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www.christianlegalsociety.org Open in urlscan Pro
35.208.251.129  Public Scan

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Submitted URL: https://bbox.blackbaudhosting.com/webforms/linkredirect?srcid=46561723&srctid=1&erid=-1650023145&trid=9917c3e9-2129-4375-b0d7-e0da...
Effective URL: https://www.christianlegalsociety.org/supporttulsa?bblinkid=267812854&bbemailid=46561723&bbejrid=-1650023145
Submission: On March 23 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form id="mongo-form">
  <div id="bboxdonation_BBEmbeddedForm" class="BBFormContainer" data-bbox-part-id="89de835e-d338-4ecc-a0ba-2bf434709767">
    <div id="bboxdonation_divForm">
      <div id="divClientError" class="BBFormErrorBlock" style="display: none"></div>
      <div class="BBFormSection BBDFormSectionGiftInfo">
        <fieldset>
          <legend>
            <div class="BBFormSectionHeading">
              <label id="bboxdonation_gift_lblHeadingDonation" class="BBFormFieldLabelEdit">Donation</label>
            </div>
          </legend>
          <div id="bboxdonation_gift_fldAmountWithLevels" class="BBFormFieldContainer BBFormFieldContainerGivingLevels BBFormErrorNoMargin" data-style="List">
            <span id="bboxdonation_gift_lblGivingLevels" class="BBFormFieldLabelGivingLevel BBFormFieldLabel BBFormFieldLabelEdit">Gift amount:</span>
            <div id="bboxdonation_gift_rdlstGivingLevels" class="BBFormRadioList">
              <div class="BBFormRadioItem BBFormRadioGivingLevelItem" tabindex="0">
                <div class="BBFormRadioButtonContainer"><input value="25" name="bboxdonation$gift$GivingLevel" type="radio" id="bboxdonation_gift_rdGivingLevel1" checked="checked"
                    class="BBFormRadioButton BBFormRadioGivingLevel BBFormRadioGivingLevelSelected"><label for="bboxdonation_gift_rdGivingLevel1" class="BBFormRadioLabel BBFormRadioLabelGivingLevel BBFormRadioLabelGivingLevelSelected"><span
                      class="BBFormRadioAmount">$25</span></label></div>
              </div>
              <div class="BBFormRadioItem BBFormRadioGivingLevelItem" tabindex="0">
                <div class="BBFormRadioButtonContainer"><input value="50" name="bboxdonation$gift$GivingLevel" type="radio" id="bboxdonation_gift_rdGivingLevel2" class="BBFormRadioButton BBFormRadioGivingLevel"><label
                    for="bboxdonation_gift_rdGivingLevel2" class="BBFormRadioLabel BBFormRadioLabelGivingLevel BBFormRadioLabelGivingLevelNotSelected"><span class="BBFormRadioAmount">$50</span></label></div>
              </div>
              <div class="BBFormRadioItem BBFormRadioGivingLevelItem" tabindex="0">
                <div class="BBFormRadioButtonContainer"><input value="75" name="bboxdonation$gift$GivingLevel" type="radio" id="bboxdonation_gift_rdGivingLevel3" class="BBFormRadioButton BBFormRadioGivingLevel"><label
                    for="bboxdonation_gift_rdGivingLevel3" class="BBFormRadioLabel BBFormRadioLabelGivingLevel BBFormRadioLabelGivingLevelNotSelected"><span class="BBFormRadioAmount">$75</span></label></div>
              </div>
              <div class="BBFormRadioItem BBFormRadioGivingLevelItem" tabindex="0">
                <div class="BBFormRadioButtonContainer"><input value="100" name="bboxdonation$gift$GivingLevel" type="radio" id="bboxdonation_gift_rdGivingLevel4" class="BBFormRadioButton BBFormRadioGivingLevel"><label
                    for="bboxdonation_gift_rdGivingLevel4" class="BBFormRadioLabel BBFormRadioLabelGivingLevel BBFormRadioLabelGivingLevelNotSelected"><span class="BBFormRadioAmount">$100</span></label></div>
              </div>
              <div class="BBFormRadioItem BBFormRadioGivingLevelItem" tabindex="0">
                <div class="BBFormRadioButtonContainer"><input value="rdGivingLevel5" name="bboxdonation$gift$GivingLevel" type="radio" id="bboxdonation_gift_rdGivingLevel5" data-min-payment="1" title="Other gift amount"
                    class="BBFormRadioButton BBFormRadioGivingLevel BBFormRadioGivingLevelOther"><label for="bboxdonation_gift_rdGivingLevel5" title="Other gift amount" aria-labelledby="bboxdonation_gift_rdGivingLevel5"
                    class="BBFormRadioLabel BBFormRadioLabelGivingLevel BBFormRadioLabelGivingLevelNotSelected BBFormRadioLabelGivingLevelOther"><span class="BBFormRadioDescriptionOther">Other</span><input name="bboxdonation$gift$txtAmountOther"
                      type="tel" id="bboxdonation_gift_txtAmountOther" class="BBFormTextbox BBFormGiftOtherAmount BBFormCurrency" data-culture="en-US" placeholder="$" aria-labelledby="bboxdonation_gift_rdGivingLevel5"
                      title="Other gift amount"></label></div>
              </div>
            </div>
            <div class="BBClearFix">
            </div>
          </div>
          <div id="bboxdonation_gift_fldPledgeAmountWhenNoLevels" class="BBFormFieldContainer BBFormNoLevels BBFormPledgeFields" style="display: none;">
            <label for="bboxdonation_gift_txtAmountPledge" id="bboxdonation_gift_lblAmountPledge" class="BBFormFieldLabel BBFormFieldLabelAmount BBFormFieldLabelEdit">Amount:</label>
            <input name="bboxdonation$gift$txtAmountPledge" type="tel" id="bboxdonation_gift_txtAmountPledge" class="BBFormTextbox BBFormCurrency" required="required" placeholder="$" data-culture="en-US" data-min-payment="10.0000">
          </div>
        </fieldset>
      </div>
      <input name="bboxdonation$gift$hdnGivingLevelButtonsEnabled" type="hidden" id="bboxdonation_gift_hdnGivingLevelButtonsEnabled" class="hdnGivingLevelButtonsEnabled" value="false">
      <input name="bboxdonation$gift$hdnPledgeDuration" type="hidden" id="bboxdonation_gift_hdnPledgeDuration" class="hdnPledgeDuration">
      <input name="bboxdonation$gift$hdnPledgePayment" type="hidden" id="bboxdonation_gift_hdnPledgePayment" class="hdnPledgePayment">
      <input name="bboxdonation$gift$hdnGiftButtonsStyle" type="hidden" id="bboxdonation_gift_hdnGiftButtonsStyle" class="hdnGiftButtonsStyle">
      <div id="bboxdonation_designation_divSection" class="BBFormSection BBDFormSectionDesignationInfo" style="display:none;">
        <fieldset>
          <legend>
            <div class="BBFormSectionHeading">
              <label id="bboxdonation_designation_lblHeadingDesignation" class="BBFormFieldLabelEdit">Designation</label>
            </div>
          </legend>
          <div class="BBFormFieldContainer">
            <label for="bboxdonation_designation_ddDesignations" id="bboxdonation_designation_lblDesignation" class="BBFormFieldLabel BBFormFieldLabelEdit">Designation:</label>
            <select name="bboxdonation$designation$ddDesignations" id="bboxdonation_designation_ddDesignations" class="BBFormSelectList">
              <option value="8">Law Student Ministries Fund</option>
            </select>
            <label for="bboxdonation_designation_txtOtherDesignation" id="bboxdonation_designation_lblOtherDesignation" style="display: none;">other Designation:</label>
            <input name="bboxdonation$designation$txtOtherDesignation" type="text" id="bboxdonation_designation_txtOtherDesignation" class="BBFormTextbox BBFormOtherDesignation" placeholder="other designation (optional)" style="display: none;">
          </div>
          <div class="BBFormFieldContainer BBFormOtherDesignationContatiner" style="display: none;">
          </div>
        </fieldset>
      </div>
      <div id="bboxdonation_billing_divBillingSection" class="BBFormSection BBDFormSectionBillingInfo BBFormAddressBlock" data-section="Billing">
        <fieldset>
          <legend>
            <div id="bboxdonation_billing_divBillingHeader" class="BBFormSectionHeading">
              <label id="bboxdonation_billing_lblHeadingContact" class="BBFormFieldLabelEdit">Billing Address</label>
            </div>
          </legend>
          <div id="bboxdonation_billing_fldOrgGift" class="BBFormFieldContainer">
            <input name="bboxdonation$billing$chkOrgGift" type="checkbox" id="bboxdonation_billing_chkOrgGift">
            <label for="bboxdonation_billing_chkOrgGift" id="bboxdonation_billing_lblOrgGift" class="BBFormFieldLabel BBFormCheckbox BBFormCheckboxLabel BBFormFieldLabelEdit">Make this gift on behalf of an organization</label>
          </div>
          <div id="fldOrgInfo" class="BBFormOrgFields" style="display: none;">
            <div class="BBFormFieldContainer BBFormFieldContainerRequired">
              <label for="bboxdonation_billing_txtOrgName" id="bboxdonation_billing_lblOrgName" class="BBFormFieldLabel BBFormFieldLabelEdit ">Organization name:</label>
              <input name="bboxdonation$billing$txtOrgName" type="text" id="bboxdonation_billing_txtOrgName" class="BBFormTextbox" required="required" data-billing-field="orgname" maxlength="60">
            </div>
          </div>
          <div id="fldIndivInfo" class="BBFormIndivFields">
            <div id="divName" class="BBFormFieldContainer BBFormFieldContainerRequired  BBTwoFields">
              <span id="bboxdonation_billing_lblFullName" class="BBFormFieldLabel BBFormFieldLabelEdit">Name:</span>
              <label for="bboxdonation_billing_ddTitle" id="bboxdonation_billing_lblTitle" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Title:</label>
              <label for="bboxdonation_billing_txtFirstName" id="bboxdonation_billing_lblFirstName" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">First name:</label>
              <input name="bboxdonation$billing$txtFirstName" type="text" id="bboxdonation_billing_txtFirstName" class="BBFormTextbox" data-billing-field="firstname" maxlength="50" required="required" placeholder="first name">
              <label for="bboxdonation_billing_txtLastName" id="bboxdonation_billing_lblLastName" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Last name:</label>
              <input name="bboxdonation$billing$txtLastName" type="text" id="bboxdonation_billing_txtLastName" class="BBFormTextbox" data-billing-field="lastname" maxlength="100" required="required" placeholder="last name">
            </div>
          </div>
          <div id="bboxdonation_billing_divEmail" class="BBFormFieldContainer BBFormFieldContainerRequired BBFormBillingEmail">
            <label for="bboxdonation_billing_txtEmail" id="bboxdonation_billing_lblEmail" class="BBFormFieldLabel BBFormFieldLabelEdit">Email:</label>
            <input name="bboxdonation$billing$txtEmail" type="email" id="bboxdonation_billing_txtEmail" class="BBFormTextbox" data-billing-field="email" required="required">
          </div>
          <div id="bboxdonation_billing_divPhone" class="BBFormFieldContainer BBFormBillingPhone BBFormFieldContainerRequired">
            <label for="bboxdonation_billing_txtPhone" id="bboxdonation_billing_lblPhone" class="BBFormFieldLabel BBFormFieldLabelEdit">Phone:</label>
            <input name="bboxdonation$billing$txtPhone" type="tel" id="bboxdonation_billing_txtPhone" class="BBFormTextbox" data-billing-field="phone" placeholder="optional">
          </div>
          <div class="BBFormAddress">
            <div class="BBFormFieldContainer BBFormFieldContainerRequired">
              <label for="bboxdonation_billing_billingAddress_ddCountry" id="bboxdonation_billing_billingAddress_lblCountry" class="BBFormFieldLabel BBFormFieldLabelEdit">Country:</label>
              <select name="bboxdonation$billing$billingAddress$ddCountry" id="bboxdonation_billing_billingAddress_ddCountry" class="BBFormSelectList BBFormCountryDropDown" required="required">
                <option selected="selected" value="United States" data-country-format="1" data-short-text="US">United States</option>
                <option value="Canada" data-country-format="3" data-short-text="CA">Canada</option>
                <option value="United Kingdom" data-country-format="2" data-short-text="GB">United Kingdom</option>
                <option value="Australia" data-country-format="4" data-short-text="AU">Australia</option>
                <option value="New Zealand" data-country-format="5" data-short-text="NZ">New Zealand</option>
                <option value="South Korea" data-country-format="2" data-short-text="KR">South Korea</option>
                <option value="Taiwan" data-country-format="2" data-short-text="TW">Taiwan</option>
                <option value="Chile" data-country-format="1" data-short-text="CL">Chile</option>
                <option value="Belgium" data-country-format="1" data-short-text="BE">Belgium</option>
                <option value="Brazil" data-country-format="1" data-short-text="BR">Brazil</option>
                <option value="India" data-country-format="1" data-short-text="IN">India</option>
              </select>
            </div>
            <div class="BBFormFieldContainer BBFormFieldContainerRequired">
              <label for="bboxdonation_billing_billingAddress_txtAddress" id="bboxdonation_billing_billingAddress_lblAddress" class="BBFormFieldLabel BBFormFieldLabelEdit">Address:</label>
              <textarea name="bboxdonation$billing$billingAddress$txtAddress" id="bboxdonation_billing_billingAddress_txtAddress" class="BBFormTextArea" rows="2" cols="30" required="required" data-country-field="address" maxlength="150"></textarea>
            </div>
            <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="1">
              <label for="bboxdonation_billing_billingAddress_txtCity" id="bboxdonation_billing_billingAddress_lblCity" class="BBFormFieldLabel BBFormFieldLabelEdit">City:</label>
              <input name="bboxdonation$billing$billingAddress$txtCity" type="text" id="bboxdonation_billing_billingAddress_txtCity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50">
            </div>
            <div class="BBTwoFields BBFieldBillingStateZip">
              <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="1">
                <label for="bboxdonation_billing_billingAddress_ddState" id="bboxdonation_billing_billingAddress_lblStateZip" class="BBFormFieldLabel BBFormFieldLabelEdit">State &amp; zip:</label>
                <div aria-describedby="bboxdonation_billing_billingAddress_ddState">
                  <span id="bboxdonation_billing_billingAddress_lblState" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">State:</span>
                </div>
                <select name="bboxdonation$billing$billingAddress$ddState" id="bboxdonation_billing_billingAddress_ddState" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
                  <option selected="selected" value="" default="default">state</option>
                  <option value="AA">AA</option>
                  <option value="AB">AB</option>
                  <option value="AE">AE</option>
                  <option value="AK">AK</option>
                  <option value="AL">AL</option>
                  <option value="AP">AP</option>
                  <option value="AR">AR</option>
                  <option value="AS">AS</option>
                  <option value="AZ">AZ</option>
                  <option value="BC">BC</option>
                  <option value="CA">CA</option>
                  <option value="CO">CO</option>
                  <option value="CT">CT</option>
                  <option value="CZ">CZ</option>
                  <option value="DC">DC</option>
                  <option value="DE">DE</option>
                  <option value="FL">FL</option>
                  <option value="FM">FM</option>
                  <option value="GA">GA</option>
                  <option value="GU">GU</option>
                  <option value="HI">HI</option>
                  <option value="IA">IA</option>
                  <option value="ID">ID</option>
                  <option value="IL">IL</option>
                  <option value="IN">IN</option>
                  <option value="KS">KS</option>
                  <option value="KY">KY</option>
                  <option value="LA">LA</option>
                  <option value="MA">MA</option>
                  <option value="MB">MB</option>
                  <option value="MD">MD</option>
                  <option value="ME">ME</option>
                  <option value="MH">MH</option>
                  <option value="MI">MI</option>
                  <option value="MN">MN</option>
                  <option value="MO">MO</option>
                  <option value="MP">MP</option>
                  <option value="MS">MS</option>
                  <option value="MT">MT</option>
                  <option value="NB">NB</option>
                  <option value="NC">NC</option>
                  <option value="ND">ND</option>
                  <option value="NE">NE</option>
                  <option value="NL">NL</option>
                  <option value="NH">NH</option>
                  <option value="NJ">NJ</option>
                  <option value="NM">NM</option>
                  <option value="NS">NS</option>
                  <option value="NT">NT</option>
                  <option value="NV">NV</option>
                  <option value="NY">NY</option>
                  <option value="OH">OH</option>
                  <option value="OK">OK</option>
                  <option value="ON">ON</option>
                  <option value="OR">OR</option>
                  <option value="PA">PA</option>
                  <option value="PE">PE</option>
                  <option value="PR">PR</option>
                  <option value="PW">PW</option>
                  <option value="QC">QC</option>
                  <option value="RI">RI</option>
                  <option value="SC">SC</option>
                  <option value="SD">SD</option>
                  <option value="SK">SK</option>
                  <option value="TN">TN</option>
                  <option value="TX">TX</option>
                  <option value="UT">UT</option>
                  <option value="VA">VA</option>
                  <option value="VI">VI</option>
                  <option value="VT">VT</option>
                  <option value="WA">WA</option>
                  <option value="WI">WI</option>
                  <option value="WV">WV</option>
                  <option value="WY">WY</option>
                  <option value="YT">YT</option>
                  <option value="NU">NU</option>
                  <option value="DEL">DEL</option>
                  <option value="NA">NA</option>
                </select>
                <label for="bboxdonation_billing_billingAddress_txtZip" id="bboxdonation_billing_billingAddress_lblZip" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Zip:</label>
                <input name="bboxdonation$billing$billingAddress$txtZip" type="tel" id="bboxdonation_billing_billingAddress_txtZip" class="BBFormTextbox" data-country-field="postcode" data-country-sync="1" required="required" maxlength="12"
                  placeholder="zip">
              </div>
            </div>
            <div class="BBTwoFields BBFieldBillingStateZip">
              <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="2" style="display: none;">
                <label for="bboxdonation_billing_billingAddress_txtUKCity" id="bboxdonation_billing_billingAddress_lblUKCityCounty" class="BBFormFieldLabel BBFormFieldLabelEdit">City &amp; county:</label>
                <div aria-describedby="bboxdonation_billing_billingAddress_txtUKCity">
                  <span id="bboxdonation_billing_billingAddress_lblUKCity" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">City:</span>
                </div>
                <input name="bboxdonation$billing$billingAddress$txtUKCity" type="text" id="bboxdonation_billing_billingAddress_txtUKCity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50"
                  placeholder="city">
                <label for="bboxdonation_billing_billingAddress_ddUKCounty" id="bboxdonation_billing_billingAddress_lblUKCounty" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">County:</label>
                <select name="bboxdonation$billing$billingAddress$ddUKCounty" id="bboxdonation_billing_billingAddress_ddUKCounty" class="BBFormSelectList GhostText" data-country-field="county">
                  <option selected="selected" value="" default="default">county (optional)</option>
                  <option value="Republic of Korea">Republic of Korea</option>
                </select>
              </div>
            </div>
            <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="2" style="display: none;">
              <label for="bboxdonation_billing_billingAddress_txtUKPostCode" id="bboxdonation_billing_billingAddress_lblUKPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">Postcode:</label>
              <input name="bboxdonation$billing$billingAddress$txtUKPostCode" type="text" id="bboxdonation_billing_billingAddress_txtUKPostCode" class="BBFormTextbox" data-country-field="postcode" data-country-sync="1" required="required"
                maxlength="12">
            </div>
            <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="3" style="display: none;">
              <label for="bboxdonation_billing_billingAddress_txtCACity" id="bboxdonation_billing_billingAddress_lblCACity" class="BBFormFieldLabel BBFormFieldLabelEdit">City:</label>
              <input name="bboxdonation$billing$billingAddress$txtCACity" type="text" id="bboxdonation_billing_billingAddress_txtCACity" class="BBFormTextbox" data-country-field="city" data-country-sync="1" required="required" maxlength="50">
            </div>
            <div class="BBTwoFields BBFieldBillingStateZip">
              <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="3" style="display: none;">
                <label for="bboxdonation_billing_billingAddress_ddCAProvince" id="bboxdonation_billing_billingAddress_lblCAProvincePostCode" class="BBFormFieldLabel BBFormFieldLabelEdit">Province &amp; postal:</label>
                <div aria-describedby="bboxdonation_billing_billingAddress_ddCAProvince">
                  <span id="bboxdonation_billing_billingAddress_lblCAProvince" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Province:</span>
                </div>
                <select name="bboxdonation$billing$billingAddress$ddCAProvince" id="bboxdonation_billing_billingAddress_ddCAProvince" class="BBFormSelectList GhostText" data-country-sync="1" data-country-field="state" required="required">
                  <option selected="selected" value="" default="default">province</option>
                  <option value="AA">AA</option>
                  <option value="AB">AB</option>
                  <option value="AE">AE</option>
                  <option value="AK">AK</option>
                  <option value="AL">AL</option>
                  <option value="AP">AP</option>
                  <option value="AR">AR</option>
                  <option value="AS">AS</option>
                  <option value="AZ">AZ</option>
                  <option value="BC">BC</option>
                  <option value="CA">CA</option>
                  <option value="CO">CO</option>
                  <option value="CT">CT</option>
                  <option value="CZ">CZ</option>
                  <option value="DC">DC</option>
                  <option value="DE">DE</option>
                  <option value="FL">FL</option>
                  <option value="FM">FM</option>
                  <option value="GA">GA</option>
                  <option value="GU">GU</option>
                  <option value="HI">HI</option>
                  <option value="IA">IA</option>
                  <option value="ID">ID</option>
                  <option value="IL">IL</option>
                  <option value="IN">IN</option>
                  <option value="KS">KS</option>
                  <option value="KY">KY</option>
                  <option value="LA">LA</option>
                  <option value="MA">MA</option>
                  <option value="MB">MB</option>
                  <option value="MD">MD</option>
                  <option value="ME">ME</option>
                  <option value="MH">MH</option>
                  <option value="MI">MI</option>
                  <option value="MN">MN</option>
                  <option value="MO">MO</option>
                  <option value="MP">MP</option>
                  <option value="MS">MS</option>
                  <option value="MT">MT</option>
                  <option value="NB">NB</option>
                  <option value="NC">NC</option>
                  <option value="ND">ND</option>
                  <option value="NE">NE</option>
                  <option value="NL">NL</option>
                  <option value="NH">NH</option>
                  <option value="NJ">NJ</option>
                  <option value="NM">NM</option>
                  <option value="NS">NS</option>
                  <option value="NT">NT</option>
                  <option value="NV">NV</option>
                  <option value="NY">NY</option>
                  <option value="OH">OH</option>
                  <option value="OK">OK</option>
                  <option value="ON">ON</option>
                  <option value="OR">OR</option>
                  <option value="PA">PA</option>
                  <option value="PE">PE</option>
                  <option value="PR">PR</option>
                  <option value="PW">PW</option>
                  <option value="QC">QC</option>
                  <option value="RI">RI</option>
                  <option value="SC">SC</option>
                  <option value="SD">SD</option>
                  <option value="SK">SK</option>
                  <option value="TN">TN</option>
                  <option value="TX">TX</option>
                  <option value="UT">UT</option>
                  <option value="VA">VA</option>
                  <option value="VI">VI</option>
                  <option value="VT">VT</option>
                  <option value="WA">WA</option>
                  <option value="WI">WI</option>
                  <option value="WV">WV</option>
                  <option value="WY">WY</option>
                  <option value="YT">YT</option>
                  <option value="NU">NU</option>
                  <option value="DEL">DEL</option>
                  <option value="NA">NA</option>
                </select>
                <label for="bboxdonation_billing_billingAddress_txtCAPostCode" id="bboxdonation_billing_billingAddress_lblCAPostCode" class="BBFormFieldLabel BBFormFieldLabelEdit BBAccessibilityOnly">Postal:</label>
                <input name="bboxdonation$billing$billingAddress$txtCAPostCode" type="text" id="bboxdonation_billing_billingAddress_txtCAPostCode" class="BBFormTextbox" required="required" data-country-sync="1" data-country-field="postcode"
                  maxlength="12" placeholder="postal">
              </div>
            </div>
            <div class="BBFormFieldContainer BBFormFieldContainerRequired" data-country-format-for="4" style="display: none;">
              <label for="bboxdonation_billing_billingAddress_txtAUCity" id="bboxdonation_billing_billingAddress_lblAUCity" class="BBFormFieldLabel BBFormFieldLabelEdit">Suburb:</label>
              <input name="bboxdonation$billing$billingAddress$txtAUCity" type="text" id="bboxdonation_billing_billingAddress_txtAUCity" class="BBFormTextbox" data-country-sync="1" data-country-field="city" required="required" maxlength="50">
            </div>
            <div class="BBTwoFields BBFieldBillingStateZip">
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