editable && isPreview() -->
<!-- ngIf: editable && !getLock('headline') -->
<!-- ngIf: editable && getLock('headline') -->
<!-- Appeal -->
<!-- ngIf: !editable -->
<div class="donation-welcome_description ng-scope" data-ng-if="!editable" sc-allow-html="block.description | scImgAssetRef | userLinks" sc-responsive-video="">
<p><span style="font-size: 24px;">Our Matching Gift opportunity is over but let's continue to celebrate the GivingTuesday spirit! Your gift today will fuel our mission to bring the very best in health care to our communities.</span></p>
</div><!-- end ngIf: !editable -->
<!-- ngIf: editable && !getLock('description') -->
<!-- ngIf: editable && getLock('description') -->
</div>
</div>
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-amount ng-scope" data-ng-controller="frsDonationAmountCtrl">
<!-- ngIf: preventRecurringFrequency -->
<!-- ngIf: show.levels() && !displayRecurringExperiment() && preventRecurringFrequency -->
<!-- ngIf: !displayRecurringExperiment() && preventRecurringFrequency -->
<!-- ngIf: showLegacyDonationGrid -->
<!-- ngIf: !showLegacyDonationGrid --><donation-grid ng-if="!showLegacyDonationGrid" donation-context="CONTEXT" frequency="MODEL.frequency" setting-page-frequency="MODEL.frequency" frequency-levels="DonationBlock.current['recurring-level']"
levels="state.levels" recurring-donation-levels="state.recurringDonationLevels" recur_until="MODEL.recur_until" amount="MODEL.items[0].raw_final_price" previous-frequency-price="MODEL.items[0].previous_frequency_price"
new-amount="MODEL.items[0].raw_final_price" preview="globalState.isPreview" currency="MODEL.payment.raw_currency_code" global-state="globalState" iaa-state="IAAState" class="ng-scope ng-isolate-scope">
<div class="donation-grid">
<!-- FREQUENCY TOGGLE-->
<!-- ngIf: !$ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 0 -->
<div data-ng-init="$ctrl.showFreqDropdown()" data-ng-if="!$ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 0" class="donation-grid__switch ng-scope" role="radiogroup"
data-ng-style="$ctrl.ctaStyle" aria-label="Select a donation frequency" style="background-color: rgba(18, 18, 18, 0.12);">
<div data-ng-click="$ctrl.selectFrequency('one-time'); $ctrl.showFreqDropdown('one-time'); $ctrl.isRecurringFrequency($event)" data-ng-keypress="$ctrl.selectFrequency('one-time',$event); $ctrl.isRecurringFrequency($event)"
data-ng-mouseover="$ctrl.toggleHover('one-time',true)" data-ng-mouseout="$ctrl.toggleHover('one-time',false)" data-ng-style="$ctrl.getStylesFrequencyOneTimeBtn('one-time')" class="donation-grid__btn once hover-state_one-time selected"
_spec="one-time" tabindex="0" data-ng-class="{'selected': $ctrl.frequency === 'one-time'}"
style="transition: 0.2s ease-in-out; color: rgb(255, 255, 255); background-color: rgb(18, 18, 18); border-radius: 24px; box-shadow: rgba(0, 0, 0, 0.2) 0px 0px 0px 1px inset, rgba(0, 0, 0, 0.2) 1px 2px 12px inset, rgba(0, 0, 0, 0.2) 1px 2px 2px inset;">
<div class="donation-grid__btn__frequency-label-container">
<i data-ng-show="$ctrl.isOneTime()" class="ci ci-checkmark eg-donation-frequency-switch__icon eg-pr1"></i>
<label for="donation-grid__radio-input" class="donation-grid__btn__frequency-label" tabindex="-1" data-id="cp-donation-form-one-time">
<input type="radio" id="donation-grid__radio-input" role="radio" tabindex="-1" name="donation-frequency" class="donation-grid__btn__frequency-input" aria-checked="true" data-id="onetime-toggle">One-time </label>
</div>
</div>
<div data-ng-click="$ctrl.selectFrequency($ctrl.frequency); $ctrl.showFreqDropdown($ctrl.recurringBtnText()); $ctrl.isRecurringFrequency($event)"
data-ng-keypress="$ctrl.selectFrequency($ctrl.recurringBtnText(),$event); $ctrl.isRecurringFrequency($event)" data-ng-mouseover="$ctrl.toggleHover('recurring',true)" data-ng-mouseout="$ctrl.toggleHover('recurring',false)"
data-ng-style="$ctrl.getStylesFrequencyRecurringBtn($ctrl.frequency)" class="donation-grid__btn monthly hover-state_recurring" _spec="recurring" tabindex="0" data-ng-class="{'selected': $ctrl.recurringBtnSelected($ctrl.frequency)}"
style="transition: 0.2s ease-in-out; color: rgba(0, 0, 0, 0.9); border-radius: 24px; box-shadow: inherit;">
<div class="donation-grid__btn__frequency-label-container">
<i data-ng-show="$ctrl.recurringBtnSelected($ctrl.frequency)" class="ci ci-checkmark eg-donation-frequency-switch__icon eg-pr1 ng-hide"></i>
<label for="donationGrid-donation-amount-monthly__radio-input" class="donation-grid__btn__frequency-label ng-binding" style="text-transform: capitalize" tabindex="-1" data-id="cp-donation-form-recurring">
<input type="radio" role="radio" id="donationGrid-donation-amount-monthly__radio-input" name="donation-frequency" tabindex="-1" class="donation-grid__btn__frequency-input" aria-checked="false" data-id="recurring-toggle"> monthly
</label>
</div>
</div>
</div><!-- end ngIf: !$ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 0 -->
<div class="donation-grid__fields-container">
<!-- ngIf: $ctrl.isFreqDropdown || ($ctrl.onlyReccurringFrequency($ctrl.frequencyLevels) && $ctrl.recurringLevels($ctrl.frequencyLevels).length > 1) -->
<!-- END DATE -->
<!-- ngIf: $ctrl.showRecurringEndDate && $ctrl.frequency !== 'one-time' -->
</div>
<!-- ngIf: !$ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.levels) !== 1 || $ctrl.showCustomAmtField($ctrl.levels))) -->
<p data-ng-if="!$ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.levels) !== 1 || $ctrl.showCustomAmtField($ctrl.levels)))" id="amount-options-label" class="ng-scope"> Choose a
<b class="ng-binding">one-time</b> amount </p><!-- end ngIf: !$ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.levels) !== 1 || $ctrl.showCustomAmtField($ctrl.levels))) -->
<!-- ngIf: $ctrl.showRecurringDonationArray && (!!$ctrl.frequency && ($ctrl.noOfDonationAmount($ctrl.recurringDonationLevels) !== 1 || $ctrl.showCustomAmtField($ctrl.recurringDonationLevels))) -->
<!-- IF MULTIPLE AMOUNT DISPLAYED -->
<!-- ngIf: !$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) > 1 || $ctrl.showCustomAmtField($ctrl.levels)) -->
<ul data-ng-if="!$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) > 1 || $ctrl.showCustomAmtField($ctrl.levels))" class="donation-grid__levels ng-scope" aria-labelledby="amount-options-label"
role="radiogroup" data-ng-class="{'multiple-amount-hidden' : $ctrl.noOfDonationAmount($ctrl.levels) === 1 && !$ctrl.showCustomAmtField($ctrl.levels)}">
<!-- ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})"
data-ng-click="$ctrl.selectAmount(level.displayAmount)" data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.toggleHover($index,true)" data-ng-mouseout="$ctrl.toggleHover($index,false)"
class="donation-grid__level-item hover-state_0" role="radio" tabindex="0" aria-checked="false" data-ng-class="{'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount, $index)" style="color: rgba(0, 0, 0, 0.87); background-color: rgba(18, 18, 18, 0.12); border: none; max-width: 50%; text-shadow: none; box-shadow: inherit;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A500" class="donation-grid__level-item__amount-label ng-binding ng-scope">
<input id="{{'D-A'+level.amount}}" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donationGrid-donation-amount" class="donation-grid__level-item__amount-input"
ng-attr-data-id="cp-donation-form-onetime-preset-{{$index + 1}}" data-amount="500" data-id="cp-donation-form-onetime-preset-1">$500 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})"
data-ng-click="$ctrl.selectAmount(level.displayAmount)" data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.toggleHover($index,true)" data-ng-mouseout="$ctrl.toggleHover($index,false)"
class="donation-grid__level-item hover-state_1" role="radio" tabindex="0" aria-checked="false" data-ng-class="{'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount, $index)" style="color: rgba(0, 0, 0, 0.87); background-color: rgba(18, 18, 18, 0.12); border: none; max-width: 50%; text-shadow: none; box-shadow: inherit;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A250" class="donation-grid__level-item__amount-label ng-binding ng-scope">
<input id="{{'D-A'+level.amount}}" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donationGrid-donation-amount" class="donation-grid__level-item__amount-input"
ng-attr-data-id="cp-donation-form-onetime-preset-{{$index + 1}}" data-amount="250" data-id="cp-donation-form-onetime-preset-2">$250 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})"
data-ng-click="$ctrl.selectAmount(level.displayAmount)" data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.toggleHover($index,true)" data-ng-mouseout="$ctrl.toggleHover($index,false)"
class="donation-grid__level-item hover-state_2 selected" role="radio" tabindex="0" aria-checked="true" data-ng-class="{'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount, $index)"
style="color: rgb(255, 255, 255); background-color: rgb(18, 18, 18); border: none; max-width: 50%; text-shadow: rgba(0, 0, 0, 0.12) 0px 2px 2px; box-shadow: rgba(0, 0, 0, 0.2) 0px 0px 0px 1px inset, rgba(0, 0, 0, 0.2) 1px 2px 12px inset, rgba(0, 0, 0, 0.2) 1px 2px 2px inset;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A100" class="donation-grid__level-item__amount-label ng-binding ng-scope">
<input id="{{'D-A'+level.amount}}" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donationGrid-donation-amount" class="donation-grid__level-item__amount-input"
ng-attr-data-id="cp-donation-form-onetime-preset-{{$index + 1}}" data-amount="100" data-id="cp-donation-form-onetime-preset-3">$100 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 -->
<li data-ng-if="level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1" data-ng-repeat="level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true})"
data-ng-click="$ctrl.selectAmount(level.displayAmount)" data-ng-keydown="$ctrl.selectAmount(level.displayAmount, $event)" data-ng-mouseover="$ctrl.toggleHover($index,true)" data-ng-mouseout="$ctrl.toggleHover($index,false)"
class="donation-grid__level-item hover-state_3" role="radio" tabindex="0" aria-checked="false" data-ng-class="{'selected': $ctrl.amount === level.displayAmount && !$ctrl.showCustomAmtSelected}"
data-ng-style="$ctrl.donationLevelStyle(level.displayAmount, $index)" style="color: rgba(0, 0, 0, 0.87); background-color: rgba(18, 18, 18, 0.12); border: none; max-width: 50%; text-shadow: none; box-shadow: inherit;">
<!-- ngIf: !level.loading --><label data-ng-if="!level.loading" for="D-A50" class="donation-grid__level-item__amount-label ng-binding ng-scope">
<input id="{{'D-A'+level.amount}}" type="radio" role="radio" tabindex="-1" aria-hidden="true" name="donationGrid-donation-amount" class="donation-grid__level-item__amount-input"
ng-attr-data-id="cp-donation-form-onetime-preset-{{$index + 1}}" data-amount="50" data-id="cp-donation-form-onetime-preset-4">$50 </label><!-- end ngIf: !level.loading -->
<!-- ngIf: level.loading -->
</li>
<!-- end ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) --><!-- ngIf: level.amount !== 'Custom' && $ctrl.noOfDonationAmount($ctrl.levels) !== 1 --><!-- end ngRepeat: level in $ctrl.levels | filter: ($ctrl.noOfDonationAmount($ctrl.levels) > 1 && { display_on_page: true}) -->
<!-- ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} --><!-- ngIf: level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' -->
<li data-ng-if="level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time'" data-ng-repeat="level in $ctrl.levels | filter: { display_on_page: true}"
data-ng-click="$ctrl.selectAmount('Custom')" class="donation-grid__level-item hover-state_other donation-grid__level-item__other ng-scope" role="radio" data-ng-class="{'selected': $ctrl.showCustomAmtSelected}">
<label for="D-AOther" class="donation-grid__level-item__amount-label other-rf">
<div id="custom-amount" class="donation-grid__amount currency-picker" data-ng-class="{'has-focus': $ctrl.show.inputFocus === true}" data-sc-form-error="highlight if amount fails" aria-invalid="false">
<donation-grid-currency class="donation-grid-currency hover-state_currency ng-isolate-scope" selected="$ctrl.showCustomAmtSelected" currency-model="$ctrl.currency" disabled="$ctrl.globalState.feeProcessing"
currency-entity="'donation'" data-ng-mouseover="$ctrl.toggleHover('currency',true)" data-ng-mouseout="$ctrl.toggleHover('currency',false)" data-ng-style="$ctrl.getOtherFieldStyles('currency')">
<div class="currency-picker__wrapper eg-pr2 ng-isolate-scope" data-ng-style="getCurrencyWrapperStyles(selected)" data-ng-class="{'no-pick': !showDropdown, 'disabled': disabled}" aria-hidden="false" sc-lock-field="disabled"
tooltip-text="tooltipText" handle-unlock="true" aria-disabled="false" style="border-color: rgb(227, 227, 227); background-color: rgb(227, 227, 227); opacity: 1;">
<div class="currency-picker__select-wrapper">
<select id="dropdown" data-ng-show="showDropdown" data-ng-model="currency" data-ng-change="syncCurrencyModel()" data-ng-options="currency as currency.longText for currency in currencyOptions track by currency.currency"
class="currency-picker__select eg-interact eg-ff ng-pristine ng-untouched ng-valid ng-not-empty ng-not-modified" aria-label="Select a currency" data-ng-disabled="disabled">
<option label="AED | United Arab Emirates Dirham" value="AED">AED | United Arab Emirates Dirham</option>
<option label="AFN | Afghan Afghani" value="AFN">AFN | Afghan Afghani</option>
<option label="ALL | Albanian Lek" value="ALL">ALL | Albanian Lek</option>
<option label="AMD | Armenian Dram" value="AMD">AMD | Armenian Dram</option>
<option label="ANG | Netherlands Antillean Guilder" value="ANG">ANG | Netherlands Antillean Guilder</option>
<option label="AOA | Angolan Kwanza" value="AOA">AOA | Angolan Kwanza</option>
<option label="ARS | Argentine Peso" value="ARS">ARS | Argentine Peso</option>
<option label="AUD | Australian Dollar" value="AUD">AUD | Australian Dollar</option>
<option label="AWG | Aruban Florin" value="AWG">AWG | Aruban Florin</option>
<option label="AZN | Azerbaijani Manat" value="AZN">AZN | Azerbaijani Manat</option>
<option label="BAM | Bosnia And Herzegovina Convertible Mark" value="BAM">BAM | Bosnia And Herzegovina Convertible Mark</option>
<option label="BBD | Barbados Dollar" value="BBD">BBD | Barbados Dollar</option>
<option label="BDT | Bangladeshi Taka" value="BDT">BDT | Bangladeshi Taka</option>
<option label="BGN | Bulgarian Lev" value="BGN">BGN | Bulgarian Lev</option>
<option label="BHD | Bahraini Dinar" value="BHD">BHD | Bahraini Dinar</option>
<option label="BIF | Burundian Franc" value="BIF">BIF | Burundian Franc</option>
<option label="BMD | Bermudian Dollar (customarily Known As Bermuda Dollar)" value="BMD">BMD | Bermudian Dollar (customarily Known As Bermuda Dollar)</option>
<option label="BND | Brunei Dollar" value="BND">BND | Brunei Dollar</option>
<option label="BOB | Boliviano" value="BOB">BOB | Boliviano</option>
<option label="BRL | Brazilian Real" value="BRL">BRL | Brazilian Real</option>
<option label="BSD | Bahamian Dollar" value="BSD">BSD | Bahamian Dollar</option>
<option label="BTN | Bhutanese Ngultrum" value="BTN">BTN | Bhutanese Ngultrum</option>
<option label="BWP | Botswana Pula" value="BWP">BWP | Botswana Pula</option>
<option label="BZD | Belize Dollar" value="BZD">BZD | Belize Dollar</option>
<option label="CAD | Canadian Dollar" value="CAD">CAD | Canadian Dollar</option>
<option label="CDF | Congolese Franc" value="CDF">CDF | Congolese Franc</option>
<option label="CHF | Swiss Franc" value="CHF">CHF | Swiss Franc</option>
<option label="CLF | Unidad De Fomento (funds Code)" value="CLF">CLF | Unidad De Fomento (funds Code)</option>
<option label="CLP | Chilean Peso" value="CLP">CLP | Chilean Peso</option>
<option label="CNY | Chinese Yuan" value="CNY">CNY | Chinese Yuan</option>
<option label="COP | Colombian Peso" value="COP">COP | Colombian Peso</option>
<option label="CRC | Costa Rican Colon" value="CRC">CRC | Costa Rican Colon</option>
<option label="CUC | Cuban Convertible Peso" value="CUC">CUC | Cuban Convertible Peso</option>
<option label="CUP | Cuban Peso" value="CUP">CUP | Cuban Peso</option>
<option label="CVE | Cape Verde Escudo" value="CVE">CVE | Cape Verde Escudo</option>
<option label="CZK | Czech Koruna" value="CZK">CZK | Czech Koruna</option>
<option label="DJF | Djiboutian Franc" value="DJF">DJF | Djiboutian Franc</option>
<option label="DKK | Danish Krone" value="DKK">DKK | Danish Krone</option>
<option label="DOP | Dominican Peso" value="DOP">DOP | Dominican Peso</option>
<option label="DZD | Algerian Dinar" value="DZD">DZD | Algerian Dinar</option>
<option label="EGP | Egyptian Pound" value="EGP">EGP | Egyptian Pound</option>
<option label="ERN | Eritrean Nakfa" value="ERN">ERN | Eritrean Nakfa</option>
<option label="ETB | Ethiopian Birr" value="ETB">ETB | Ethiopian Birr</option>
<option label="EUR | Euro" value="EUR">EUR | Euro</option>
<option label="FJD | Fiji Dollar" value="FJD">FJD | Fiji Dollar</option>
<option label="FKP | Falkland Islands Pound" value="FKP">FKP | Falkland Islands Pound</option>
<option label="GBP | Pound Sterling" value="GBP">GBP | Pound Sterling</option>
<option label="GEL | Georgian Lari" value="GEL">GEL | Georgian Lari</option>
<option label="GHS | Ghanaian Cedi" value="GHS">GHS | Ghanaian Cedi</option>
<option label="GIP | Gibraltar Pound" value="GIP">GIP | Gibraltar Pound</option>
<option label="GMD | Gambian Dalasi" value="GMD">GMD | Gambian Dalasi</option>
<option label="GNF | Guinean Franc" value="GNF">GNF | Guinean Franc</option>
<option label="GTQ | Guatemalan Quetzal" value="GTQ">GTQ | Guatemalan Quetzal</option>
<option label="GYD | Guyanese Dollar" value="GYD">GYD | Guyanese Dollar</option>
<option label="HKD | Hong Kong Dollar" value="HKD">HKD | Hong Kong Dollar</option>
<option label="HNL | Honduran Lempira" value="HNL">HNL | Honduran Lempira</option>
<option label="HTG | Haitian Gourde" value="HTG">HTG | Haitian Gourde</option>
<option label="HUF | Hungarian Forint" value="HUF">HUF | Hungarian Forint</option>
<option label="IDR | Indonesian Rupiah" value="IDR">IDR | Indonesian Rupiah</option>
<option label="ILS | Israeli New Shekel" value="ILS">ILS | Israeli New Shekel</option>
<option label="INR | Indian Rupee" value="INR">INR | Indian Rupee</option>
<option label="IQD | Iraqi Dinar" value="IQD">IQD | Iraqi Dinar</option>
<option label="IRR | Iranian Rial" value="IRR">IRR | Iranian Rial</option>
<option label="ISK | Icelandic Króna" value="ISK">ISK | Icelandic Króna</option>
<option label="JMD | Jamaican Dollar" value="JMD">JMD | Jamaican Dollar</option>
<option label="JOD | Jordanian Dinar" value="JOD">JOD | Jordanian Dinar</option>
<option label="JPY | Japanese Yen" value="JPY">JPY | Japanese Yen</option>
<option label="KES | Kenyan Shilling" value="KES">KES | Kenyan Shilling</option>
<option label="KGS | Kyrgyzstani Som" value="KGS">KGS | Kyrgyzstani Som</option>
<option label="KHR | Cambodian Riel" value="KHR">KHR | Cambodian Riel</option>
<option label="KMF | Comoro Franc" value="KMF">KMF | Comoro Franc</option>
<option label="KPW | North Korean Won" value="KPW">KPW | North Korean Won</option>
<option label="KRW | South Korean Won" value="KRW">KRW | South Korean Won</option>
<option label="KWD | Kuwaiti Dinar" value="KWD">KWD | Kuwaiti Dinar</option>
<option label="KYD | Cayman Islands Dollar" value="KYD">KYD | Cayman Islands Dollar</option>
<option label="KZT | Kazakhstani Tenge" value="KZT">KZT | Kazakhstani Tenge</option>
<option label="LAK | Lao Kip" value="LAK">LAK | Lao Kip</option>
<option label="LBP | Lebanese Pound" value="LBP">LBP | Lebanese Pound</option>
<option label="LKR | Sri Lankan Rupee" value="LKR">LKR | Sri Lankan Rupee</option>
<option label="LRD | Liberian Dollar" value="LRD">LRD | Liberian Dollar</option>
<option label="LSL | Lesotho Loti" value="LSL">LSL | Lesotho Loti</option>
<option label="LYD | Libyan Dinar" value="LYD">LYD | Libyan Dinar</option>
<option label="MAD | Moroccan Dirham" value="MAD">MAD | Moroccan Dirham</option>
<option label="MDL | Moldovan Leu" value="MDL">MDL | Moldovan Leu</option>
<option label="MGA | Malagasy Ariary" value="MGA">MGA | Malagasy Ariary</option>
<option label="MKD | Macedonian Denar" value="MKD">MKD | Macedonian Denar</option>
<option label="MMK | Myanma Kyat" value="MMK">MMK | Myanma Kyat</option>
<option label="MNT | Mongolian Tugrik" value="MNT">MNT | Mongolian Tugrik</option>
<option label="MOP | Macanese Pataca" value="MOP">MOP | Macanese Pataca</option>
<option label="MUR | Mauritian Rupee" value="MUR">MUR | Mauritian Rupee</option>
<option label="MVR | Maldivian Rufiyaa" value="MVR">MVR | Maldivian Rufiyaa</option>
<option label="MWK | Malawian Kwacha" value="MWK">MWK | Malawian Kwacha</option>
<option label="MXN | Mexican Peso" value="MXN">MXN | Mexican Peso</option>
<option label="MYR | Malaysian Ringgit" value="MYR">MYR | Malaysian Ringgit</option>
<option label="MZN | Mozambican Metical" value="MZN">MZN | Mozambican Metical</option>
<option label="NAD | Namibian Dollar" value="NAD">NAD | Namibian Dollar</option>
<option label="NGN | Nigerian Naira" value="NGN">NGN | Nigerian Naira</option>
<option label="NIO | Nicaraguan Córdoba" value="NIO">NIO | Nicaraguan Córdoba</option>
<option label="NOK | Norwegian Krone" value="NOK">NOK | Norwegian Krone</option>
<option label="NPR | Nepalese Rupee" value="NPR">NPR | Nepalese Rupee</option>
<option label="NZD | New Zealand Dollar" value="NZD">NZD | New Zealand Dollar</option>
<option label="OMR | Omani Rial" value="OMR">OMR | Omani Rial</option>
<option label="PAB | Panamanian Balboa" value="PAB">PAB | Panamanian Balboa</option>
<option label="PEN | Peruvian Nuevo Sol" value="PEN">PEN | Peruvian Nuevo Sol</option>
<option label="PGK | Papua New Guinean Kina" value="PGK">PGK | Papua New Guinean Kina</option>
<option label="PHP | Philippine Peso" value="PHP">PHP | Philippine Peso</option>
<option label="PKR | Pakistani Rupee" value="PKR">PKR | Pakistani Rupee</option>
<option label="PLN | Polish Złoty" value="PLN">PLN | Polish Złoty</option>
<option label="PYG | Paraguayan Guaraní" value="PYG">PYG | Paraguayan Guaraní</option>
<option label="QAR | Qatari Riyal" value="QAR">QAR | Qatari Riyal</option>
<option label="RON | Romanian New Leu" value="RON">RON | Romanian New Leu</option>
<option label="RSD | Serbian Dinar" value="RSD">RSD | Serbian Dinar</option>
<option label="RWF | Rwandan Franc" value="RWF">RWF | Rwandan Franc</option>
<option label="SAR | Saudi Riyal" value="SAR">SAR | Saudi Riyal</option>
<option label="SBD | Solomon Islands Dollar" value="SBD">SBD | Solomon Islands Dollar</option>
<option label="SCR | Seychelles Rupee" value="SCR">SCR | Seychelles Rupee</option>
<option label="SDG | Sudanese Pound" value="SDG">SDG | Sudanese Pound</option>
<option label="SEK | Swedish Krona/kronor" value="SEK">SEK | Swedish Krona/kronor</option>
<option label="SGD | Singapore Dollar" value="SGD">SGD | Singapore Dollar</option>
<option label="SHP | Saint Helena Pound" value="SHP">SHP | Saint Helena Pound</option>
<option label="SLL | Sierra Leonean Leone" value="SLL">SLL | Sierra Leonean Leone</option>
<option label="SOS | Somali Shilling" value="SOS">SOS | Somali Shilling</option>
<option label="SRD | Surinamese Dollar" value="SRD">SRD | Surinamese Dollar</option>
<option label="SSP | South Sudanese Pound" value="SSP">SSP | South Sudanese Pound</option>
<option label="STD | São Tomé And Príncipe Dobra" value="STD">STD | São Tomé And Príncipe Dobra</option>
<option label="SYP | Syrian Pound" value="SYP">SYP | Syrian Pound</option>
<option label="SZL | Swazi Lilangeni" value="SZL">SZL | Swazi Lilangeni</option>
<option label="THB | Thai Baht" value="THB">THB | Thai Baht</option>
<option label="TJS | Tajikistani Somoni" value="TJS">TJS | Tajikistani Somoni</option>
<option label="TMT | Turkmenistani Manat" value="TMT">TMT | Turkmenistani Manat</option>
<option label="TND | Tunisian Dinar" value="TND">TND | Tunisian Dinar</option>
<option label="TOP | Tongan Paʻanga" value="TOP">TOP | Tongan Paʻanga</option>
<option label="TRY | Turkish Lira" value="TRY">TRY | Turkish Lira</option>
<option label="TTD | Trinidad And Tobago Dollar" value="TTD">TTD | Trinidad And Tobago Dollar</option>
<option label="TWD | New Taiwan Dollar" value="TWD">TWD | New Taiwan Dollar</option>
<option label="TZS | Tanzanian Shilling" value="TZS">TZS | Tanzanian Shilling</option>
<option label="UAH | Ukrainian Hryvnia" value="UAH">UAH | Ukrainian Hryvnia</option>
<option label="UGX | Ugandan Shilling" value="UGX">UGX | Ugandan Shilling</option>
<option label="USD | United States Dollar" value="USD" selected="selected">USD | United States Dollar</option>
<option label="UYU | Uruguayan Peso" value="UYU">UYU | Uruguayan Peso</option>
<option label="UZS | Uzbekistan Som" value="UZS">UZS | Uzbekistan Som</option>
<option label="VND | Vietnamese Dong" value="VND">VND | Vietnamese Dong</option>
<option label="VUV | Vanuatu Vatu" value="VUV">VUV | Vanuatu Vatu</option>
<option label="WST | Samoan Tala" value="WST">WST | Samoan Tala</option>
<option label="XAF | CFA Franc BEAC" value="XAF">XAF | CFA Franc BEAC</option>
<option label="XCD | East Caribbean Dollar" value="XCD">XCD | East Caribbean Dollar</option>
<option label="XDR | Special Drawing Rights" value="XDR">XDR | Special Drawing Rights</option>
<option label="XOF | CFA Franc BCEAO" value="XOF">XOF | CFA Franc BCEAO</option>
<option label="XPF | CFP Franc" value="XPF">XPF | CFP Franc</option>
<option label="YER | Yemeni Rial" value="YER">YER | Yemeni Rial</option>
<option label="ZAR | South African Rand" value="ZAR">ZAR | South African Rand</option>
</select>
<span class="currency-picker__short eg-ff ng-binding" data-ng-style="getCurrencyLabelStyles(selected)"
style="border-color: rgb(227, 227, 227) white rgb(227, 227, 227) rgb(227, 227, 227); background-color: rgb(227, 227, 227); border-right-width: 1px; border-right-style: solid; background-image: unset;">USD
<!-- ngIf: !isDisabled() --><i class="fa fa-caret-down ng-scope" ng-if="!isDisabled()"></i><!-- end ngIf: !isDisabled() --></span>
</div>
</div>
</donation-grid-currency>
<donation-grid-custom-amount model="$ctrl.otherAmount" modal-bind-value="$ctrl.amount" selected="$ctrl.showCustomAmtSelected" currency-code="$ctrl.currency" round-currency="false" name="'amount'" label="''" placeholder="'Other'"
data-ng-mouseover="$ctrl.toggleHover('custom_amount',true)" data-ng-mouseout="$ctrl.toggleHover('custom_amount',false)" data-ng-style="$ctrl.getOtherFieldStyles('custom_amount')"
class="currency-field rf donation-grid-custom-amount hover-state_custom_amount ng-isolate-scope" currency-aria-label="Enter an other amount to donate" input-data-id="cp-donation-form-onetime-custom">
<div class="donation-grid-custom-amount-container">
<span ng-class="{'selected': $ctrl.selected}" ng-style="!$ctrl.selected ? $ctrl.getStylesDefault() : $ctrl.getStylesSelected()" class="ng-binding"
style="background-color: rgb(227, 227, 227); border-color: rgb(227, 227, 227);">$</span>
<input ng-model="$ctrl.model" ng-model-options="{ getterSetter: $ctrl.getterSetter }" name="amount" sc-currency="" sc-validity-reporter="" sc-validity-classes="" data-sc-focus="$ctrl.focusWhen"
round-currency="$ctrl.roundCurrency" ng-disabled="$ctrl.disableFlag" ng-required="$ctrl.required" ng-focus="$ctrl.onFocus = true" ng-blur="$ctrl.onBlur()" ng-change="$ctrl.onChange()" max="$ctrl.max" min="$ctrl.min"
autocomplete="off" placeholder="Other" aria-label="Enter an other amount to donate" qa-id="text-input" _spec="input" type="string" inputmode="numeric" ng-class="{'selected': $ctrl.selected}"
class="form__text-input--dark eg-ff eg-bold6 ng-pristine ng-untouched ng-isolate-scope ng-empty sc-valid ng-valid-required ng-not-modified ng-valid-min ng-valid ng-valid-max"
ng-style="!$ctrl.selected ? $ctrl.getStylesDefault() : $ctrl.getStylesSelected()" data-id="cp-donation-form-onetime-custom" style="background-color: rgb(227, 227, 227); border-color: rgb(227, 227, 227);">
</div>
<div style="position: absolute; width: 100%; left: 0; text-align: left" aria-live="polite">
<form-error name="$ctrl.name" messages="$ctrl.errorMessages" _spec="errors" class="ng-isolate-scope">
<p class="form__error" aria-live="polite" role="alert" sc-validity-message="::$ctrl.name" messages="::$ctrl.messages" style="display: none;"></p>
</form-error>
</div>
</donation-grid-custom-amount>
</div>
</label>
</li><!-- end ngIf: level.amount === 'Custom' && $ctrl.showCustomAmtField($ctrl.levels) && $ctrl.frequency === 'one-time' --><!-- end ngRepeat: level in $ctrl.levels | filter: { display_on_page: true} -->
</ul><!-- end ngIf: !$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) > 1 || $ctrl.showCustomAmtField($ctrl.levels)) -->
<!-- IF MULTIPLE RECURRING DONATION AMOUNT DISPLAYED -->
<!-- ngIf: $ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.recurringDonationLevels) > 1 || $ctrl.showCustomAmtField($ctrl.recurringDonationLevels)) -->
<!-- IF ONLY SINGLE AMOUNT DISPLAYED-->
<!-- ngIf: !$ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.levels) === 1 && !$ctrl.showCustomAmtField($ctrl.levels)) -->
<!-- IF ONLY SINGLE RECURRING AMOUNT DISPLAYED-->
<!-- ngIf: $ctrl.showRecurringDonationArray && ($ctrl.noOfDonationAmount($ctrl.recurringDonationLevels) === 1 && !$ctrl.showCustomAmtField($ctrl.recurringDonationLevels)) -->
</div>
</donation-grid><!-- end ngIf: !showLegacyDonationGrid -->
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-dedication ng-scope" data-ng-controller="frsDonationDedicationCtrl">
<button type="button" class="sc-checkbox " data-ng-click="toggle()" role="checkbox" aria-checked="false" data-sc-checkbox="" data-ng-model="state.dedicationFormEnabled" name="dedicate"
aria-label="Dedicate my donation in honor or in memory of someone"><span class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true"> Dedicate my donation <strong class="ng-scope">in honor or in
memory</strong> of someone </span></button>
<div data-ng-show="show.dedicationForm()" data-ng-form="dedicationForm" id="donation-page_checkout_dedication-form" class="ng-pristine ng-hide ng-valid-email-address ng-invalid ng-invalid-required">
<!-- ngInclude: ::template('type') -->
<div data-heap-ignore="true" data-ng-include="::template('type')" class="mp-sensitive ng-scope">
<div class="donation-table ng-scope">
<div class="donation-table-label-type">
<label class="donation-label">Type</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<radio-group role="radiogroup" aria-label="select dedication type" class="ng-isolate-scope"><ng-transclude>
<radio-control ng-model="dedicationModel.type" name="'type'" value="'honor'" ng-required="true" aria-label="select to donate in honor of someone"
class="ng-pristine ng-untouched ng-valid ng-scope ng-isolate-scope ng-not-empty ng-valid-required ng-not-modified" required="required">
<button class="form__radio-control checked" aria-checked="true" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)" ng-disabled="$ctrl.disabled"
type="button" aria-label="select to donate in honor of someone" _spec="button">
<span class="form__radio-control_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control_label" qa-id="radio-field" ng-transclude="" _spec="label"> In honor of … </span>
</button>
</radio-control>
<radio-control ng-model="dedicationModel.type" name="'type'" value="'memory'" ng-required="true" aria-label="select to donate in memory of someone"
class="ng-pristine ng-untouched ng-valid ng-scope ng-isolate-scope ng-not-empty ng-valid-required ng-not-modified" required="required">
<button class="form__radio-control" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)" ng-disabled="$ctrl.disabled"
type="button" aria-label="select to donate in memory of someone" _spec="button">
<span class="form__radio-control_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control_label" qa-id="radio-field" ng-transclude="" _spec="label"> In memory of … </span>
</button>
</radio-control>
</ng-transclude></radio-group>
</div>
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('honoree') -->
<div data-heap-ignore="true" data-ng-include="::template('honoree')" class="mp-sensitive ng-scope">
<div class="donation-table donation-dedication__honoree ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half">
<span class="donation-label required" data-sc-form-error="highlight if dedicationForm.honoree_first_name fails">Honoree’s First Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="dedicationModel.honoree_first_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.honoree_first_name fails" type="text" name="honoree_first_name" aria-label="honoree's first name" required="" aria-invalid="false">
</div>
<div class="donation-table_column half">
<span class="donation-label required" data-sc-form-error="highlight if dedicationForm.honoree_last_name fails">Honoree’s Last Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="dedicationModel.honoree_last_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.honoree_last_name fails" type="text" name="honoree_last_name" aria-label="honoree's last name" required="" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if [dedicationForm.honoree_first_name, dedicationForm.honoree_last_name] fails required" style="display: none;"> Don't forget to give us a name for the dedication.
</span>
</div>
</div>
</div>
</div>
<!-- ngIf: show.emailForm() || state.postcardEnabled --><!-- ngInclude: ::template('recipient-email') -->
<div data-heap-ignore="true" data-ng-include="::template('recipient-email')" data-ng-if="show.emailForm() || state.postcardEnabled" class="mp-sensitive ng-scope">
<div class="donation-table donation-dedication_recipient-info ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<label class="donation-label" data-ng-class="{required: show.requiredDedicationInfo()}" data-sc-form-error="highlight if [dedicationForm.name, dedicationForm.email_address] fails">Recipient's email</label>
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-email-address ng-valid-required ng-not-modified" data-ng-model="dedicationModel.email_address" data-sc-validate-email-address=""
data-sc-retain-focus-validity="" data-sc-form-error="highlight if dedicationForm.email_address fails" data-ng-required="show.requiredDedicationInfo()" type="text" name="email_address" placeholder="Email Address"
aria-label="recipient's email address, not required, use to optionally send a notification email" aria-invalid="false">
</div>
</div>
<div>
<span aria-live="polite" role="alert" class="donation-error ng-binding" data-sc-form-error="show if dedicationForm.email_address fails emailAddress" style="display: none;"> Please enter dedication recipient email in the format:
name@domain.com. </span>
</div>
<small class="donation-table_row-helper ng-binding"> Optionally send a notification email </small>
</div>
</div>
<div class="donation-table donation-dedication_recipient-info ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half">
<span class="donation-label" data-sc-form-error="highlight if billing_first_name fails" data-ng-class="{required: show.requiredDedicationInfo() || state.postcardEnabled}">Recipient’s First Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-required ng-not-modified" data-ng-model="dedicationModel.first_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.first_name fails" type="text" name="first_name" ng-required="show.requiredDedicationInfo() || state.postcardEnabled" aria-label="recipient's first name" aria-invalid="false">
</div>
<div class="donation-table_column half">
<span class="donation-label" data-sc-form-error="highlight if billing_first_name fails" data-ng-class="{required: show.requiredDedicationInfo() || state.postcardEnabled}">Recipient’s Last Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-valid ng-empty ng-valid-required ng-not-modified" data-ng-model="dedicationModel.last_name" data-sc-retain-focus-validity=""
data-sc-form-error="highlight if dedicationForm.last_name fails" type="text" name="last_name" ng-required="show.requiredDedicationInfo() || state.postcardEnabled" aria-label="recipient's last name" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if [dedicationForm.name,dedicationForm.email_address] fails required" style="display: none;"> Don't forget to include the of your recipient. </span>
</div>
</div>
</div>
</div><!-- end ngIf: show.emailForm() || state.postcardEnabled -->
<!-- ngIf: show.postcardToggle() -->
<!-- ngIf: show.postcardForm() -->
<!-- ngIf: show.emailForm() || state.postcardEnabled --><!-- ngInclude: ::template('recipient-message') -->
<div data-heap-ignore="true" data-ng-include="::template('recipient-message')" data-ng-if="show.emailForm() || state.postcardEnabled" class="mp-sensitive ng-scope">
<div class="donation-dedication_message ng-scope" data-sc-form-error="highlight if dedicationForm.ecard_message fails" aria-invalid="false">
<!-- Message Text -->
<div class="donation-dedication_message-text half" data-ng-class="{ half: show.ecardsForm() }">
<div class="donation-dedication_message-label">
<label class="donation-label" for="dedicationMessage" data-sc-form-error="highlight if dedicationForm.ecard_message fails">Your Message to the Recipient</label>
<!-- ngIf: dedicationModel.ecard_id -->
</div>
<textarea class="donation-dedication_message-input ng-pristine ng-untouched ng-valid ng-empty ng-not-modified" data-sc-form-error="highlight if dedicationForm.ecard_message fails" data-ng-model="dedicationModel.ecard_message"
data-sc-retain-focus-validity="" name="ecard_message" aria-label="Your Message to the Recipient." aria-invalid="false"></textarea>
<small class="donation-dedication_message-helper"> Please spell check, include how you would like your name(s) signed, mention the amount if desired, and format your message as you would like it delivered. </small>
</div>
<!-- Image (ecard) -->
<!-- ngIf: show.ecardsForm() -->
<div class="donation-dedication_message-ecard ng-scope" data-ng-if="show.ecardsForm()">
<label class="donation-dedication_message-label">Include an e-Card?</label>
<radio-group role="radiogroup" aria-label="select eCard to send" class="ng-isolate-scope"><ng-transclude>
<div class="donation-dedication_message-ecard-none ng-scope">
<radio-control ng-model="dedicationModel.ecard_id" name="'ecard_id'" value="null" aria-label="don't include an e-card design with the e-mail"
class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control checked" aria-checked="true" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)" ng-disabled="$ctrl.disabled"
type="button" aria-label="don't include an e-card design with the e-mail" _spec="button">
<span class="form__radio-control_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control_label" qa-id="radio-field" ng-transclude="" _spec="label"> No e-Card </span>
</button>
</radio-control>
</div>
<div class="donation-dedication_message-ecard-grid ng-scope">
<!-- ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(18, 18, 18);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 1" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 1" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/27714878/a038feda-8207-11ef-9be1-0a58a9feac04.png" alt="dedication message ecard 1"
src="https://assets.classy.org/27714878/a038feda-8207-11ef-9be1-0a58a9feac04.png">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(18, 18, 18);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 2" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 2" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/27714878/a1bd6318-8207-11ef-a05c-0a58a9feac02.png" alt="dedication message ecard 2"
src="https://assets.classy.org/27714878/a1bd6318-8207-11ef-a05c-0a58a9feac02.png">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(18, 18, 18);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 3" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 3" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/27714878/a38f1baa-8207-11ef-84a2-0e453865b58f.png" alt="dedication message ecard 3"
src="https://assets.classy.org/27714878/a38f1baa-8207-11ef-84a2-0e453865b58f.png">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<div class="donation-dedication_message-ecard-item ng-scope" data-ng-repeat="ecard in list.ecards | orderBy: 'order'" data-ng-class="{'active': dedicationModel.ecard_id == ecard.id }" data-ng-click="selectEcard(ecard.id)"
data-ng-style="{color: theme.current.styles.primaryColor}" style="color: rgb(18, 18, 18);">
<div class="donation-dedication_message-ecard-radio">
<radio-control value="ecard.id" ng-model="dedicationModel.ecard_id" name="'ecard_id'" size="'small'" aria-label="e-Card option 4" class="ng-pristine ng-untouched ng-valid ng-isolate-scope ng-not-empty ng-not-modified">
<button class="form__radio-control--small" aria-checked="false" role="radio" tabindex="0" ng-class="{ checked: $ctrl.isChecked() }" ng-click="$ctrl.select()" ng-keydown="$ctrl.onKeyDown($event)"
ng-disabled="$ctrl.disabled" type="button" aria-label="e-Card option 4" _spec="button">
<span class="form__radio-control--small_input" sc-error-class="$ctrl.ngModelCtrl.$name" ng-style="{ color: $ctrl.color }" _spec="radio" style="color: rgb(18, 18, 18);"></span>
<span class="form__radio-control--small_label" qa-id="radio-field" ng-transclude="" _spec="label"></span>
</button>
</radio-control>
</div>
<img class="donation-dedication_message-ecard-image" data-ng-src="https://assets.classy.org/27714878/a7665dec-8207-11ef-9aac-0a58a9feac02.png" alt="dedication message ecard 4"
src="https://assets.classy.org/27714878/a7665dec-8207-11ef-9aac-0a58a9feac02.png">
</div><!-- end ngRepeat: ecard in list.ecards | orderBy: 'order' -->
<!-- ngIf: dedicationModel.ecard_id -->
</div>
</ng-transclude></radio-group>
</div><!-- end ngIf: show.ecardsForm() -->
</div>
</div><!-- end ngIf: show.emailForm() || state.postcardEnabled -->
</div>
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section class="donation-credit ng-scope no-fundraising" ng-class="{'no-fundraising': !campaign.HAS_FUNDRAISING}" data-ng-controller="frsDonationCreditCtrl">
<!-- ngIf: !campaign.current.disable_donation_attribution && campaign.HAS_FUNDRAISING -->
<!-- ngIf: show.designation() -->
</section>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<div class="donation-donor ng-scope" data-ng-controller="frsDonationDonorCtrl" aria-labelledby="donationPage_your-information-heading" id="donation-page_checkout_donor-information-form">
<h2 class="donation-subtitle" id="donationPage_your-information-heading">Your Information</h2>
<!-- ngIf: show.prefix() --><!-- ngInclude: ::template('prefix') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('prefix')" data-ng-if="show.prefix()">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label" data-ng-class="{ required: list.optionalQuestions.prefix.is_required }" data-sc-form-error="highlight if optional_prefix fails">Title</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column third">
<select class="donation-select ng-pristine ng-untouched ng-valid ng-empty ng-valid-required ng-not-modified" data-ng-model="META.answers.prefix" data-ng-model-options="{ getterSetter: true }"
data-sc-form-error="highlight if optional_prefix fails" data-ng-required="list.optionalQuestions.prefix.is_required" data-ng-options="option.label as option.label for option in list.optionalQuestions.prefix.enum_options"
name="optional_prefix" aria-label="Title" aria-invalid="false">
<option value="" class="" selected="selected">Please Select</option>
<option label="Dr." value="string:Dr.">Dr.</option>
<option label="Mr." value="string:Mr.">Mr.</option>
<option label="Mrs." value="string:Mrs.">Mrs.</option>
<option label="Ms." value="string:Ms.">Ms.</option>
<option label="Mx." value="string:Mx.">Mx.</option>
</select>
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if optional_prefix fails required" style="display: none;"> Please select a title. </span>
</div>
</div>
</div>
</div><!-- end ngIf: show.prefix() -->
<!-- ngInclude: ::template('name') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('name')">
<div class="donation-table ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half" data-ng-class="show.middleName() ? 'third' : 'half'">
<span class="donation-label required" data-sc-form-error="highlight if member_first_name fails">First Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="META.member_first_name" data-sc-form-error="highlight if member_first_name fails"
data-sc-retain-focus-validity="" type="text" name="member_first_name" aria-label="Please enter your first name" required="" aria-invalid="false">
</div>
<!-- ngIf: show.middleName() -->
<div class="donation-table_column half" data-ng-class="show.middleName() ? 'third' : 'half'">
<span class="donation-label required" data-sc-form-error="highlight if member_last_name fails">Last Name</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="META.member_last_name" data-sc-form-error="highlight if member_last_name fails"
data-sc-retain-focus-validity="" type="text" name="member_last_name" aria-label="Please enter your last name" required="" aria-invalid="false">
</div>
</div>
<div aria-live="assertive">
<span class="donation-error ng-binding" data-sc-form-error="show if [member_first_name,optional_middle_name,member_last_name] fails" ng-bind="build.nameError()" style="display: none;">Be sure to provide your name.</span>
</div>
<!-- ngIf: show.anonymous() || show.anonymousDonationAmounts() -->
<div class="donation-table_columns donation-table_columns_without_margin ng-scope" data-ng-if="show.anonymous() || show.anonymousDonationAmounts()">
<!-- ngIf: show.anonymous() -->
<div class="donation-table_column ng-scope" data-ng-if="show.anonymous()">
<button type="button" class="inline sc-checkbox " data-ng-click="toggle()" role="checkbox" aria-checked="false" data-sc-checkbox="" aria-label="Make donation anonymous" data-ng-model="MODEL.is_anonymous" name="is_anonymous"><span
class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true"> Hide my name from the public. </span></button>
<i tabindex="0" class="fa fa-question-circle donation-tooltip inline ng-binding ng-isolate-scope" data-sc-tooltip="" data-sc-tooltip-class="donation-tooltip_message" data-ng-style="{ color: theme.current.styles.primaryColor }" data-hasqtip="0" style="color: rgb(18, 18, 18);"></i>
</div><!-- end ngIf: show.anonymous() -->
<!-- ngIf: show.anonymousDonationAmounts() -->
</div><!-- end ngIf: show.anonymous() || show.anonymousDonationAmounts() -->
</div>
</div>
</div>
<!-- ngIf: show.suffix() --><!-- ngInclude: ::template('suffix') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('suffix')" data-ng-if="show.suffix()">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label" data-ng-class="{ required: list.optionalQuestions.suffix.is_required }" data-sc-form-error="highlight if optional_suffix fails">Suffix</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column third">
<!-- TODO: Does Angular let you do this? -->
<select class="donation-select ng-pristine ng-untouched ng-valid ng-empty ng-valid-required ng-not-modified" data-ng-model="META.answers.suffix" data-ng-model-options="{ getterSetter: true }"
data-sc-form-error="highlight if optional_suffix fails" data-ng-required="list.optionalQuestions.suffix.is_required" name="optional_suffix" aria-label="suffix" aria-invalid="false">
<option value="" selected="selected">Please Select</option>
<option value="Sr.">Sr.</option>
<option value="Jr.">Jr.</option>
<option value="II">II</option>
<option value="III">III</option>
<option value="IV">IV</option>
<option value="V">V</option>
</select>
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if optional_suffix fails required" style="display: none;"> Please select a suffix. </span>
</div>
</div>
</div>
</div><!-- end ngIf: show.suffix() -->
<!-- ngInclude: ::template('email') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('email')">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if member_email_address fails">Email</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column">
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-valid-email-address ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.member_email_address"
data-sc-form-error="highlight if member_email_address fails" data-sc-validate-email-address="" data-sc-retain-focus-validity="" type="text" name="member_email_address" aria-label="Email address. Your receipt will be emailed here."
required="" aria-invalid="false">
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if member_email_address fails required" style="display: none;"> Don't forget your email address. </span>
<span class="donation-error ng-binding" data-sc-form-error="show if member_email_address fails emailAddress" style="display: none;"> Please enter in the format: name@domain.com. </span>
</div>
<small class="donation-table_row-helper"> Your receipt will be emailed here. </small>
<sc-consent data-show="!campaign.current.hide_contact_opt_in" data-opt-in="MODEL.opt_in" data-language="MODEL.opt_in_wording" name="opt_in" class="ng-isolate-scope">
<!-- ngIf: $ctrl.show -->
<div data-ng-if="$ctrl.show" data-ng-hide="$ctrl.hide" class="sc-consent ng-scope">
<button type="button" class="sc-checkbox_top sc-checkbox checked" data-ng-click="toggle()" role="checkbox" aria-checked="true" data-sc-checkbox="" data-ng-model="$ctrl.optIn" aria-label="It's okay to contact me in the future."
name="opt_in"><span class="sc-checkbox_input"></span><span class="sc-checkbox_label" data-ng-transclude="" aria-hidden="true"> It's okay to contact me in the future. </span></button>
</div><!-- end ngIf: $ctrl.show -->
</sc-consent>
</div>
</div>
</div>
<div>
<!-- ngInclude: ::template('billing-address1') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-address1')">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if billing_address1 fails">Address</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<div data-class="donation-text_input" data-name="billing_address1" ng-model="MODEL.billing_address1" data-sc-retain-focus-validity="" data-sc-address-lookup="" data-parser="parseBillingAddressAutocomplete(response)"
data-aria-label="address 1" data-placeholder="Enter your address" data-required="true" class="ng-pristine ng-untouched ng-isolate-scope ng-empty ng-invalid ng-invalid-required ng-not-modified"><input type="text"
class="donation-text_input pac-target-input" name="billing_address1" placeholder="Enter your address" required="" data-sc-form-error="highlight if billing_address1 fails" aria-invalid="false" autocomplete="off"></div>
</div>
</div>
<div style="display: flex; justify-content: space-between">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_address1 fails required" style="display: none;"> Don't forget to provide an address. </span>
</div>
<!-- ngIf: !showAddressLine2 -->
<div style="display: flex; align-items: center" data-ng-if="!showAddressLine2" data-ng-click="handleAddLine2Click()" class="ng-scope">
<img width="22px" height="22x" sc-cdn-src="/static/global/images/add-circle.svg" class="ng-isolate-scope" src="https://prod-frs.content.classy.org/prod/c40f1f6469c9bda83cde41c18ccbffcb385a94b1/static/global/images/add-circle.svg">
<span> Add apt., suite, floor </span>
</div><!-- end ngIf: !showAddressLine2 -->
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('billing-address2') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-address2')"><!-- ngIf: showAddressLine2 -->
</div>
<!-- ngInclude: ::template('billing-zip-city') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-zip-city')">
<div class="donation-table ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half">
<span class="donation-label required ng-binding" name="billing_postal_code_label" data-sc-form-error="highlight if billing_postal_code fails">ZIP</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.billing_postal_code" data-sc-form-error="highlight if billing_postal_code fails"
data-sc-retain-focus-validity="" type="text" name="billing_postal_code" aria-label="ZIP" required="" aria-invalid="false">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" name="billing_postal_code_error">
</span>
</div>
</div>
<div class="donation-table_column half">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if billing_city fails">City</label>
</div>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.billing_city" data-sc-form-error="highlight if billing_city fails"
data-sc-retain-focus-validity="" type="text" name="billing_city" aria-label="billing city" required="" aria-invalid="false">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_city fails required" style="display: none;"> Don't forget to provide a city. </span>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('billing-state-country') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('billing-state-country')">
<div class="donation-table ng-scope">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column half" data-ng-show="show.states()">
<span class="donation-label required" data-sc-form-error="highlight if billing_state fails">State</span>
<select ng-options="state.value as state.label for state in states" qa-id="select-field" aria-label="billing state" class="donation-select ng-empty ng-invalid ng-invalid-required ng-not-modified"
data-ng-model="MODEL.billing_state" data-sc-form-error="highlight if billing_state fails" data-sc-select-states="" data-only-states="true" name="billing_state" required="required" aria-invalid="false">
<option value="" class="">Please Select</option>
<option label="Alabama" value="string:AL">Alabama</option>
<option label="Alaska" value="string:AK">Alaska</option>
<option label="Arizona" value="string:AZ">Arizona</option>
<option label="Arkansas" value="string:AR">Arkansas</option>
<option label="California" value="string:CA">California</option>
<option label="Colorado" value="string:CO">Colorado</option>
<option label="Connecticut" value="string:CT">Connecticut</option>
<option label="Delaware" value="string:DE">Delaware</option>
<option label="District of Columbia" value="string:DC">District of Columbia</option>
<option label="Florida" value="string:FL">Florida</option>
<option label="Georgia" value="string:GA">Georgia</option>
<option label="Hawaii" value="string:HI">Hawaii</option>
<option label="Idaho" value="string:ID">Idaho</option>
<option label="Illinois" value="string:IL">Illinois</option>
<option label="Indiana" value="string:IN">Indiana</option>
<option label="Iowa" value="string:IA">Iowa</option>
<option label="Kansas" value="string:KS">Kansas</option>
<option label="Kentucky" value="string:KY">Kentucky</option>
<option label="Louisiana" value="string:LA">Louisiana</option>
<option label="Maine" value="string:ME">Maine</option>
<option label="Maryland" value="string:MD">Maryland</option>
<option label="Massachusetts" value="string:MA">Massachusetts</option>
<option label="Michigan" value="string:MI">Michigan</option>
<option label="Minnesota" value="string:MN">Minnesota</option>
<option label="Mississippi" value="string:MS">Mississippi</option>
<option label="Missouri" value="string:MO">Missouri</option>
<option label="Montana" value="string:MT">Montana</option>
<option label="Nebraska" value="string:NE">Nebraska</option>
<option label="Nevada" value="string:NV">Nevada</option>
<option label="New Hampshire" value="string:NH">New Hampshire</option>
<option label="New Jersey" value="string:NJ">New Jersey</option>
<option label="New Mexico" value="string:NM">New Mexico</option>
<option label="New York" value="string:NY">New York</option>
<option label="North Carolina" value="string:NC">North Carolina</option>
<option label="North Dakota" value="string:ND">North Dakota</option>
<option label="Ohio" value="string:OH">Ohio</option>
<option label="Oklahoma" value="string:OK">Oklahoma</option>
<option label="Oregon" value="string:OR">Oregon</option>
<option label="Pennsylvania" value="string:PA">Pennsylvania</option>
<option label="Rhode Island" value="string:RI">Rhode Island</option>
<option label="South Carolina" value="string:SC">South Carolina</option>
<option label="South Dakota" value="string:SD">South Dakota</option>
<option label="Tennessee" value="string:TN">Tennessee</option>
<option label="Texas" value="string:TX">Texas</option>
<option label="Utah" value="string:UT">Utah</option>
<option label="Vermont" value="string:VT">Vermont</option>
<option label="Virginia" value="string:VA">Virginia</option>
<option label="Washington" value="string:WA">Washington</option>
<option label="West Virginia" value="string:WV">West Virginia</option>
<option label="Wisconsin" value="string:WI">Wisconsin</option>
<option label="Wyoming" value="string:WY">Wyoming</option>
<option label="Armed Forces (the) Americas" value="string:AA">Armed Forces (the) Americas</option>
<option label="Armed Forces Europe" value="string:AE">Armed Forces Europe</option>
<option label="Armed Forces Pacific" value="string:AP">Armed Forces Pacific</option>
<option label="American Samoa" value="string:AS">American Samoa</option>
<option label="Guam" value="string:GU">Guam</option>
<option label="Northern Mariana Islands" value="string:MP">Northern Mariana Islands</option>
<option label="Puerto Rico" value="string:PR">Puerto Rico</option>
<option label="Virgin Islands" value="string:VI">Virgin Islands</option>
</select>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_state fails required" style="display: none;"> Don't forget to provide a state. </span>
</div>
</div>
<div class="donation-table_column half ng-hide" data-ng-show="show.provinces()">
<span class="donation-label required" data-sc-form-error="highlight if billing_state fails">Province</span>
<select ng-options="province.value as province.label for province in provinces" class="donation-select ng-empty ng-invalid ng-invalid-required ng-not-modified" data-ng-model="MODEL.billing_state"
data-sc-form-error="highlight if billing_state fails" data-sc-select-provinces="" name="billing_state" aria-label="billing province" required="required" aria-invalid="false">
<option value="?" selected="selected"></option>
<option value="" class="">Please Select</option>
<option label="Alberta (AB)" value="string:AB">Alberta (AB)</option>
<option label="British Columbia (BC)" value="string:BC">British Columbia (BC)</option>
<option label="Manitoba (MB)" value="string:MB">Manitoba (MB)</option>
<option label="New Brunswick (NB)" value="string:NB">New Brunswick (NB)</option>
<option label="Newfoundland and Labrador (NL)" value="string:NL">Newfoundland and Labrador (NL)</option>
<option label="Northwest Territories (NT)" value="string:NT">Northwest Territories (NT)</option>
<option label="Nova Scotia (NS)" value="string:NS">Nova Scotia (NS)</option>
<option label="Nunavut (NU)" value="string:NU">Nunavut (NU)</option>
<option label="Prince Edward Island (PE)" value="string:PE">Prince Edward Island (PE)</option>
<option label="Saskatchewan (SK)" value="string:SK">Saskatchewan (SK)</option>
<option label="Ontario (ON)" value="string:ON">Ontario (ON)</option>
<option label="Quebec (QC)" value="string:QC">Quebec (QC)</option>
<option label="Yukon (YT)" value="string:YT">Yukon (YT)</option>
</select>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_state fails required" style="display: none;"> Don't forget to provide a province. </span>
</div>
</div>
<div class="donation-table_column half ng-hide" data-ng-show="show.genericLevel1()">
<span class="donation-label required" data-sc-form-error="highlight if billing_state fails">Region</span>
<input class="donation-text_input ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-maxlength ng-not-modified" data-ng-model="MODEL.billing_state" data-sc-form-error="highlight if billing_state fails"
data-sc-retain-focus-validity="" type="text" name="billing_state" aria-label="billing region" ng-maxlength="32" maxlength="32" required="" aria-invalid="false">
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_state fails required" style="display: none;"> Don't forget to provide a region. </span>
</div>
</div>
<div class="donation-table_column half">
<div class="donation-table_label">
<label class="donation-label required" data-sc-form-error="highlight if billing_country fails">Country</label>
</div>
<!-- TODO: Exclude SG? -->
<select ng-options="country.value as country.label disable when country.disable for country in countries" qa-id="select-field" class="donation-select ng-not-empty ng-valid ng-valid-required ng-not-modified"
data-ng-model="MODEL.billing_country" data-sc-form-error="highlight if billing_country fails" data-sc-select-countries="" name="billing_country" aria-label="billing country" required="required" aria-invalid="false">
<option value="" class="">Please Select</option>
<option label="Afghanistan" value="string:AF">Afghanistan</option>
<option label="Aland Islands" value="string:AX">Aland Islands</option>
<option label="Albania" value="string:AL">Albania</option>
<option label="Algeria" value="string:DZ">Algeria</option>
<option label="American Samoa" value="string:AS">American Samoa</option>
<option label="Andorra" value="string:AD">Andorra</option>
<option label="Angola" value="string:AO">Angola</option>
<option label="Anguilla" value="string:AI">Anguilla</option>
<option label="Antarctica" value="string:AQ">Antarctica</option>
<option label="Antigua and Barbuda" value="string:AG">Antigua and Barbuda</option>
<option label="Argentina" value="string:AR">Argentina</option>
<option label="Armenia" value="string:AM">Armenia</option>
<option label="Aruba" value="string:AW">Aruba</option>
<option label="Australia" value="string:AU">Australia</option>
<option label="Austria" value="string:AT">Austria</option>
<option label="Azerbaijan" value="string:AZ">Azerbaijan</option>
<option label="Bahamas" value="string:BS">Bahamas</option>
<option label="Bahrain" value="string:BH">Bahrain</option>
<option label="Bangladesh" value="string:BD">Bangladesh</option>
<option label="Barbados" value="string:BB">Barbados</option>
<option label="Belgium" value="string:BE">Belgium</option>
<option label="Belize" value="string:BZ">Belize</option>
<option label="Benin" value="string:BJ">Benin</option>
<option label="Bermuda" value="string:BM">Bermuda</option>
<option label="Bhutan" value="string:BT">Bhutan</option>
<option label="Bolivia" value="string:BO">Bolivia</option>
<option label="Bonaire, Saint Eustatius and Saba " value="string:BQ">Bonaire, Saint Eustatius and Saba </option>
<option label="Bosnia and Herzegovina" value="string:BA">Bosnia and Herzegovina</option>
<option label="Botswana" value="string:BW">Botswana</option>
<option label="Bouvet Island" value="string:BV">Bouvet Island</option>
<option label="Brazil" value="string:BR">Brazil</option>
<option label="British Indian Ocean Territory" value="string:IO">British Indian Ocean Territory</option>
<option label="British Virgin Islands" value="string:VG">British Virgin Islands</option>
<option label="Brunei" value="string:BN">Brunei</option>
<option label="Bulgaria" value="string:BG">Bulgaria</option>
<option label="Burkina Faso" value="string:BF">Burkina Faso</option>
<option label="Burundi" value="string:BI">Burundi</option>
<option label="Cambodia" value="string:KH">Cambodia</option>
<option label="Cameroon" value="string:CM">Cameroon</option>
<option label="Canada" value="string:CA">Canada</option>
<option label="Cape Verde" value="string:CV">Cape Verde</option>
<option label="Cayman Islands" value="string:KY">Cayman Islands</option>
<option label="Central African Republic" value="string:CF">Central African Republic</option>
<option label="Chad" value="string:TD">Chad</option>
<option label="Chile" value="string:CL">Chile</option>
<option label="China" value="string:CN">China</option>
<option label="Christmas Island" value="string:CX">Christmas Island</option>
<option label="Cocos Islands" value="string:CC">Cocos Islands</option>
<option label="Colombia" value="string:CO">Colombia</option>
<option label="Comoros" value="string:KM">Comoros</option>
<option label="Cook Islands" value="string:CK">Cook Islands</option>
<option label="Costa Rica" value="string:CR">Costa Rica</option>
<option label="Croatia" value="string:HR">Croatia</option>
<option label="Cuba" value="string:CU">Cuba</option>
<option label="Curacao" value="string:CW">Curacao</option>
<option label="Cyprus" value="string:CY">Cyprus</option>
<option label="Czech Republic" value="string:CZ">Czech Republic</option>
<option label="Denmark" value="string:DK">Denmark</option>
<option label="Djibouti" value="string:DJ">Djibouti</option>
<option label="Dominica" value="string:DM">Dominica</option>
<option label="Dominican Republic" value="string:DO">Dominican Republic</option>
<option label="East Timor" value="string:TL">East Timor</option>
<option label="Ecuador" value="string:EC">Ecuador</option>
<option label="Egypt" value="string:EG">Egypt</option>
<option label="El Salvador" value="string:SV">El Salvador</option>
<option label="Equatorial Guinea" value="string:GQ">Equatorial Guinea</option>
<option label="Eritrea" value="string:ER">Eritrea</option>
<option label="Estonia" value="string:EE">Estonia</option>
<option label="Ethiopia" value="string:ET">Ethiopia</option>
<option label="Falkland Islands" value="string:FK">Falkland Islands</option>
<option label="Faroe Islands" value="string:FO">Faroe Islands</option>
<option label="Fiji" value="string:FJ">Fiji</option>
<option label="Finland" value="string:FI">Finland</option>
<option label="France" value="string:FR">France</option>
<option label="French Guiana" value="string:GF">French Guiana</option>
<option label="French Polynesia" value="string:PF">French Polynesia</option>
<option label="French Southern Territories" value="string:TF">French Southern Territories</option>
<option label="Gabon" value="string:GA">Gabon</option>
<option label="Gambia" value="string:GM">Gambia</option>
<option label="Georgia" value="string:GE">Georgia</option>
<option label="Germany" value="string:DE">Germany</option>
<option label="Ghana" value="string:GH">Ghana</option>
<option label="Gibraltar" value="string:GI">Gibraltar</option>
<option label="Greece" value="string:GR">Greece</option>
<option label="Greenland" value="string:GL">Greenland</option>
<option label="Grenada" value="string:GD">Grenada</option>
<option label="Guadeloupe" value="string:GP">Guadeloupe</option>
<option label="Guam" value="string:GU">Guam</option>
<option label="Guatemala" value="string:GT">Guatemala</option>
<option label="Guernsey" value="string:GG">Guernsey</option>
<option label="Guinea" value="string:GN">Guinea</option>
<option label="Guinea-Bissau" value="string:GW">Guinea-Bissau</option>
<option label="Guyana" value="string:GY">Guyana</option>
<option label="Haiti" value="string:HT">Haiti</option>
<option label="Heard Island and McDonald Islands" value="string:HM">Heard Island and McDonald Islands</option>
<option label="Honduras" value="string:HN">Honduras</option>
<option label="Hong Kong" value="string:HK">Hong Kong</option>
<option label="Hungary" value="string:HU">Hungary</option>
<option label="Iceland" value="string:IS">Iceland</option>
<option label="India" value="string:IN">India</option>
<option label="Indonesia" value="string:ID">Indonesia</option>
<option label="Ireland" value="string:IE">Ireland</option>
<option label="Isle of Man" value="string:IM">Isle of Man</option>
<option label="Israel" value="string:IL">Israel</option>
<option label="Italy" value="string:IT">Italy</option>
<option label="Ivory Coast" value="string:CI">Ivory Coast</option>
<option label="Jamaica" value="string:JM">Jamaica</option>
<option label="Japan" value="string:JP">Japan</option>
<option label="Jersey" value="string:JE">Jersey</option>
<option label="Jordan" value="string:JO">Jordan</option>
<option label="Kazakhstan" value="string:KZ">Kazakhstan</option>
<option label="Kenya" value="string:KE">Kenya</option>
<option label="Kiribati" value="string:KI">Kiribati</option>
<option label="Kosovo" value="string:XK">Kosovo</option>
<option label="Kuwait" value="string:KW">Kuwait</option>
<option label="Kyrgyzstan" value="string:KG">Kyrgyzstan</option>
<option label="Laos" value="string:LA">Laos</option>
<option label="Latvia" value="string:LV">Latvia</option>
<option label="Lebanon" value="string:LB">Lebanon</option>
<option label="Lesotho" value="string:LS">Lesotho</option>
<option label="Libya" value="string:LY">Libya</option>
<option label="Liechtenstein" value="string:LI">Liechtenstein</option>
<option label="Lithuania" value="string:LT">Lithuania</option>
<option label="Luxembourg" value="string:LU">Luxembourg</option>
<option label="Macao" value="string:MO">Macao</option>
<option label="Macedonia" value="string:MK">Macedonia</option>
<option label="Madagascar" value="string:MG">Madagascar</option>
<option label="Malawi" value="string:MW">Malawi</option>
<option label="Malaysia" value="string:MY">Malaysia</option>
<option label="Maldives" value="string:MV">Maldives</option>
<option label="Mali" value="string:ML">Mali</option>
<option label="Malta" value="string:MT">Malta</option>
<option label="Marshall Islands" value="string:MH">Marshall Islands</option>
<option label="Martinique" value="string:MQ">Martinique</option>
<option label="Mauritania" value="string:MR">Mauritania</option>
<option label="Mauritius" value="string:MU">Mauritius</option>
<option label="Mayotte" value="string:YT">Mayotte</option>
<option label="Mexico" value="string:MX">Mexico</option>
<option label="Micronesia" value="string:FM">Micronesia</option>
<option label="Moldova" value="string:MD">Moldova</option>
<option label="Monaco" value="string:MC">Monaco</option>
<option label="Mongolia" value="string:MN">Mongolia</option>
<option label="Montenegro" value="string:ME">Montenegro</option>
<option label="Montserrat" value="string:MS">Montserrat</option>
<option label="Morocco" value="string:MA">Morocco</option>
<option label="Mozambique" value="string:MZ">Mozambique</option>
<option label="Myanmar" value="string:MM">Myanmar</option>
<option label="Namibia" value="string:NA">Namibia</option>
<option label="Nauru" value="string:NR">Nauru</option>
<option label="Nepal" value="string:NP">Nepal</option>
<option label="Netherlands" value="string:NL">Netherlands</option>
<option label="New Caledonia" value="string:NC">New Caledonia</option>
<option label="New Zealand" value="string:NZ">New Zealand</option>
<option label="Nicaragua" value="string:NI">Nicaragua</option>
<option label="Niger" value="string:NE">Niger</option>
<option label="Nigeria" value="string:NG">Nigeria</option>
<option label="Niue" value="string:NU">Niue</option>
<option label="Norfolk Island" value="string:NF">Norfolk Island</option>
<option label="Northern Mariana Islands" value="string:MP">Northern Mariana Islands</option>
<option label="Norway" value="string:NO">Norway</option>
<option label="Oman" value="string:OM">Oman</option>
<option label="Pakistan" value="string:PK">Pakistan</option>
<option label="Palau" value="string:PW">Palau</option>
<option label="Palestinian Territory" value="string:PS">Palestinian Territory</option>
<option label="Panama" value="string:PA">Panama</option>
<option label="Papua New Guinea" value="string:PG">Papua New Guinea</option>
<option label="Paraguay" value="string:PY">Paraguay</option>
<option label="Peru" value="string:PE">Peru</option>
<option label="Philippines" value="string:PH">Philippines</option>
<option label="Pitcairn" value="string:PN">Pitcairn</option>
<option label="Poland" value="string:PL">Poland</option>
<option label="Portugal" value="string:PT">Portugal</option>
<option label="Puerto Rico" value="string:PR">Puerto Rico</option>
<option label="Qatar" value="string:QA">Qatar</option>
<option label="Republic of the Congo" value="string:CG">Republic of the Congo</option>
<option label="Reunion" value="string:RE">Reunion</option>
<option label="Romania" value="string:RO">Romania</option>
<option label="Russia" value="string:RU">Russia</option>
<option label="Rwanda" value="string:RW">Rwanda</option>
<option label="Saint Barthelemy" value="string:BL">Saint Barthelemy</option>
<option label="Saint Helena" value="string:SH">Saint Helena</option>
<option label="Saint Kitts and Nevis" value="string:KN">Saint Kitts and Nevis</option>
<option label="Saint Lucia" value="string:LC">Saint Lucia</option>
<option label="Saint Martin" value="string:MF">Saint Martin</option>
<option label="Saint Pierre and Miquelon" value="string:PM">Saint Pierre and Miquelon</option>
<option label="Saint Vincent and the Grenadines" value="string:VC">Saint Vincent and the Grenadines</option>
<option label="Samoa" value="string:WS">Samoa</option>
<option label="San Marino" value="string:SM">San Marino</option>
<option label="Sao Tome and Principe" value="string:ST">Sao Tome and Principe</option>
<option label="Saudi Arabia" value="string:SA">Saudi Arabia</option>
<option label="Senegal" value="string:SN">Senegal</option>
<option label="Serbia" value="string:RS">Serbia</option>
<option label="Seychelles" value="string:SC">Seychelles</option>
<option label="Singapore" value="string:SG">Singapore</option>
<option label="Sint Maarten" value="string:SX">Sint Maarten</option>
<option label="Slovakia" value="string:SK">Slovakia</option>
<option label="Slovenia" value="string:SI">Slovenia</option>
<option label="Solomon Islands" value="string:SB">Solomon Islands</option>
<option label="South Africa" value="string:ZA">South Africa</option>
<option label="South Georgia and the South Sandwich Islands" value="string:GS">South Georgia and the South Sandwich Islands</option>
<option label="South Korea" value="string:KR">South Korea</option>
<option label="South Sudan" value="string:SS">South Sudan</option>
<option label="Spain" value="string:ES">Spain</option>
<option label="Sri Lanka" value="string:LK">Sri Lanka</option>
<option label="Suriname" value="string:SR">Suriname</option>
<option label="Svalbard and Jan Mayen" value="string:SJ">Svalbard and Jan Mayen</option>
<option label="Swaziland" value="string:SZ">Swaziland</option>
<option label="Sweden" value="string:SE">Sweden</option>
<option label="Switzerland" value="string:CH">Switzerland</option>
<option label="Taiwan" value="string:TW">Taiwan</option>
<option label="Tajikistan" value="string:TJ">Tajikistan</option>
<option label="Tanzania" value="string:TZ">Tanzania</option>
<option label="Thailand" value="string:TH">Thailand</option>
<option label="Togo" value="string:TG">Togo</option>
<option label="Tokelau" value="string:TK">Tokelau</option>
<option label="Tonga" value="string:TO">Tonga</option>
<option label="Trinidad and Tobago" value="string:TT">Trinidad and Tobago</option>
<option label="Tunisia" value="string:TN">Tunisia</option>
<option label="Turkey" value="string:TR">Turkey</option>
<option label="Turkmenistan" value="string:TM">Turkmenistan</option>
<option label="Turks and Caicos Islands" value="string:TC">Turks and Caicos Islands</option>
<option label="Tuvalu" value="string:TV">Tuvalu</option>
<option label="U.S. Virgin Islands" value="string:VI">U.S. Virgin Islands</option>
<option label="Uganda" value="string:UG">Uganda</option>
<option label="Ukraine" value="string:UA">Ukraine</option>
<option label="United Arab Emirates" value="string:AE">United Arab Emirates</option>
<option label="United Kingdom" value="string:GB">United Kingdom</option>
<option label="United States" value="string:US" selected="selected">United States</option>
<option label="United States Minor Outlying Islands" value="string:UM">United States Minor Outlying Islands</option>
<option label="Uruguay" value="string:UY">Uruguay</option>
<option label="Uzbekistan" value="string:UZ">Uzbekistan</option>
<option label="Vanuatu" value="string:VU">Vanuatu</option>
<option label="Vatican" value="string:VA">Vatican</option>
<option label="Venezuela" value="string:VE">Venezuela</option>
<option label="Vietnam" value="string:VN">Vietnam</option>
<option label="Wallis and Futuna" value="string:WF">Wallis and Futuna</option>
<option label="Western Sahara" value="string:EH">Western Sahara</option>
<option label="Yemen" value="string:YE">Yemen</option>
<option label="Zambia" value="string:ZM">Zambia</option>
</select>
<!-- ngIf: countryResitrictedText -->
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if billing_country fails required" style="display: none;"> Please select your country. </span>
</div>
</div>
</div>
</div>
</div>
<!-- ngInclude: ::template('phone') -->
<div data-heap-ignore="true" class="mp-sensitive ng-scope" data-ng-include="::template('phone')">
<div class="donation-table ng-scope">
<div class="donation-table_label">
<label class="donation-label required" data-ng-class="{ required: get.homephone('is_required') }" data-sc-form-error="highlight if member_phone fails">Phone Number</label>
</div>
<div class="donation-table_row">
<div class="donation-table_columns">
<div class="donation-table_column half">
<div data-class="donation-text_input" data-ng-model="MODEL.member_phone" data-ng-required="get.homephone('is_required')" data-sc-phone-input="" data-name="member_phone" aria-label="phone number, numbers only"
class="ng-pristine ng-untouched ng-isolate-scope ng-empty ng-valid-phone-number ng-invalid ng-invalid-required ng-not-modified" required="required">
<div class="iti iti--allow-dropdown iti--show-flags iti--inline-dropdown">
<div class="iti__country-container"><button type="button" class="iti__selected-country" aria-expanded="false" aria-label="Selected country" aria-haspopup="true" aria-controls="iti-0__dropdown-content" role="combobox"
tabindex="0" title="United States: +1">
<div class="iti__selected-country-primary">
<div class="iti__flag iti__us"><span class="iti__a11y-text">United States +1</span></div>
<div class="iti__arrow" aria-hidden="true"></div>
</div>
</button>
<div id="iti-0__dropdown-content" class="iti__dropdown-content iti__hide "><input type="text" class="iti__search-input" placeholder="Search" role="combobox" aria-expanded="true" aria-label="Search"
aria-controls="iti-0__country-listbox" aria-autocomplete="list" autocomplete="off"><span class="iti__a11y-text">244 results found</span>
<ul class="iti__country-list" id="iti-0__country-listbox" role="listbox" aria-label="List of countries">
<li id="iti-0__item-af" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="93" data-country-code="af" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__af"></div>
</div><span class="iti__country-name">Afghanistan</span><span class="iti__dial-code">+93</span>
</li>
<li id="iti-0__item-al" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="355" data-country-code="al" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__al"></div>
</div><span class="iti__country-name">Albania</span><span class="iti__dial-code">+355</span>
</li>
<li id="iti-0__item-dz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="213" data-country-code="dz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dz"></div>
</div><span class="iti__country-name">Algeria</span><span class="iti__dial-code">+213</span>
</li>
<li id="iti-0__item-as" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="as" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__as"></div>
</div><span class="iti__country-name">American Samoa</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-ad" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="376" data-country-code="ad" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ad"></div>
</div><span class="iti__country-name">Andorra</span><span class="iti__dial-code">+376</span>
</li>
<li id="iti-0__item-ao" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="244" data-country-code="ao" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ao"></div>
</div><span class="iti__country-name">Angola</span><span class="iti__dial-code">+244</span>
</li>
<li id="iti-0__item-ai" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="ai" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ai"></div>
</div><span class="iti__country-name">Anguilla</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-ag" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="ag" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ag"></div>
</div><span class="iti__country-name">Antigua & Barbuda</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-ar" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="54" data-country-code="ar" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ar"></div>
</div><span class="iti__country-name">Argentina</span><span class="iti__dial-code">+54</span>
</li>
<li id="iti-0__item-am" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="374" data-country-code="am" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__am"></div>
</div><span class="iti__country-name">Armenia</span><span class="iti__dial-code">+374</span>
</li>
<li id="iti-0__item-aw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="297" data-country-code="aw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__aw"></div>
</div><span class="iti__country-name">Aruba</span><span class="iti__dial-code">+297</span>
</li>
<li id="iti-0__item-ac" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="247" data-country-code="ac" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ac"></div>
</div><span class="iti__country-name">Ascension Island</span><span class="iti__dial-code">+247</span>
</li>
<li id="iti-0__item-au" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="61" data-country-code="au" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__au"></div>
</div><span class="iti__country-name">Australia</span><span class="iti__dial-code">+61</span>
</li>
<li id="iti-0__item-at" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="43" data-country-code="at" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__at"></div>
</div><span class="iti__country-name">Austria</span><span class="iti__dial-code">+43</span>
</li>
<li id="iti-0__item-az" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="994" data-country-code="az" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__az"></div>
</div><span class="iti__country-name">Azerbaijan</span><span class="iti__dial-code">+994</span>
</li>
<li id="iti-0__item-bs" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="bs" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bs"></div>
</div><span class="iti__country-name">Bahamas</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-bh" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="973" data-country-code="bh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bh"></div>
</div><span class="iti__country-name">Bahrain</span><span class="iti__dial-code">+973</span>
</li>
<li id="iti-0__item-bd" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="880" data-country-code="bd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bd"></div>
</div><span class="iti__country-name">Bangladesh</span><span class="iti__dial-code">+880</span>
</li>
<li id="iti-0__item-bb" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="bb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bb"></div>
</div><span class="iti__country-name">Barbados</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-by" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="375" data-country-code="by" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__by"></div>
</div><span class="iti__country-name">Belarus</span><span class="iti__dial-code">+375</span>
</li>
<li id="iti-0__item-be" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="32" data-country-code="be" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__be"></div>
</div><span class="iti__country-name">Belgium</span><span class="iti__dial-code">+32</span>
</li>
<li id="iti-0__item-bz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="501" data-country-code="bz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bz"></div>
</div><span class="iti__country-name">Belize</span><span class="iti__dial-code">+501</span>
</li>
<li id="iti-0__item-bj" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="229" data-country-code="bj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bj"></div>
</div><span class="iti__country-name">Benin</span><span class="iti__dial-code">+229</span>
</li>
<li id="iti-0__item-bm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="bm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bm"></div>
</div><span class="iti__country-name">Bermuda</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-bt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="975" data-country-code="bt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bt"></div>
</div><span class="iti__country-name">Bhutan</span><span class="iti__dial-code">+975</span>
</li>
<li id="iti-0__item-bo" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="591" data-country-code="bo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bo"></div>
</div><span class="iti__country-name">Bolivia</span><span class="iti__dial-code">+591</span>
</li>
<li id="iti-0__item-ba" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="387" data-country-code="ba" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ba"></div>
</div><span class="iti__country-name">Bosnia & Herzegovina</span><span class="iti__dial-code">+387</span>
</li>
<li id="iti-0__item-bw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="267" data-country-code="bw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bw"></div>
</div><span class="iti__country-name">Botswana</span><span class="iti__dial-code">+267</span>
</li>
<li id="iti-0__item-br" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="55" data-country-code="br" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__br"></div>
</div><span class="iti__country-name">Brazil</span><span class="iti__dial-code">+55</span>
</li>
<li id="iti-0__item-io" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="246" data-country-code="io" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__io"></div>
</div><span class="iti__country-name">British Indian Ocean Territory</span><span class="iti__dial-code">+246</span>
</li>
<li id="iti-0__item-vg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="vg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vg"></div>
</div><span class="iti__country-name">British Virgin Islands</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-bn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="673" data-country-code="bn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bn"></div>
</div><span class="iti__country-name">Brunei</span><span class="iti__dial-code">+673</span>
</li>
<li id="iti-0__item-bg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="359" data-country-code="bg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bg"></div>
</div><span class="iti__country-name">Bulgaria</span><span class="iti__dial-code">+359</span>
</li>
<li id="iti-0__item-bf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="226" data-country-code="bf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bf"></div>
</div><span class="iti__country-name">Burkina Faso</span><span class="iti__dial-code">+226</span>
</li>
<li id="iti-0__item-bi" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="257" data-country-code="bi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bi"></div>
</div><span class="iti__country-name">Burundi</span><span class="iti__dial-code">+257</span>
</li>
<li id="iti-0__item-kh" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="855" data-country-code="kh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kh"></div>
</div><span class="iti__country-name">Cambodia</span><span class="iti__dial-code">+855</span>
</li>
<li id="iti-0__item-cm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="237" data-country-code="cm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cm"></div>
</div><span class="iti__country-name">Cameroon</span><span class="iti__dial-code">+237</span>
</li>
<li id="iti-0__item-ca" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="ca" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ca"></div>
</div><span class="iti__country-name">Canada</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-cv" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="238" data-country-code="cv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cv"></div>
</div><span class="iti__country-name">Cape Verde</span><span class="iti__dial-code">+238</span>
</li>
<li id="iti-0__item-bq" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="599" data-country-code="bq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bq"></div>
</div><span class="iti__country-name">Caribbean Netherlands</span><span class="iti__dial-code">+599</span>
</li>
<li id="iti-0__item-ky" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="ky" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ky"></div>
</div><span class="iti__country-name">Cayman Islands</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-cf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="236" data-country-code="cf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cf"></div>
</div><span class="iti__country-name">Central African Republic</span><span class="iti__dial-code">+236</span>
</li>
<li id="iti-0__item-td" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="235" data-country-code="td" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__td"></div>
</div><span class="iti__country-name">Chad</span><span class="iti__dial-code">+235</span>
</li>
<li id="iti-0__item-cl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="56" data-country-code="cl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cl"></div>
</div><span class="iti__country-name">Chile</span><span class="iti__dial-code">+56</span>
</li>
<li id="iti-0__item-cn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="86" data-country-code="cn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cn"></div>
</div><span class="iti__country-name">China</span><span class="iti__dial-code">+86</span>
</li>
<li id="iti-0__item-cx" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="61" data-country-code="cx" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cx"></div>
</div><span class="iti__country-name">Christmas Island</span><span class="iti__dial-code">+61</span>
</li>
<li id="iti-0__item-cc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="61" data-country-code="cc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cc"></div>
</div><span class="iti__country-name">Cocos (Keeling) Islands</span><span class="iti__dial-code">+61</span>
</li>
<li id="iti-0__item-co" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="57" data-country-code="co" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__co"></div>
</div><span class="iti__country-name">Colombia</span><span class="iti__dial-code">+57</span>
</li>
<li id="iti-0__item-km" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="269" data-country-code="km" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__km"></div>
</div><span class="iti__country-name">Comoros</span><span class="iti__dial-code">+269</span>
</li>
<li id="iti-0__item-cg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="242" data-country-code="cg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cg"></div>
</div><span class="iti__country-name">Congo - Brazzaville</span><span class="iti__dial-code">+242</span>
</li>
<li id="iti-0__item-cd" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="243" data-country-code="cd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cd"></div>
</div><span class="iti__country-name">Congo - Kinshasa</span><span class="iti__dial-code">+243</span>
</li>
<li id="iti-0__item-ck" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="682" data-country-code="ck" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ck"></div>
</div><span class="iti__country-name">Cook Islands</span><span class="iti__dial-code">+682</span>
</li>
<li id="iti-0__item-cr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="506" data-country-code="cr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cr"></div>
</div><span class="iti__country-name">Costa Rica</span><span class="iti__dial-code">+506</span>
</li>
<li id="iti-0__item-hr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="385" data-country-code="hr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hr"></div>
</div><span class="iti__country-name">Croatia</span><span class="iti__dial-code">+385</span>
</li>
<li id="iti-0__item-cu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="53" data-country-code="cu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cu"></div>
</div><span class="iti__country-name">Cuba</span><span class="iti__dial-code">+53</span>
</li>
<li id="iti-0__item-cw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="599" data-country-code="cw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cw"></div>
</div><span class="iti__country-name">Curaçao</span><span class="iti__dial-code">+599</span>
</li>
<li id="iti-0__item-cy" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="357" data-country-code="cy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cy"></div>
</div><span class="iti__country-name">Cyprus</span><span class="iti__dial-code">+357</span>
</li>
<li id="iti-0__item-cz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="420" data-country-code="cz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cz"></div>
</div><span class="iti__country-name">Czechia</span><span class="iti__dial-code">+420</span>
</li>
<li id="iti-0__item-ci" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="225" data-country-code="ci" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ci"></div>
</div><span class="iti__country-name">Côte d’Ivoire</span><span class="iti__dial-code">+225</span>
</li>
<li id="iti-0__item-dk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="45" data-country-code="dk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dk"></div>
</div><span class="iti__country-name">Denmark</span><span class="iti__dial-code">+45</span>
</li>
<li id="iti-0__item-dj" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="253" data-country-code="dj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dj"></div>
</div><span class="iti__country-name">Djibouti</span><span class="iti__dial-code">+253</span>
</li>
<li id="iti-0__item-dm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="dm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dm"></div>
</div><span class="iti__country-name">Dominica</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-do" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="do" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__do"></div>
</div><span class="iti__country-name">Dominican Republic</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-ec" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="593" data-country-code="ec" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ec"></div>
</div><span class="iti__country-name">Ecuador</span><span class="iti__dial-code">+593</span>
</li>
<li id="iti-0__item-eg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="20" data-country-code="eg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__eg"></div>
</div><span class="iti__country-name">Egypt</span><span class="iti__dial-code">+20</span>
</li>
<li id="iti-0__item-sv" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="503" data-country-code="sv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sv"></div>
</div><span class="iti__country-name">El Salvador</span><span class="iti__dial-code">+503</span>
</li>
<li id="iti-0__item-gq" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="240" data-country-code="gq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gq"></div>
</div><span class="iti__country-name">Equatorial Guinea</span><span class="iti__dial-code">+240</span>
</li>
<li id="iti-0__item-er" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="291" data-country-code="er" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__er"></div>
</div><span class="iti__country-name">Eritrea</span><span class="iti__dial-code">+291</span>
</li>
<li id="iti-0__item-ee" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="372" data-country-code="ee" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ee"></div>
</div><span class="iti__country-name">Estonia</span><span class="iti__dial-code">+372</span>
</li>
<li id="iti-0__item-sz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="268" data-country-code="sz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sz"></div>
</div><span class="iti__country-name">Eswatini</span><span class="iti__dial-code">+268</span>
</li>
<li id="iti-0__item-et" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="251" data-country-code="et" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__et"></div>
</div><span class="iti__country-name">Ethiopia</span><span class="iti__dial-code">+251</span>
</li>
<li id="iti-0__item-fk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="500" data-country-code="fk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fk"></div>
</div><span class="iti__country-name">Falkland Islands</span><span class="iti__dial-code">+500</span>
</li>
<li id="iti-0__item-fo" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="298" data-country-code="fo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fo"></div>
</div><span class="iti__country-name">Faroe Islands</span><span class="iti__dial-code">+298</span>
</li>
<li id="iti-0__item-fj" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="679" data-country-code="fj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fj"></div>
</div><span class="iti__country-name">Fiji</span><span class="iti__dial-code">+679</span>
</li>
<li id="iti-0__item-fi" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="358" data-country-code="fi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fi"></div>
</div><span class="iti__country-name">Finland</span><span class="iti__dial-code">+358</span>
</li>
<li id="iti-0__item-fr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="33" data-country-code="fr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fr"></div>
</div><span class="iti__country-name">France</span><span class="iti__dial-code">+33</span>
</li>
<li id="iti-0__item-gf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="594" data-country-code="gf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gf"></div>
</div><span class="iti__country-name">French Guiana</span><span class="iti__dial-code">+594</span>
</li>
<li id="iti-0__item-pf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="689" data-country-code="pf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pf"></div>
</div><span class="iti__country-name">French Polynesia</span><span class="iti__dial-code">+689</span>
</li>
<li id="iti-0__item-ga" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="241" data-country-code="ga" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ga"></div>
</div><span class="iti__country-name">Gabon</span><span class="iti__dial-code">+241</span>
</li>
<li id="iti-0__item-gm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="220" data-country-code="gm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gm"></div>
</div><span class="iti__country-name">Gambia</span><span class="iti__dial-code">+220</span>
</li>
<li id="iti-0__item-ge" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="995" data-country-code="ge" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ge"></div>
</div><span class="iti__country-name">Georgia</span><span class="iti__dial-code">+995</span>
</li>
<li id="iti-0__item-de" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="49" data-country-code="de" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__de"></div>
</div><span class="iti__country-name">Germany</span><span class="iti__dial-code">+49</span>
</li>
<li id="iti-0__item-gh" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="233" data-country-code="gh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gh"></div>
</div><span class="iti__country-name">Ghana</span><span class="iti__dial-code">+233</span>
</li>
<li id="iti-0__item-gi" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="350" data-country-code="gi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gi"></div>
</div><span class="iti__country-name">Gibraltar</span><span class="iti__dial-code">+350</span>
</li>
<li id="iti-0__item-gr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="30" data-country-code="gr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gr"></div>
</div><span class="iti__country-name">Greece</span><span class="iti__dial-code">+30</span>
</li>
<li id="iti-0__item-gl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="299" data-country-code="gl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gl"></div>
</div><span class="iti__country-name">Greenland</span><span class="iti__dial-code">+299</span>
</li>
<li id="iti-0__item-gd" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="gd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gd"></div>
</div><span class="iti__country-name">Grenada</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-gp" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="590" data-country-code="gp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gp"></div>
</div><span class="iti__country-name">Guadeloupe</span><span class="iti__dial-code">+590</span>
</li>
<li id="iti-0__item-gu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="gu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gu"></div>
</div><span class="iti__country-name">Guam</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-gt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="502" data-country-code="gt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gt"></div>
</div><span class="iti__country-name">Guatemala</span><span class="iti__dial-code">+502</span>
</li>
<li id="iti-0__item-gg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="44" data-country-code="gg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gg"></div>
</div><span class="iti__country-name">Guernsey</span><span class="iti__dial-code">+44</span>
</li>
<li id="iti-0__item-gn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="224" data-country-code="gn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gn"></div>
</div><span class="iti__country-name">Guinea</span><span class="iti__dial-code">+224</span>
</li>
<li id="iti-0__item-gw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="245" data-country-code="gw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gw"></div>
</div><span class="iti__country-name">Guinea-Bissau</span><span class="iti__dial-code">+245</span>
</li>
<li id="iti-0__item-gy" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="592" data-country-code="gy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gy"></div>
</div><span class="iti__country-name">Guyana</span><span class="iti__dial-code">+592</span>
</li>
<li id="iti-0__item-ht" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="509" data-country-code="ht" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ht"></div>
</div><span class="iti__country-name">Haiti</span><span class="iti__dial-code">+509</span>
</li>
<li id="iti-0__item-hn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="504" data-country-code="hn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hn"></div>
</div><span class="iti__country-name">Honduras</span><span class="iti__dial-code">+504</span>
</li>
<li id="iti-0__item-hk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="852" data-country-code="hk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hk"></div>
</div><span class="iti__country-name">Hong Kong SAR China</span><span class="iti__dial-code">+852</span>
</li>
<li id="iti-0__item-hu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="36" data-country-code="hu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hu"></div>
</div><span class="iti__country-name">Hungary</span><span class="iti__dial-code">+36</span>
</li>
<li id="iti-0__item-is" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="354" data-country-code="is" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__is"></div>
</div><span class="iti__country-name">Iceland</span><span class="iti__dial-code">+354</span>
</li>
<li id="iti-0__item-in" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="91" data-country-code="in" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__in"></div>
</div><span class="iti__country-name">India</span><span class="iti__dial-code">+91</span>
</li>
<li id="iti-0__item-id" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="62" data-country-code="id" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__id"></div>
</div><span class="iti__country-name">Indonesia</span><span class="iti__dial-code">+62</span>
</li>
<li id="iti-0__item-ir" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="98" data-country-code="ir" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ir"></div>
</div><span class="iti__country-name">Iran</span><span class="iti__dial-code">+98</span>
</li>
<li id="iti-0__item-iq" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="964" data-country-code="iq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__iq"></div>
</div><span class="iti__country-name">Iraq</span><span class="iti__dial-code">+964</span>
</li>
<li id="iti-0__item-ie" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="353" data-country-code="ie" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ie"></div>
</div><span class="iti__country-name">Ireland</span><span class="iti__dial-code">+353</span>
</li>
<li id="iti-0__item-im" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="44" data-country-code="im" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__im"></div>
</div><span class="iti__country-name">Isle of Man</span><span class="iti__dial-code">+44</span>
</li>
<li id="iti-0__item-il" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="972" data-country-code="il" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__il"></div>
</div><span class="iti__country-name">Israel</span><span class="iti__dial-code">+972</span>
</li>
<li id="iti-0__item-it" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="39" data-country-code="it" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__it"></div>
</div><span class="iti__country-name">Italy</span><span class="iti__dial-code">+39</span>
</li>
<li id="iti-0__item-jm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="jm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__jm"></div>
</div><span class="iti__country-name">Jamaica</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-jp" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="81" data-country-code="jp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__jp"></div>
</div><span class="iti__country-name">Japan</span><span class="iti__dial-code">+81</span>
</li>
<li id="iti-0__item-je" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="44" data-country-code="je" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__je"></div>
</div><span class="iti__country-name">Jersey</span><span class="iti__dial-code">+44</span>
</li>
<li id="iti-0__item-jo" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="962" data-country-code="jo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__jo"></div>
</div><span class="iti__country-name">Jordan</span><span class="iti__dial-code">+962</span>
</li>
<li id="iti-0__item-kz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="7" data-country-code="kz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kz"></div>
</div><span class="iti__country-name">Kazakhstan</span><span class="iti__dial-code">+7</span>
</li>
<li id="iti-0__item-ke" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="254" data-country-code="ke" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ke"></div>
</div><span class="iti__country-name">Kenya</span><span class="iti__dial-code">+254</span>
</li>
<li id="iti-0__item-ki" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="686" data-country-code="ki" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ki"></div>
</div><span class="iti__country-name">Kiribati</span><span class="iti__dial-code">+686</span>
</li>
<li id="iti-0__item-xk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="383" data-country-code="xk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__xk"></div>
</div><span class="iti__country-name">Kosovo</span><span class="iti__dial-code">+383</span>
</li>
<li id="iti-0__item-kw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="965" data-country-code="kw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kw"></div>
</div><span class="iti__country-name">Kuwait</span><span class="iti__dial-code">+965</span>
</li>
<li id="iti-0__item-kg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="996" data-country-code="kg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kg"></div>
</div><span class="iti__country-name">Kyrgyzstan</span><span class="iti__dial-code">+996</span>
</li>
<li id="iti-0__item-la" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="856" data-country-code="la" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__la"></div>
</div><span class="iti__country-name">Laos</span><span class="iti__dial-code">+856</span>
</li>
<li id="iti-0__item-lv" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="371" data-country-code="lv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lv"></div>
</div><span class="iti__country-name">Latvia</span><span class="iti__dial-code">+371</span>
</li>
<li id="iti-0__item-lb" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="961" data-country-code="lb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lb"></div>
</div><span class="iti__country-name">Lebanon</span><span class="iti__dial-code">+961</span>
</li>
<li id="iti-0__item-ls" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="266" data-country-code="ls" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ls"></div>
</div><span class="iti__country-name">Lesotho</span><span class="iti__dial-code">+266</span>
</li>
<li id="iti-0__item-lr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="231" data-country-code="lr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lr"></div>
</div><span class="iti__country-name">Liberia</span><span class="iti__dial-code">+231</span>
</li>
<li id="iti-0__item-ly" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="218" data-country-code="ly" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ly"></div>
</div><span class="iti__country-name">Libya</span><span class="iti__dial-code">+218</span>
</li>
<li id="iti-0__item-li" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="423" data-country-code="li" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__li"></div>
</div><span class="iti__country-name">Liechtenstein</span><span class="iti__dial-code">+423</span>
</li>
<li id="iti-0__item-lt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="370" data-country-code="lt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lt"></div>
</div><span class="iti__country-name">Lithuania</span><span class="iti__dial-code">+370</span>
</li>
<li id="iti-0__item-lu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="352" data-country-code="lu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lu"></div>
</div><span class="iti__country-name">Luxembourg</span><span class="iti__dial-code">+352</span>
</li>
<li id="iti-0__item-mo" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="853" data-country-code="mo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mo"></div>
</div><span class="iti__country-name">Macao SAR China</span><span class="iti__dial-code">+853</span>
</li>
<li id="iti-0__item-mg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="261" data-country-code="mg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mg"></div>
</div><span class="iti__country-name">Madagascar</span><span class="iti__dial-code">+261</span>
</li>
<li id="iti-0__item-mw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="265" data-country-code="mw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mw"></div>
</div><span class="iti__country-name">Malawi</span><span class="iti__dial-code">+265</span>
</li>
<li id="iti-0__item-my" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="60" data-country-code="my" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__my"></div>
</div><span class="iti__country-name">Malaysia</span><span class="iti__dial-code">+60</span>
</li>
<li id="iti-0__item-mv" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="960" data-country-code="mv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mv"></div>
</div><span class="iti__country-name">Maldives</span><span class="iti__dial-code">+960</span>
</li>
<li id="iti-0__item-ml" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="223" data-country-code="ml" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ml"></div>
</div><span class="iti__country-name">Mali</span><span class="iti__dial-code">+223</span>
</li>
<li id="iti-0__item-mt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="356" data-country-code="mt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mt"></div>
</div><span class="iti__country-name">Malta</span><span class="iti__dial-code">+356</span>
</li>
<li id="iti-0__item-mh" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="692" data-country-code="mh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mh"></div>
</div><span class="iti__country-name">Marshall Islands</span><span class="iti__dial-code">+692</span>
</li>
<li id="iti-0__item-mq" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="596" data-country-code="mq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mq"></div>
</div><span class="iti__country-name">Martinique</span><span class="iti__dial-code">+596</span>
</li>
<li id="iti-0__item-mr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="222" data-country-code="mr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mr"></div>
</div><span class="iti__country-name">Mauritania</span><span class="iti__dial-code">+222</span>
</li>
<li id="iti-0__item-mu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="230" data-country-code="mu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mu"></div>
</div><span class="iti__country-name">Mauritius</span><span class="iti__dial-code">+230</span>
</li>
<li id="iti-0__item-yt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="262" data-country-code="yt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__yt"></div>
</div><span class="iti__country-name">Mayotte</span><span class="iti__dial-code">+262</span>
</li>
<li id="iti-0__item-mx" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="52" data-country-code="mx" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mx"></div>
</div><span class="iti__country-name">Mexico</span><span class="iti__dial-code">+52</span>
</li>
<li id="iti-0__item-fm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="691" data-country-code="fm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fm"></div>
</div><span class="iti__country-name">Micronesia</span><span class="iti__dial-code">+691</span>
</li>
<li id="iti-0__item-md" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="373" data-country-code="md" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__md"></div>
</div><span class="iti__country-name">Moldova</span><span class="iti__dial-code">+373</span>
</li>
<li id="iti-0__item-mc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="377" data-country-code="mc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mc"></div>
</div><span class="iti__country-name">Monaco</span><span class="iti__dial-code">+377</span>
</li>
<li id="iti-0__item-mn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="976" data-country-code="mn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mn"></div>
</div><span class="iti__country-name">Mongolia</span><span class="iti__dial-code">+976</span>
</li>
<li id="iti-0__item-me" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="382" data-country-code="me" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__me"></div>
</div><span class="iti__country-name">Montenegro</span><span class="iti__dial-code">+382</span>
</li>
<li id="iti-0__item-ms" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="ms" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ms"></div>
</div><span class="iti__country-name">Montserrat</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-ma" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="212" data-country-code="ma" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ma"></div>
</div><span class="iti__country-name">Morocco</span><span class="iti__dial-code">+212</span>
</li>
<li id="iti-0__item-mz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="258" data-country-code="mz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mz"></div>
</div><span class="iti__country-name">Mozambique</span><span class="iti__dial-code">+258</span>
</li>
<li id="iti-0__item-mm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="95" data-country-code="mm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mm"></div>
</div><span class="iti__country-name">Myanmar (Burma)</span><span class="iti__dial-code">+95</span>
</li>
<li id="iti-0__item-na" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="264" data-country-code="na" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__na"></div>
</div><span class="iti__country-name">Namibia</span><span class="iti__dial-code">+264</span>
</li>
<li id="iti-0__item-nr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="674" data-country-code="nr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nr"></div>
</div><span class="iti__country-name">Nauru</span><span class="iti__dial-code">+674</span>
</li>
<li id="iti-0__item-np" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="977" data-country-code="np" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__np"></div>
</div><span class="iti__country-name">Nepal</span><span class="iti__dial-code">+977</span>
</li>
<li id="iti-0__item-nl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="31" data-country-code="nl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nl"></div>
</div><span class="iti__country-name">Netherlands</span><span class="iti__dial-code">+31</span>
</li>
<li id="iti-0__item-nc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="687" data-country-code="nc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nc"></div>
</div><span class="iti__country-name">New Caledonia</span><span class="iti__dial-code">+687</span>
</li>
<li id="iti-0__item-nz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="64" data-country-code="nz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nz"></div>
</div><span class="iti__country-name">New Zealand</span><span class="iti__dial-code">+64</span>
</li>
<li id="iti-0__item-ni" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="505" data-country-code="ni" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ni"></div>
</div><span class="iti__country-name">Nicaragua</span><span class="iti__dial-code">+505</span>
</li>
<li id="iti-0__item-ne" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="227" data-country-code="ne" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ne"></div>
</div><span class="iti__country-name">Niger</span><span class="iti__dial-code">+227</span>
</li>
<li id="iti-0__item-ng" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="234" data-country-code="ng" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ng"></div>
</div><span class="iti__country-name">Nigeria</span><span class="iti__dial-code">+234</span>
</li>
<li id="iti-0__item-nu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="683" data-country-code="nu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nu"></div>
</div><span class="iti__country-name">Niue</span><span class="iti__dial-code">+683</span>
</li>
<li id="iti-0__item-nf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="672" data-country-code="nf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nf"></div>
</div><span class="iti__country-name">Norfolk Island</span><span class="iti__dial-code">+672</span>
</li>
<li id="iti-0__item-kp" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="850" data-country-code="kp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kp"></div>
</div><span class="iti__country-name">North Korea</span><span class="iti__dial-code">+850</span>
</li>
<li id="iti-0__item-mk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="389" data-country-code="mk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mk"></div>
</div><span class="iti__country-name">North Macedonia</span><span class="iti__dial-code">+389</span>
</li>
<li id="iti-0__item-mp" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="mp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mp"></div>
</div><span class="iti__country-name">Northern Mariana Islands</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-no" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="47" data-country-code="no" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__no"></div>
</div><span class="iti__country-name">Norway</span><span class="iti__dial-code">+47</span>
</li>
<li id="iti-0__item-om" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="968" data-country-code="om" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__om"></div>
</div><span class="iti__country-name">Oman</span><span class="iti__dial-code">+968</span>
</li>
<li id="iti-0__item-pk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="92" data-country-code="pk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pk"></div>
</div><span class="iti__country-name">Pakistan</span><span class="iti__dial-code">+92</span>
</li>
<li id="iti-0__item-pw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="680" data-country-code="pw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pw"></div>
</div><span class="iti__country-name">Palau</span><span class="iti__dial-code">+680</span>
</li>
<li id="iti-0__item-ps" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="970" data-country-code="ps" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ps"></div>
</div><span class="iti__country-name">Palestinian Territories</span><span class="iti__dial-code">+970</span>
</li>
<li id="iti-0__item-pa" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="507" data-country-code="pa" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pa"></div>
</div><span class="iti__country-name">Panama</span><span class="iti__dial-code">+507</span>
</li>
<li id="iti-0__item-pg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="675" data-country-code="pg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pg"></div>
</div><span class="iti__country-name">Papua New Guinea</span><span class="iti__dial-code">+675</span>
</li>
<li id="iti-0__item-py" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="595" data-country-code="py" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__py"></div>
</div><span class="iti__country-name">Paraguay</span><span class="iti__dial-code">+595</span>
</li>
<li id="iti-0__item-pe" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="51" data-country-code="pe" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pe"></div>
</div><span class="iti__country-name">Peru</span><span class="iti__dial-code">+51</span>
</li>
<li id="iti-0__item-ph" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="63" data-country-code="ph" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ph"></div>
</div><span class="iti__country-name">Philippines</span><span class="iti__dial-code">+63</span>
</li>
<li id="iti-0__item-pl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="48" data-country-code="pl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pl"></div>
</div><span class="iti__country-name">Poland</span><span class="iti__dial-code">+48</span>
</li>
<li id="iti-0__item-pt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="351" data-country-code="pt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pt"></div>
</div><span class="iti__country-name">Portugal</span><span class="iti__dial-code">+351</span>
</li>
<li id="iti-0__item-pr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="pr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pr"></div>
</div><span class="iti__country-name">Puerto Rico</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-qa" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="974" data-country-code="qa" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__qa"></div>
</div><span class="iti__country-name">Qatar</span><span class="iti__dial-code">+974</span>
</li>
<li id="iti-0__item-ro" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="40" data-country-code="ro" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ro"></div>
</div><span class="iti__country-name">Romania</span><span class="iti__dial-code">+40</span>
</li>
<li id="iti-0__item-ru" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="7" data-country-code="ru" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ru"></div>
</div><span class="iti__country-name">Russia</span><span class="iti__dial-code">+7</span>
</li>
<li id="iti-0__item-rw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="250" data-country-code="rw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__rw"></div>
</div><span class="iti__country-name">Rwanda</span><span class="iti__dial-code">+250</span>
</li>
<li id="iti-0__item-re" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="262" data-country-code="re" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__re"></div>
</div><span class="iti__country-name">Réunion</span><span class="iti__dial-code">+262</span>
</li>
<li id="iti-0__item-ws" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="685" data-country-code="ws" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ws"></div>
</div><span class="iti__country-name">Samoa</span><span class="iti__dial-code">+685</span>
</li>
<li id="iti-0__item-sm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="378" data-country-code="sm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sm"></div>
</div><span class="iti__country-name">San Marino</span><span class="iti__dial-code">+378</span>
</li>
<li id="iti-0__item-sa" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="966" data-country-code="sa" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sa"></div>
</div><span class="iti__country-name">Saudi Arabia</span><span class="iti__dial-code">+966</span>
</li>
<li id="iti-0__item-sn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="221" data-country-code="sn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sn"></div>
</div><span class="iti__country-name">Senegal</span><span class="iti__dial-code">+221</span>
</li>
<li id="iti-0__item-rs" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="381" data-country-code="rs" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__rs"></div>
</div><span class="iti__country-name">Serbia</span><span class="iti__dial-code">+381</span>
</li>
<li id="iti-0__item-sc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="248" data-country-code="sc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sc"></div>
</div><span class="iti__country-name">Seychelles</span><span class="iti__dial-code">+248</span>
</li>
<li id="iti-0__item-sl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="232" data-country-code="sl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sl"></div>
</div><span class="iti__country-name">Sierra Leone</span><span class="iti__dial-code">+232</span>
</li>
<li id="iti-0__item-sg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="65" data-country-code="sg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sg"></div>
</div><span class="iti__country-name">Singapore</span><span class="iti__dial-code">+65</span>
</li>
<li id="iti-0__item-sx" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="sx" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sx"></div>
</div><span class="iti__country-name">Sint Maarten</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-sk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="421" data-country-code="sk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sk"></div>
</div><span class="iti__country-name">Slovakia</span><span class="iti__dial-code">+421</span>
</li>
<li id="iti-0__item-si" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="386" data-country-code="si" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__si"></div>
</div><span class="iti__country-name">Slovenia</span><span class="iti__dial-code">+386</span>
</li>
<li id="iti-0__item-sb" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="677" data-country-code="sb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sb"></div>
</div><span class="iti__country-name">Solomon Islands</span><span class="iti__dial-code">+677</span>
</li>
<li id="iti-0__item-so" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="252" data-country-code="so" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__so"></div>
</div><span class="iti__country-name">Somalia</span><span class="iti__dial-code">+252</span>
</li>
<li id="iti-0__item-za" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="27" data-country-code="za" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__za"></div>
</div><span class="iti__country-name">South Africa</span><span class="iti__dial-code">+27</span>
</li>
<li id="iti-0__item-kr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="82" data-country-code="kr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kr"></div>
</div><span class="iti__country-name">South Korea</span><span class="iti__dial-code">+82</span>
</li>
<li id="iti-0__item-ss" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="211" data-country-code="ss" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ss"></div>
</div><span class="iti__country-name">South Sudan</span><span class="iti__dial-code">+211</span>
</li>
<li id="iti-0__item-es" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="34" data-country-code="es" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__es"></div>
</div><span class="iti__country-name">Spain</span><span class="iti__dial-code">+34</span>
</li>
<li id="iti-0__item-lk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="94" data-country-code="lk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lk"></div>
</div><span class="iti__country-name">Sri Lanka</span><span class="iti__dial-code">+94</span>
</li>
<li id="iti-0__item-bl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="590" data-country-code="bl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bl"></div>
</div><span class="iti__country-name">St. Barthélemy</span><span class="iti__dial-code">+590</span>
</li>
<li id="iti-0__item-sh" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="290" data-country-code="sh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sh"></div>
</div><span class="iti__country-name">St. Helena</span><span class="iti__dial-code">+290</span>
</li>
<li id="iti-0__item-kn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="kn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kn"></div>
</div><span class="iti__country-name">St. Kitts & Nevis</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-lc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="lc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lc"></div>
</div><span class="iti__country-name">St. Lucia</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-mf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="590" data-country-code="mf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mf"></div>
</div><span class="iti__country-name">St. Martin</span><span class="iti__dial-code">+590</span>
</li>
<li id="iti-0__item-pm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="508" data-country-code="pm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pm"></div>
</div><span class="iti__country-name">St. Pierre & Miquelon</span><span class="iti__dial-code">+508</span>
</li>
<li id="iti-0__item-vc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="vc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vc"></div>
</div><span class="iti__country-name">St. Vincent & Grenadines</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-sd" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="249" data-country-code="sd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sd"></div>
</div><span class="iti__country-name">Sudan</span><span class="iti__dial-code">+249</span>
</li>
<li id="iti-0__item-sr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="597" data-country-code="sr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sr"></div>
</div><span class="iti__country-name">Suriname</span><span class="iti__dial-code">+597</span>
</li>
<li id="iti-0__item-sj" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="47" data-country-code="sj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sj"></div>
</div><span class="iti__country-name">Svalbard & Jan Mayen</span><span class="iti__dial-code">+47</span>
</li>
<li id="iti-0__item-se" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="46" data-country-code="se" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__se"></div>
</div><span class="iti__country-name">Sweden</span><span class="iti__dial-code">+46</span>
</li>
<li id="iti-0__item-ch" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="41" data-country-code="ch" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ch"></div>
</div><span class="iti__country-name">Switzerland</span><span class="iti__dial-code">+41</span>
</li>
<li id="iti-0__item-sy" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="963" data-country-code="sy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sy"></div>
</div><span class="iti__country-name">Syria</span><span class="iti__dial-code">+963</span>
</li>
<li id="iti-0__item-st" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="239" data-country-code="st" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__st"></div>
</div><span class="iti__country-name">São Tomé & Príncipe</span><span class="iti__dial-code">+239</span>
</li>
<li id="iti-0__item-tw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="886" data-country-code="tw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tw"></div>
</div><span class="iti__country-name">Taiwan</span><span class="iti__dial-code">+886</span>
</li>
<li id="iti-0__item-tj" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="992" data-country-code="tj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tj"></div>
</div><span class="iti__country-name">Tajikistan</span><span class="iti__dial-code">+992</span>
</li>
<li id="iti-0__item-tz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="255" data-country-code="tz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tz"></div>
</div><span class="iti__country-name">Tanzania</span><span class="iti__dial-code">+255</span>
</li>
<li id="iti-0__item-th" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="66" data-country-code="th" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__th"></div>
</div><span class="iti__country-name">Thailand</span><span class="iti__dial-code">+66</span>
</li>
<li id="iti-0__item-tl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="670" data-country-code="tl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tl"></div>
</div><span class="iti__country-name">Timor-Leste</span><span class="iti__dial-code">+670</span>
</li>
<li id="iti-0__item-tg" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="228" data-country-code="tg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tg"></div>
</div><span class="iti__country-name">Togo</span><span class="iti__dial-code">+228</span>
</li>
<li id="iti-0__item-tk" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="690" data-country-code="tk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tk"></div>
</div><span class="iti__country-name">Tokelau</span><span class="iti__dial-code">+690</span>
</li>
<li id="iti-0__item-to" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="676" data-country-code="to" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__to"></div>
</div><span class="iti__country-name">Tonga</span><span class="iti__dial-code">+676</span>
</li>
<li id="iti-0__item-tt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="tt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tt"></div>
</div><span class="iti__country-name">Trinidad & Tobago</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-tn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="216" data-country-code="tn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tn"></div>
</div><span class="iti__country-name">Tunisia</span><span class="iti__dial-code">+216</span>
</li>
<li id="iti-0__item-tr" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="90" data-country-code="tr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tr"></div>
</div><span class="iti__country-name">Turkey</span><span class="iti__dial-code">+90</span>
</li>
<li id="iti-0__item-tm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="993" data-country-code="tm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tm"></div>
</div><span class="iti__country-name">Turkmenistan</span><span class="iti__dial-code">+993</span>
</li>
<li id="iti-0__item-tc" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="tc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tc"></div>
</div><span class="iti__country-name">Turks & Caicos Islands</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-tv" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="688" data-country-code="tv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tv"></div>
</div><span class="iti__country-name">Tuvalu</span><span class="iti__dial-code">+688</span>
</li>
<li id="iti-0__item-vi" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="vi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vi"></div>
</div><span class="iti__country-name">U.S. Virgin Islands</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-ug" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="256" data-country-code="ug" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ug"></div>
</div><span class="iti__country-name">Uganda</span><span class="iti__dial-code">+256</span>
</li>
<li id="iti-0__item-ua" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="380" data-country-code="ua" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ua"></div>
</div><span class="iti__country-name">Ukraine</span><span class="iti__dial-code">+380</span>
</li>
<li id="iti-0__item-ae" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="971" data-country-code="ae" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ae"></div>
</div><span class="iti__country-name">United Arab Emirates</span><span class="iti__dial-code">+971</span>
</li>
<li id="iti-0__item-gb" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="44" data-country-code="gb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gb"></div>
</div><span class="iti__country-name">United Kingdom</span><span class="iti__dial-code">+44</span>
</li>
<li id="iti-0__item-us" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="1" data-country-code="us" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__us"></div>
</div><span class="iti__country-name">United States</span><span class="iti__dial-code">+1</span>
</li>
<li id="iti-0__item-uy" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="598" data-country-code="uy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__uy"></div>
</div><span class="iti__country-name">Uruguay</span><span class="iti__dial-code">+598</span>
</li>
<li id="iti-0__item-uz" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="998" data-country-code="uz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__uz"></div>
</div><span class="iti__country-name">Uzbekistan</span><span class="iti__dial-code">+998</span>
</li>
<li id="iti-0__item-vu" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="678" data-country-code="vu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vu"></div>
</div><span class="iti__country-name">Vanuatu</span><span class="iti__dial-code">+678</span>
</li>
<li id="iti-0__item-va" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="39" data-country-code="va" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__va"></div>
</div><span class="iti__country-name">Vatican City</span><span class="iti__dial-code">+39</span>
</li>
<li id="iti-0__item-ve" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="58" data-country-code="ve" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ve"></div>
</div><span class="iti__country-name">Venezuela</span><span class="iti__dial-code">+58</span>
</li>
<li id="iti-0__item-vn" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="84" data-country-code="vn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vn"></div>
</div><span class="iti__country-name">Vietnam</span><span class="iti__dial-code">+84</span>
</li>
<li id="iti-0__item-wf" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="681" data-country-code="wf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__wf"></div>
</div><span class="iti__country-name">Wallis & Futuna</span><span class="iti__dial-code">+681</span>
</li>
<li id="iti-0__item-eh" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="212" data-country-code="eh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__eh"></div>
</div><span class="iti__country-name">Western Sahara</span><span class="iti__dial-code">+212</span>
</li>
<li id="iti-0__item-ye" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="967" data-country-code="ye" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ye"></div>
</div><span class="iti__country-name">Yemen</span><span class="iti__dial-code">+967</span>
</li>
<li id="iti-0__item-zm" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="260" data-country-code="zm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__zm"></div>
</div><span class="iti__country-name">Zambia</span><span class="iti__dial-code">+260</span>
</li>
<li id="iti-0__item-zw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="263" data-country-code="zw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__zw"></div>
</div><span class="iti__country-name">Zimbabwe</span><span class="iti__dial-code">+263</span>
</li>
<li id="iti-0__item-ax" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="358" data-country-code="ax" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ax"></div>
</div><span class="iti__country-name">Åland Islands</span><span class="iti__dial-code">+358</span>
</li>
</ul>
</div>
</div><input inputmode="numeric" type="tel" aria-label="phone number, numbers only" class="donation-text_input iti__tel-input" name="member_phone" placeholder="(201) 555-0123" data-sc-form-error="highlight if member_phone fails"
ng-required="" aria-invalid="false" autocomplete="off" data-intl-tel-input-id="0">
</div>
</div>
</div>
</div>
<div aria-live="polite" role="alert">
<span class="donation-error ng-binding" data-sc-form-error="show if member_phone fails phoneNumber" style="display: none;"> Please enter a valid phone number. </span>
<span class="donation-error ng-binding" data-sc-form-error="show if member_phone fails required" style="display: none;"> Don't forget your phone number. </span>
</div>
</div>
</div>
</div>
<!-- ngIf: show.cellPhone() -->
<!-- ngIf: show.comment() -->
<!-- ngIf: show.company() -->
<!-- ngIf: show.blog() -->
<!-- ngIf: show.website() -->
<!-- ngIf: show.gender() -->
<!-- ngIf: show.pronoun() -->
<!-- ngIf: show.birthdate() -->
<!-- ngIf: show.customQuestions() -->
</div>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<div data-ng-controller="frsDonationPaymentCtrl" id="df_checkout_donation-payment" class="donation-payment ng-scope" aria-label="Payment Details">
<div>
<cp-payment-widget id="classy-payment-widget" api="API" payment="MODEL.payment" submit-digital-wallets="submitDigitalWallets" fee-processing="globalState.feeProcessing" meta="META" parent-model="MODEL" hide-postal="true"
currency="MODEL.payment.raw_currency_code" validate-form="helpers.validateForm" class="ng-isolate-scope">
<div class="donation-payment-method-select row" ng-hide="$ctrl.hideButtons">
<div class="eg-payment-button-mask ng-hide" data-ng-show="!$ctrl.arePaymentButtonEnabled"></div>
<div class="column-md-7">
<summary-amount amount="$ctrl.meta.summaryAmount" recur_until="$ctrl.parentModel.recur_until" feeprocessing="$ctrl.feeProcessing" frequency="$ctrl.parentModel.frequency" taxcompliance="$ctrl.meta.unsupportedTaxCompliance"
currency="$ctrl.parentModel.payment.raw_currency_code" estimatedcharge="$ctrl.meta.estimatedCharge" class="ng-isolate-scope">
<p class="donation-summary-amount">
<span class="sr-only">your currently selected donation amount is </span>
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-label ng-binding ng-scope" aria-hidden="true" ng-if="!$ctrl.preventRecurringFrequency">One-time
donation</span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-amount ng-binding" data-ng-class="{ processing: $ctrl.feeprocessing }"> $100.00<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-currency ng-binding">USD</span>
<span class="donation-summary-amount-processing">
<span class="donation-summary-amount-processing-spinner"></span>
</span>
</span>
<!-- ngIf: !$ctrl.preventRecurringFrequency && $ctrl.recurUntil -->
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-date ng-binding ng-scope" ng-if="!$ctrl.preventRecurringFrequency"></span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.taxCompliance -->
</p>
</summary-amount>
<fee-on-top fot="$ctrl.parentModel.fee_on_top" class="ng-isolate-scope"><!-- ngIf: $ctrl.showFOT() -->
<div class="donation-table ng-scope" ng-if="$ctrl.showFOT()" style="margin-top:0">
<div class="donation-table_row">
<div class="donation-table_columns donation-table_columns_without_margin">
<div class="donation-table_column">
<button type="button" class="fot-checkbox sc-checkbox " data-ng-click="toggle()" role="checkbox" aria-checked="false" data-sc-checkbox="" data-ng-model="$ctrl.fot" name="donation_fot" data-id="DCF-check"
aria-label="I’d like to cover the fees associated with my donation so more of my donation goes directly to New York-Presbyterian Fund, Inc."><span class="sc-checkbox_input"></span><span class="sc-checkbox_label"
data-ng-transclude="" aria-hidden="true">
<span data-sc-ctx-bind-html="$ctrl.classyModeAppeal() | scTrustedHtml" class="ng-scope">
<p>I’d like to cover the fees associated with my donation so more of my donation goes directly to New York-Presbyterian Fund, Inc.</p>
</span>
</span></button>
</div>
</div>
</div>
</div><!-- end ngIf: $ctrl.showFOT() -->
</fee-on-top>
</div>
<div class="column-md-5">
<small class="cp-payment-widget__terms ng-binding" ng-bind-html="$ctrl.terms()">By donating, you agree to our <a href="https://www.nyp.org/privacy-notice" target="_blank">Privacy Policy</a> and
<a href="https://www.classy.org/terms" target="_blank">Classy's Terms</a> and <a href="https://www.classy.org/terms/privacy/" target="_blank">Privacy Policy</a>. Classy facilitates your donations.</small>
<!-- ngIf: !$ctrl.isTrial --><cp-digital-wallets data-ng-if="!$ctrl.isTrial" frequency="$ctrl.parentModel.frequency" amount="$ctrl.getAmount()" currency="$ctrl.parentModel.payment.raw_currency_code" submit="$ctrl.submitDigitalWallets"
pay-type="$ctrl.meta.digitalWalletType" fot="$ctrl.parentModel.fee_on_top" classymode="$ctrl.isClassyMode" validate-form="$ctrl.validateForm()"
class="ng-scope ng-isolate-scope"><!-- ngIf: $ctrl.showDigitalWallets --></cp-digital-wallets><!-- end ngIf: !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.paypal() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.paypalCommerce() || $ctrl.show.venmo() -->
<button data-tracked-element="donation-page_checkout_credit-card-btn" class="payment-method-select-btn__cc" type="button" style="background:rgb(18, 18, 18)" ng-click="$ctrl.showCardInputs()" aria-expanded="false"
aria-controls="donation-page_checkout_payment-form donation-page_checkout_payment-details" data-id="paymethod-card">Credit Card</button>
<!-- ngIf: $ctrl.show.achButton() && !$ctrl.isTrial --><cp-plaid-widget data-ng-if="$ctrl.show.achButton() && !$ctrl.isTrial" &="" model="$ctrl.payment.ach" sc-validity-reporter="" ng-model="$ctrl.payment.ach.status"
on-ready="$ctrl.onAchReady()" on-success="$ctrl.onAchSuccess(lastFour, accountType)" on-cancel="$ctrl.onAchCancel()" currency="$ctrl.currency" validate-form="$ctrl.validateForm()"
class="ng-pristine ng-untouched ng-valid ng-scope ng-isolate-scope ng-not-empty ng-not-modified">
<button type="button" data-id="paymethod-ach" data-tracked-element="donation-page_checkout_ach-plaid-btn" class="payment-method-select-btn__ach" ng-style="{ 'background': $ctrl.primaryColor }"
ng-show="$ctrl.model.status !== $ctrl.constants.STATUS.INACTIVE" ng-click="$ctrl.openPlaidDialog()" tabindex="0" style="background: rgb(18, 18, 18);"> Bank Transfer </button>
</cp-plaid-widget><!-- end ngIf: $ctrl.show.achButton() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.accountRoutingButton() && !$ctrl.isTrial -->
<!-- ngIf: $ctrl.show.crypto() && !$ctrl.isTrial -->
<small class="cp-payment-widget__powered"> Powered by Classy from GoFundMe </small>
</div>
</div>
<!-- ngIf: $ctrl.meta.showPaymentDetails -->
<!-- ngIf: $ctrl.meta.showPaymentDetails -->
</cp-payment-widget>
</div>
<!-- ngIf: META.showPaymentDetails -->
</div>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
<section class="block-component ng-scope" data-ng-repeat="component in list.components | filter:{section:'main'} | orderBy:'order'">
<!-- ngInclude: component.templateUrl -->
<div data-ng-include="component.templateUrl" class="ng-scope">
<section id="df_checkout_donation-footer" class="donation-footer ng-scope ng-hide" data-ng-controller="frsDonationFooterCtrl" data-ng-show="META.showPaymentDetails">
<div class="donation-footer_container">
<!-- ngIf: show.terms() -->
<!-- ngIf: show.feeOnTop() -->
<div class="donation-footer_controls">
<!-- ngIf: !editable --><button id="donate-cta-main" data-id="cp-donation-form-donate" class="donation-footer_submit ng-binding ng-scope" ng-if="!editable" data-ng-style="{'background-color': theme.current.styles.primaryColor}"
data-ng-disabled="globalState.processing || globalState.submitDisabled" data-ng-bind="block['submit-button-text'] || 'Donate' " aria-label="click give now to donate $100.00" type="submit"
style="background-color: rgb(18, 18, 18);">Donate</button><!-- end ngIf: !editable -->
<!-- ngIf: editable -->
</div>
<div class="donation-footer_summary">
<!-- ngIf: show.creditee() -->
<summary-amount amount="META.summaryAmount" recur_until="MODEL.recur_until" feeprocessing="globalState.feeProcessing" frequency="MODEL.frequency" taxcompliance="META.unsupportedTaxCompliance" currency="MODEL.payment.raw_currency_code"
estimatedcharge="META.estimatedCharge" class="ng-isolate-scope">
<p class="donation-summary-amount">
<span class="sr-only">your currently selected donation amount is </span>
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-label ng-binding ng-scope" aria-hidden="true" ng-if="!$ctrl.preventRecurringFrequency">One-time
donation</span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-amount ng-binding" data-ng-class="{ processing: $ctrl.feeprocessing }"> $100.00<!-- ngIf: $ctrl.preventRecurringFrequency -->
<span class="donation-summary-amount-currency ng-binding">USD</span>
<span class="donation-summary-amount-processing">
<span class="donation-summary-amount-processing-spinner"></span>
</span>
</span>
<!-- ngIf: !$ctrl.preventRecurringFrequency && $ctrl.recurUntil -->
<!-- ngIf: !$ctrl.preventRecurringFrequency --><span class="donation-summary-amount-date ng-binding ng-scope" ng-if="!$ctrl.preventRecurringFrequency"></span><!-- end ngIf: !$ctrl.preventRecurringFrequency -->
<!-- ngIf: $ctrl.taxCompliance -->
</p>
</summary-amount>
</div>
<!-- ngIf: show.terms() -->
<!-- ngIf: META.unsupportedTaxCompliance -->
</div>
</section>
<div class="donation-border-top donation-footer__compliance ng-scope ng-hide" ng-show="META.showTaxComplianceLanguage">
<p ng-bind-html="META.taxComplianceLanguage" class="ng-binding"></p>
</div>
</div>
</section><!-- end ngRepeat: component in list.components | filter:{section:'main'} | orderBy:'order' -->
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Close GIVINGTUESDAY WAS A CELEBRATION OF HOPE! Our Matching Gift opportunity is over but let's continue to celebrate the GivingTuesday spirit! Your gift today will fuel our mission to bring the very best in health care to our communities. 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