donate.voa.org
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Submitted URL: https://donate.voa.org/site/R?i=RR4U_QpI4phfyiW6kkszs6RTmE82LkKgopsxYiEmAuWbSQqvQHal4A
Effective URL: https://donate.voa.org/site/Donation2?idb=1846847344&df_id=21969&mfc_pref=T&21969.donation=form1&idb=0
Submission: On December 16 via manual from US — Scanned from DE
Effective URL: https://donate.voa.org/site/Donation2?idb=1846847344&df_id=21969&mfc_pref=T&21969.donation=form1&idb=0
Submission: On December 16 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: process — POST https://donate.voa.org/site/Donation2
<form name="process" id="ProcessForm" action="https://donate.voa.org/site/Donation2" method="post" onsubmit="return checkDoubleClick();">
<div class="donation-form-container responsive">
<script type="text/javascript">
<!--
function reloadPage() {
window.location.reload(true);
}
function testAjax() {
var xmlHttp = null;
// Opera 8.0+, Firefox, Chrome, Safari
try {
xmlHttp = new XMLHttpRequest();
} catch (e) {
// Internet Explorer Browsers
try {
xmlHttp = new ActiveXObject("Msxml2.XMLHTTP");
} catch (e) {
try {
xmlHttp = new ActiveXObject("Microsoft.XMLHTTP");
} catch (e) {
return false;
}
}
}
xmlHttp.open('POST', 'AjaxHelper;jsessionid=00000000.app30130b?NONCE_TOKEN=097AB0A9B802ACE228E0407C09C01655', true);
xmlHttp.send();
}
addOnLoadHandler(testAjax);
//
-->
</script>
<div class="donation-form-content">
<input type="hidden" name="user_donation_amt" id="user_donation_amt" value="">
<input type="hidden" name="company_min_matching_amt" id="company_min_matching_amt" value="">
<input type="hidden" name="currency_locale" id="currency_locale" value="en_US">
<input type="hidden" name="default_appealhidden" id="default_appealhidden" value="Z22NATLFUR">
<input type="hidden" name="default_packagehidden" id="default_packagehidden" value="Z22NATLXFURWB">
<div class="form-row">
<div class="html-caption-container">
<!-- UPDATE THE LOGO FOR THIS DONATION FORM -->
<!-- END UPDATE THE LOGO FOR THIS DONATION FORM -->
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<!-- Facebook Pixel Code -->
<script type="text/javascript">
// <![CDATA[
! function(f, b, e, v, n, t, s) {
if (f.fbq) return;
n = f.fbq = function() {
n.callMethod ? n.callMethod.apply(n, arguments) : n.queue.push(arguments)
};
if (!f._fbq) f._fbq = n;
n.push = n;
n.loaded = !0;
n.version = '2.0';
n.queue = [];
t = b.createElement(e);
t.async = !0;
t.src = v;
s = b.getElementsByTagName(e)[0];
s.parentNode.insertBefore(t, s)
}(window, document, 'script', 'https://connect.facebook.net/en_US/fbevents.js');
fbq('init', '1648479288736734');
fbq('track', 'PageView');
// ]]>
</script>
<noscript><img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=1648479288736734&ev=PageView&noscript=1" /></noscript><!-- End Facebook Pixel Code -->
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<!-- UPDATE THE INTRO TEXT AND IMAGE (DESKTOP) FOR THIS DONATION FORM -->
<div class="intro">
<p id="intro_text" style="font-size: 16px; line-height: 24px; color: #000000; margin-bottom: 20px; text-align: left;"><span style="font-size: 160%;"><strong>Give to Your Neighbor this Holiday Season [2X Match]</strong></span></p>
<p id="intro_text" style="font-size: 16px; line-height: 24px; color: #000000; margin-bottom: 20px; text-align: left;">We enter this holiday season knowing many of our neighbors are spending it out in the cold and in urgent need. Your
donation can help feed and shelter them, and give them hope. Right now, donations are being matched dollar for dollar.</p>
<p id="intro_text" style="font-size: 16px; line-height: 24px; color: #000000; margin-bottom: 20px; text-align: left;">Give today and love your neighbor in the most meaningful way.</p>
</div>
<!-- END UPDATE THE INTRO TEXT AND IMAGE (DESKTOP) FOR THIS DONATION FORM --> <!-- UPDATE THE INTRO TEXT (MOBILE) FOR THIS DONATION FORM -->
<!-- END UPDATE THE INTRO TEXT (MOBILE) FOR THIS DONATION FORM -->
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<!--Script font image. Can be moved above donation level or below additional fee agreement-->
<img style="margin:0 auto;display:block;" src="../images/content/pagebuilder/donationscript.png">
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<!-- Donation form IMAGES and Charity Badges -->
</div>
</div>
<div class="don-standard-levels form-row">
<div class="levels-label">
</div>
<div id="level_standard_row" class="form-row form-donation-level">
<div class="form-content">
<span class="field-required"></span> <span class="aural-only">Field Is Required</span>
<span class="FormLabelText">Select Gift Amount:</span>
<div class="donation-level-general-ask">
</div>
<div class="donation-level-tabs"><input type="radio" name="tabs" id="onetime-level" checked="checked" value="one-time-gift"><label for="onetime-level">One-time</label><input type="radio" name="tabs" id="monthly-level"
value="monthly-gift"><label for="monthly-level">Monthly</label></div>
<div class="donation-levels">
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33136" value="33136" onclick="evalMatchingGift('$25.00');
updateDonorCoverAmount('$25.00');" class="don-radio">
</div>
<label for="level_standardexpanded33136" onclick="">
<div class="donation-level-amount-container"> $25 </div>
<div class="donation-level-label-container"> $25 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33136expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container active">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33137" value="33137" checked="checked" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');" class="don-radio">
</div>
<label for="level_standardexpanded33137" onclick="">
<div class="donation-level-amount-container"> $50 </div>
<div class="donation-level-label-container"> $50 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33137expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33138" value="33138" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');" class="don-radio">
</div>
<label for="level_standardexpanded33138" onclick="">
<div class="donation-level-amount-container"> $100 </div>
<div class="donation-level-label-container"> $100 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33138expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33139" value="33139" onclick="evalMatchingGift('$200.00');
updateDonorCoverAmount('$200.00');" class="don-radio">
</div>
<label for="level_standardexpanded33139" onclick="">
<div class="donation-level-amount-container"> $200 </div>
<div class="donation-level-label-container"> $200 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33139expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33140" value="33140" onclick="evalMatchingGift('$500.00');
updateDonorCoverAmount('$500.00');" class="don-radio">
</div>
<label for="level_standardexpanded33140" onclick="">
<div class="donation-level-amount-container"> $500 </div>
<div class="donation-level-label-container"> $500 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33140expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33141" value="33141" onclick="evalMatchingGift('$10.00');
updateDonorCoverAmount('$10.00');" class="don-radio">
</div>
<label for="level_standardexpanded33141" onclick="">
<div class="donation-level-amount-container"> $10 </div>
<div class="donation-level-label-container"> $10 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33141expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33142" value="33142" onclick="evalMatchingGift('$15.00');
updateDonorCoverAmount('$15.00');" class="don-radio">
</div>
<label for="level_standardexpanded33142" onclick="">
<div class="donation-level-amount-container"> $15 </div>
<div class="donation-level-label-container"> $15 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33142expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33143" value="33143" onclick="evalMatchingGift('$25.00');
updateDonorCoverAmount('$25.00');" class="don-radio">
</div>
<label for="level_standardexpanded33143" onclick="">
<div class="donation-level-amount-container"> $25 </div>
<div class="donation-level-label-container"> $25 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33143expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33144" value="33144" onclick="evalMatchingGift('$50.00');
updateDonorCoverAmount('$50.00');" class="don-radio">
</div>
<label for="level_standardexpanded33144" onclick="">
<div class="donation-level-amount-container"> $50 </div>
<div class="donation-level-label-container"> $50 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33144expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container" style="display: none;">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33145" value="33145" onclick="evalMatchingGift('$100.00');
updateDonorCoverAmount('$100.00');" class="don-radio">
</div>
<label for="level_standardexpanded33145" onclick="">
<div class="donation-level-amount-container"> $100 </div>
<div class="donation-level-label-container"> $100 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33145expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container" id="user-entered-row">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded33146" value="33146" onclick="evalMatchingGift(document.getElementById('level_standardexpanded33146amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded33146amount').value);" class="don-radio other-radio">
</div>
<label for="level_standardexpanded33146" onclick="">
<div class="donation-level-label-container"> Other </div>
</label>
<div class="donation-level-user-entered">
<label for="level_standardexpanded33146amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded33146amount" id="level_standardexpanded33146amount" value="" size="12"
onfocus="var el = document.getElementById ('level_standardexpanded33146');if (el) el.click(); fire_obs_comp_event('level_standardexpanded33146amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded33146amount', this, event);evalMatchingGift(value);" onkeyup="fire_obs_comp_event('level_standardexpanded33146amount', this, event);evalMatchingGift(value);"
onblur="fire_obs_comp_event('level_standardexpanded33146amount', this);updateDonorCoverAmount(value);" class="don-other" placeholder="$Other">
</div>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_33146expandedsubmit" value="true">
</div>
</div>
</div>
</div>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observables
jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
var syncAction = function(obj) {
if (obj.is(':checked')) {
obj.closest('div.donation-level-container').addClass('selected');
} else {
obj.closest('div.donation-level-container').removeClass('selected');
};
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('div.donation-level-container').removeClass('selected');
syncAction(jQuery(this));
});
});
});
});
</script><noscript> </noscript>
</div>
<div class="levels-gift-aid">
</div>
<input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true">
<script type="text/javascript">
function updateDonorCoverAmount(gift) {
if (typeof updateAmount !== "undefined") {
updateAmount(gift);
}
};
function evalMatchingGift(gift) {}
</script><noscript> </noscript>
</div>
<div class="donation-level-container-generic-repeat form-input">
<div class="donation-section-label"> Make this a Monthly Gift. </div>
<div class="generic-repeat-label-checkbox-container">
<input type="checkbox" name="level_standardauto_repeatname" id="level_standardauto_repeatname" onclick="fire_obs_comp_event('level_standardauto_repeat', this);" onkeypress="fire_obs_comp_event('level_standardauto_repeat', this);">
<label for="level_standardauto_repeatname"> Your gift will be charged on a monthly basis. You may cancel at any time. </label>
</div>
<input type="hidden" name="level_standardauto_repeatsubmit" id="level_standardauto_repeatsubmit" value="true">
</div>
<div id="additional_amount_row" class="form-row form-text">
<div class="form-content">
<label for="additional_amountname">Additional Amount:</label>
<div class="form-input">
<input type="text" name="additional_amountname" id="additional_amountname" value="" maxlength="15" onchange="fire_obs_comp_event('additional_amount', this);">
</div>
</div>
<input type="hidden" name="additional_amountsubmit" id="additional_amountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('additional_amount', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('additional_amount_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('additional_amountname')) {
document.getElementById('additional_amountname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('additional_amountname')) return document.getElementById('additional_amountname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
<div class="form-row">
<div class="html-caption-container">
<!--DO NOT EDIT This is an automated field that displays the first image from the right column on mobile devices-->
<div class="from-right-column show-mobile">
<div class="show-mobile also-show-mobile"><img src="../images/content/pagebuilder/VOA0042_YEHYN1-SmDON.jpg" border="0" alt="Older woman with white hair. House your neighbor."></div>
</div>
</div>
</div>
<h2 class="section-header-container"> 1. Billing Information </h2>
<div id="billing_first_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name</label>
<input type="text" name="billing_first_namename" id="billing_first_namename" value="" maxlength="50" required="required">
<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_last_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name</label>
<input type="text" name="billing_last_namename" id="billing_last_namename" value="" maxlength="50" required="required">
<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street1_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street 1</label>
<input type="text" name="billing_addr_street1name" id="billing_addr_street1name" value="" maxlength="50" required="required">
<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street1_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street2_row" class="form-row form-text">
<div class="form-content">
<label for="billing_addr_street2name">Street 2</label>
<input type="text" name="billing_addr_street2name" id="billing_addr_street2name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street2submit" id="billing_addr_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street2_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_city_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City</label>
<input type="text" name="billing_addr_cityname" id="billing_addr_cityname" value="" maxlength="50" required="required">
<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_city_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_state_row" class="form-row form-selectlist">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_state">State/Province</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" onchange="fire_obs_comp_event('billing_addr_state', this)" required="required">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_state', src);
}
}
var el = document.getElementById('billing_addr_state');
if (el) {
Utils.addEvent(el, 'change', billing_addr_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_zip_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">Zip/Postal Code</label>
<input type="text" name="billing_addr_zipname" id="billing_addr_zipname" value="" maxlength="50" required="required">
<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_zip_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_country_row" class="form-row form-selectlist">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_country">Country</label>
<select name="billing_addr_country" id="billing_addr_country" size="1" onchange="fire_obs_comp_event('billing_addr_country', this)" required="required">
<option></option>
<option value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivarian Republic of Venezuela">Bolivarian Republic of Venezuela</option>
<option value="Bonaire, Sint Eustatios and Saba">Bonaire, Sint Eustatios and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Democratic People's Republic of Korea">Democratic People's Republic of Korea</option>
<option value="The Democratic Republic of the Congo">The Democratic Republic of the Congo</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="The Former Yugoslav Republic of Macedonia">The Former Yugoslav Republic of Macedonia</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Islamic Republic of Iran">Islamic Republic of Iran</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Plurinational State of Bolivia">Plurinational State of Bolivia</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Korea">Republic of Korea</option>
<option value="Republic of Moldova">Republic of Moldova</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French)">Saint Martin (French)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls.</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch)">Sint Maarten (Dutch)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United Republic of Tanzania">United Republic of Tanzania</option>
<option value="Uruguay">Uruguay</option>
<option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_countrysubmit" id="billing_addr_countrysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_country_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_country_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_country', src);
}
}
var el = document.getElementById('billing_addr_country');
if (el) {
Utils.addEvent(el, 'change', billing_addr_country_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div class="custom-field-container form-row mobile_number_input_container">
<div class="form-content">
<div class="form-input-label-block">
<label for="mobile_number_input">Phone Number</label>
</div>
<input type="text" name="mobile_number_input" id="mobile_number_input" value="" maxlength="255">
<input type="hidden" name="mobile_numbersubmit" id="mobile_numbersubmit" value="true">
</div>
</div>
<div id="donor_email_address_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">Email Address</label>
<input type="text" name="donor_email_addressname" id="donor_email_addressname" value="" maxlength="255" required="required">
<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_address', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_address_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div class="form-row form-checkbox" id="donor_email_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="hidden" name="donor_email_opt_inname" id="donor_email_opt_inname" value="implicit">
<span class="auto-opt-in-warning-message">If you donate and have not already registered, you will receive periodic updates and communications from Volunteers of America.</span>
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_opt_in', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_opt_in_Row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_email_opt_inname')) {
document.getElementById('donor_email_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_email_opt_inname')) return document.getElementById('donor_email_opt_inname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true">
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<small>You'll receive email updates from Volunteers of America. You can unsubscribe at any time.</small>
</div>
</div>
<h2 class="section-header-container"> 2. Payment Details </h2>
<div class="payment-type-element-container">
<div id="payment_cc_container" class="payment-field-container">
<h3>Credit Card Information:</h3>
<div id="responsive_payment_typecc_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="responsive_payment_typecc_type_Discover" id="responsive_payment_typecc_type_Discover">
</li>
<li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="responsive_payment_typecc_type_American_Express" id="responsive_payment_typecc_type_American_Express">
</li>
<li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="responsive_payment_typecc_type_MasterCard" id="responsive_payment_typecc_type_MasterCard">
</li>
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="responsive_payment_typecc_type_Visa" id="responsive_payment_typecc_type_Visa">
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_typesubmit" id="responsive_payment_typecc_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typecc_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_numbername">Credit Card Number:</label>
<input type="text" name="responsive_payment_typecc_numbername" id="responsive_payment_typecc_numbername" value="" maxlength="22" autocomplete="off">
<input type="hidden" name="responsive_payment_typecc_numbersubmit" id="responsive_payment_typecc_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_number_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typecc_number'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_cvv_row" class="form-row form-text cvv-input">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_cvvname">
<span class="FormLabelText">CVV Number:</span>
</label>
<a href="http://help.convio.net/site/PageServer?s_site=voa&pagename=user_donation_cvv" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typecc_cvvname" id="responsive_payment_typecc_cvvname" value="" maxlength="4" autocomplete="cc-csc">
<input type="hidden" name="responsive_payment_typecc_cvvsubmit" id="responsive_payment_typecc_cvvsubmit" value="true">
<script type="text/javascript">
//chrome is mapping cvv as card name
if (/Chrome/.test(navigator.userAgent) && /Google Inc/.test(navigator.vendor)) {
document.getElementById('responsive_payment_typecc_cvvname').autocomplete = 'cc-csc';
}
var comp = new ObservableComponent('responsive_payment_typecc_cvv', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_cvv_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_exp_date_row" class="form-row form-date">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_exp_date_MONTH">
<span class="label-text"><span class="label-text"><!-- <span class="field-required"></span> --> Expiration Date: <strong>Be sure to edit this field to your card's actual expiration date!</strong></span>
</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="responsive_payment_typecc_exp_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<fieldset class="cardExpGroup">
<select name="responsive_payment_typecc_exp_date_MONTH" id="responsive_payment_typecc_exp_date_MONTH" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_MONTH', this)">
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12" selected="selected">12</option>
</select>
<select name="responsive_payment_typecc_exp_date_YEAR" id="responsive_payment_typecc_exp_date_YEAR" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_YEAR', this)">
<option value="2021" selected="selected">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
</select>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_exp_date_DAY" id="responsive_payment_typecc_exp_date_DAY" value="1">
<noscript> </noscript>
</div>
<input type="hidden" name="responsive_payment_typecc_exp_datesubmit" id="responsive_payment_typecc_exp_datesubmit" value="true">
<noscript> </noscript>
</div>
</div>
</div>
<input type="hidden" name="responsive_payment_typesubmit" id="responsive_payment_typesubmit" value="true">
<script type="text/javascript">
function PaymentObserver() {
this.observe = function(_event) {
var sVal = _event.component.get();
switch (sVal) {
case 'check':
hide_element('payment_cc_container');
hide_element('payment_bank_container');
show_element('payment_check_container');
break;
case 'credit':
hide_element('payment_bank_container');
hide_element('payment_check_container');
show_element('payment_cc_container');
break;
case 'ach':
hide_element('payment_cc_container');
hide_element('payment_check_container');
show_element('payment_bank_container');
break;
case 'paypal':
case 'amazon':
case 'mobilepay':
default:
// hide all
hide_element('payment_bank_container');
hide_element('payment_cc_container');
hide_element('payment_check_container');
break;
}
}
}
// Set the observer to show/hide the relevant fields
observe_component('responsive_payment_typepay_typeradio', new PaymentObserver());
</script><noscript> </noscript>
</div>
<div class="custom-field-container form-row ">
<div class="form-content">
<div class="form-input-label-block add-amt-cont">
<label for="additional_fee_agreement_dropdown">Add an additional 3% to offset fees?</label>
</div>
<fieldset>
<input type="checkbox" name="additional_fee_agreement_radio" id="additional_fee_agreement_radio" value="true">
<label class="custom-element-checkbox-label" for="additional_fee_agreement_radio"> I'd like to help cover the 3% processing fee for my donation.</label>
</fieldset>
<input type="hidden" name="additional_fee_agreementsubmit" id="additional_fee_agreementsubmit" value="true">
</div>
</div>
<div class="button-container clearfix">
<div class="button-sub-container">
<button class="step-button action-button finish-step" type="submit" id="pstep_finish" name="pstep_finish" value="GIVE NOW >">DONATE $50.00</button>
</div>
</div>
<input type="hidden" name="idb" id="idb" value="1846847344">
<input type="hidden" name="df_id" id="df_id" value="21969">
<input type="hidden" name="mfc_pref" id="mfc_pref" value="T">
<div class="form-row">
<div class="html-caption-container">
<style>
*,
html,
body,
form,
input,
input.AddressBookButtons,
input.Advocacy,
input.btn,
input.btnLg,
input.btnMed,
input.btnMini,
input.btnSm,
select,
select.Advocacy,
textarea,
legend,
ul,
ol,
li,
option,
table,
tr,
th,
th.rfl_infoStatus,
td,
td.AlertListDescription,
td.cstmBack,
p,
p.cstmBtnText,
p.cstmFrame,
p.cstmHeading,
p.cstmText,
p.cstmTitle,
p.dividerHeading,
p.scrollingText,
span.cstmHeading,
a,
a.btn,
a.btn:visited,
a.cstmBtnText:hover,
a.cstmBtnText:link,
a.cstmBtnText:visited,
#navList,
.AdvocacyInstructions,
.AdvocacyNSFix,
.BlogHeader,
.Button,
.Divider,
.FieldLabels,
.FormBox,
.FormBox06,
.FormBoxHeader,
.Hint,
.Instructions,
.Instructions,
.ListItem0,
.ListItem1,
.NetscapeFix,
.NoteText,
.ObjTitle,
.PhotoLinks,
.Premiums,
.ProgressBox,
.ProgressBoxCurrent,
.SectionHead,
.SmallButton,
.Smaller,
.SmallerC,
.TribBtnText1,
.Upgrades,
.WhatNext,
.alphacube_content,
.dialog_content,
.dialog_title,
.explicit,
.fr_register_another,
.paraBlueSansSmall,
.smallBlack,
.smallSans,
.smallSansBold,
.smallWhiteBoldSans,
.smallWhiteSans,
.smallestBlackSans {
color: #3c3c3c;
font-family: "Source Sans Pro";
}
div.responsive .donation-levels label div {
width: 100px;
height: 48px;
background-color: #ffffff;
border: 4px solid #b32317;
}
.donation-level-amount-container {
font-size: 30px;
line-height: 22px;
color: #b32317;
font-family: "Source Sans Pro";
text-align: center;
}
.donation-level-container-generic-repeat {
margin-bottom: 30px;
margin-top: 20px;
}
.gift_designation_2_dropdown {
font-size: 14px;
}
.donation-level-general-ask {
margin-top: 5px;
}
#billing_last_name_row,
#billing_first_name_row {
width: 50%;
}
/*#donor_email_addressname {margin-left: 10px;width: 97%;}*/
.custom-field-container label[for="gift_designation_2_dropdown"] {
color: #3c3c3c;
font-family: "Source Sans Pro";
font-size: 1em;
}
h3 {
font-size: 22px;
}
#donor_email_opt_in_Row {
display: none !important
}
.mobile_number_input_container label:after {
content: ' (optional)'
}
#level_standardauto_repeatname {
/*vertical-align: baseline;*/
}
#level_standardauto_repeatname {
vertical-align: top;
position: relative;
top: -20px;
}
label.error,
div.responsive span.field-required,
label[for="responsive_payment_typecc_exp_date_MONTH"] .aural-only {
display: inline-block !important;
/*vertical-align: baseline;*/
}
.generic-repeat-label-checkbox-container label {
/*font-weight: 700;*/
}
.donation-section-label {
font-weight: 700;
margin-left: 15px;
}
#responsive_payment_typecc_type_row {
display: none;
}
#payment_cc_container:first-child h3 {
display: none;
}
div.responsive .donation-levels input[type="text"] {
/*font-size: 30px;
line-height: 22px;
color: #2566a4;
font-family: "Source Sans Pro";
text-align: center; */
width: 140px;
height: 48px;
background-color: #ffffff;
border: 4px solid #888888;
font-size: 25px !important;
line-height: 22px;
color: #888888 !important;
font-family: "Source Sans Pro";
text-align: center !important;
}
div.button-container {
margin-top: 0;
padding-top: 0;
}
label+div.donation-level-user-entered {
margin-left: 0;
}
div.responsive .donation-levels input[type="text"]:focus {}
div.donation-level-container {
margin: 0;
margin-right: 7px;
}
.section-header-container h2 {
font-size: 16px;
line-height: 26px;
color: #333333;
font-family: "Source Sans Pro";
}
div.responsive a.next-step:hover,
div.responsive button.next-step:hover,
div.responsive button.action-button:hover,
div.responsive a.next-step:active,
div.responsive button.next-step:active,
div.responsive button.action-button:active {
color: #fff !important;
background: #c72d25;
background-image: none !important;
}
div.donation-level-user-entered {
margin-top: -30px;
font-size: 30px;
line-height: 22px;
color: #888888;
font-family: "Source Sans Pro";
text-align: center;
}
/*
#billing_addr_street1_row, #billing_addr_street2_row
{
float: left;
width: 40%;
}
#billing_addr_state_row{
padding-left: 0px;
}
#billing_addr_state_row, #billing_addr_street2_row{
padding-left: 10px;
}
*/
.radio-button-container {
width: 180px;
float: left;
color: #b32317;
height: 48px;
background-color: #ffffff;
border: 4px solid #b32317;
margin-right: 20px;
font-family: "Source Sans Pro", sans-serif;
font-size: 2.6rem;
line-height: 36px;
padding: 10px 15px;
text-align: center;
}
.radio-button-container label {
color: #b32317;
}
.radio-button-container label:hover,
.radio-button-container label:focus {
color: #fff;
}
.radio-button-container.active,
.radio-button-container:hover {
background-color: #b32317;
color: #fff !important;
}
.radio-button-container.active label {
color: #fff;
}
input[name="gift_designation_2_radio"] {
display: none;
}
input[name="gift_designation_input"] {
display: none;
}
.custom-field-container fieldset {
border: none;
margin: 0;
padding: 0;
}
.custom-field-container fieldset:last {
display: none;
}
div.form-input-label-block,
div.donation-level-expanded-label {
position: relative;
bottom: 12px;
}
.custom-field-container .form-row fieldset {
padding: 0;
}
.custom-field-container.form-row.mobile_number_input_container {
text-align: left;
}
@media screen and (max-width: 1010px) {
.section-header-container,
.payment-type-selection-container.payment-field-container>h3,
#level_flexible_row .FormLabelText,
#level_flexiblegift_type_Row fieldset legend {
float: left;
width: 100%;
font-size: 30px;
line-height: 34px;
color: #3c3c3c;
font-family: "Source Sans Pro";
}
#donor_email_addressname {
margin-left: 0px;
width: 100%;
}
.intro-text-mobile img {
width: auto;
margin: auto;
/*margin-top:15px;*/
}
.intro-text-mobile p strong {
color: #fff;
}
.html-caption-container hr {
display: none;
}
.donation-form-intro h1 {
color: #3c3c3c;
}
#billing_last_name_row,
#billing_first_name_row {
width: 49%;
}
#billing_last_name_row {
margin-left: 10px;
}
.mobile-bg-img {
background-color: #fff;
}
}
@media screen and (max-width: 1010px) {
.mobile-bg-img {
background-position: right -125px;
}
}
@media screen and (max-width: 675px) {
.mobile-bg-img {
background-position: right -39px;
}
}
@media screen and (max-width: 489px) {
div.responsive .donation-levels label div {
width: 100% !important;
}
#billing_last_name_row {
margin-left: 0px;
}
#billing_last_name_row,
#billing_first_name_row {
width: 100%;
}
div.donation-level-container {
margin: 0;
margin-left: 0;
float: left;
width: 50%;
}
.donation-levels label {
margin-bottom: 10px;
}
.radio-button-container {
width: 100%;
}
.section-header-container,
.payment-type-selection-container.payment-field-container>h3,
#level_flexible_row .FormLabelText,
#level_flexiblegift_type_Row fieldset legend {
font-size: 2.4rem;
}
.custom-field-container fieldset {
border: none;
padding: 0 !important;
}
.donation-level-user-entered input {
position: relative: top:10px;
left: -10px;
}
.generic-repeat-label-checkbox-container label {
display: block;
padding-left: 15px;
margin-top: -20px;
}
}
</style>
<style>
#footer {
display: inherit;
}
.intro {
text-align: center;
}
.donation-level-label-input-container {
display: none !important;
}
div.responsive .donation-levels label div {
height: 45px;
line-height: none;
padding: 0;
/* width: 86px;*/
}
div.responsive .donation-levels input[type="text"] {
background: #ececec none repeat scroll 0 0;
border: 5px solid #b7b7b7 !important;
border-radius: 0 !important;
color: #000000;
cursor: text;
display: block;
font-family: "Source Sans Pro", sans-serif;
font-size: 1.8rem;
height: 45px !important;
padding: 0;
text-align: left;
vertical-align: middle;
/* width: auto !important;*/
}
div.donation-level-container:nth-child(5)>div:nth-child(1)>div:nth-child(1)>label:nth-child(2) {
display: none !important;
}
</style>
<script>
// YUI start
Y.use('jquery-noconflict', function() {
jQuery(function($) {
$('.donation-level-user-entered input').attr('placeholder', '$Other');
$('#national_text').hide();
$('div.radio-button-container > input[id="gift_designation_2_radio_My Local Office"]').parent().addClass('active');
//Select designee radio when designee is clicked
$('div.radio-button-container').click(function() {
$('div.radio-button-container.active').removeClass("active");
$(this).addClass('active');
$(this).find('input:radio').prop("checked", true);
$(this).val('').prop("checked", true);
var select = $(this).find('input:radio');
var id = select.attr('id');
if (id == "gift_designation_2_radio_My Local Office") {
$('#national_text').hide();
$('#local_text').show();
} else {
$('#local_text').hide();
$('#national_text').show();
}
//console.log("amount div clicked");
});
//YUI close
});
});
</script>
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<!-- DO NOT REMOVE -->
<script src="//code.jquery.com/jquery-1.7.2.min.js"></script>
<script type="text/javascript">
jQuery(document).ready(function($) {
jQuery("label[for='additional_fee_agreement_dropdown']").parent().addClass("add-amt-cont");
jQuery("div.donation-level-user-entered").closest(".donation-level-container").attr("id", "user-entered-row");
jQuery("div.donation-level-container input[type=radio]").each(function() {
jQuery(this).addClass("don-radio");
});
jQuery("div#user-entered-row input[type=radio]").each(function() {
jQuery(this).addClass("other-radio");
});
jQuery("div#user-entered-row input[type=text]").each(function() {
jQuery(this).addClass("don-other");
});
function getDonVal() {
if (jQuery("input.other-radio").is(":checked")) {
var donVal = parseFloat(jQuery(".don-other").val().replace(/[^0-9\.]+/g, "")).toFixed(2);
$(".don-other").on("change keyup", function() {
var donVal = parseFloat(jQuery(".don-other").val().replace(/[^0-9\.]+/g, "")).toFixed(2);
});
} else {
var donVal = parseFloat(jQuery(".don-radio:checked").closest(".donation-level-input-container").find(".donation-level-label-container").text().replace(/[^0-9\.]+/g, ""));
var donVal = Number(donVal).toFixed(2);
}
var donVal = Number(donVal).toFixed(2);
var addAmtVal = (donVal * .03).toFixed(3);
var addAmtVal = (Math.round(addAmtVal * 100) / 100).toFixed(2);
var newDonVal = Number(Number((donVal) * .03) + Number(donVal)).toFixed(2);
if (jQuery("#additional_fee_agreement_radio").is(":checked")) {
if (isNaN(donVal)) {
jQuery("#additional_amountname").val("");
jQuery("#pstep_next, #pstep_finish").html("DONATE $" + donVal);
jQuery("div.add-amt-calc").hide();
jQuery("#cur-gift-amt,#add-amt-perc,#new-gift-amt").html("$0.00");
} else {
jQuery("#additional_amountname").val(addAmtVal);
jQuery("div.add-amt-calc").show();
jQuery("#pstep_next, #pstep_finish").html("DONATE $" + newDonVal);
}
jQuery("#fees-checked").val("true");
} else {
jQuery("div.add-amt-calc").hide();
jQuery("#additional_amountname").val("");
jQuery("#pstep_next, #pstep_finish").html("DONATE $" + donVal);
jQuery("#fees-checked").val("false");
}
if (isNaN(donVal)) {
jQuery("#additional_amountname").val("");
jQuery("#pstep_next, pstep_finish").html("DONATE $" + donVal);
jQuery("div.add-amt-calc").hide();
jQuery("#cur-gift-amt,#add-amt-perc,#new-gift-amt").html("$0.00");
} else {
if (jQuery("#additional_fee_agreement_radio").is(":checked")) {
jQuery("#cur-gift-amt").html("$" + donVal);
jQuery("#add-amt-perc").html("$" + addAmtVal);
jQuery("#new-gift-amt").html("$" + newDonVal);
jQuery("div.add-amt-calc").show();
}
}
};
jQuery("input.don-radio, #additional_amounthidden, #additional_amountname, #additional_fee_agreement_radio, .don-other").on('click keyup', getDonVal);
jQuery("#additional_fee_agreement_radio").on("change keyup", function() {
if (!jQuery(this).is(':checked')) {
jQuery("#additional_amountname").val("");
jQuery("#pstep_next, #pstep_finish").html("DONATE $" + donVal);
jQuery("div.add-amt-calc").hide();
}
});
getDonVal();
});
</script>
<style type="text/css">
div.donation-form-container.responsive .form-input-label-block.add-amt-cont,
div.donation-form-container.responsive label[for=additional_fee_agreement_dropdown] {
display: none;
}
div.donation-form-container.responsive label[for=additional_fee_agreement_radio],
.add-amt-calc {
font-size: 18px;
/*font-weight: 700;
padding-top: 12px;
color: #011068;*/
}
.add-amt-calc {
display: none;
}
.add-amt-calc span {
color: #000;
font-weight: bold;
}
div#additional_amount_row {
position: absolute;
visibility: hidden;
left: -100000em;
}
@media only screen and (max-width: 767px) {
div.responsive div.form-checkbox label,
.mobile div.responsive div.form-checkbox label,
label.custom-element-checkbox-label {
max-width: 90%;
}
}
</style>
<script>
$(document).ready(function() {});
</script>
</div>
</div>
</div>
<input type="hidden" name="21969.donation" id="21969.donation" value="form1">
</div>
<script type="text/javascript">
var submitted = false;
function checkDoubleClick() {
var elCheck = '';
if (elCheck == 'el') {
alert('Form submission is not enabled when previewing an individual data element.');
return false;
} else if (submitted) {
alert('You have already submitted this payment. Please wait....');
return false;
} else {
submitted = true;
return true;
}
}
</script><noscript> </noscript>
</form>Text Content
Give by Phone Give to Your Neighbor this Holiday Season [2X Match] We enter this holiday season knowing many of our neighbors are spending it out in the cold and in urgent need. Your donation can help feed and shelter them, and give them hope. Right now, donations are being matched dollar for dollar. Give today and love your neighbor in the most meaningful way. <img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=1648479288736734&ev=PageView&noscript=1" /> Give to Your Neighbor this Holiday Season [2X Match] We enter this holiday season knowing many of our neighbors are spending it out in the cold and in urgent need. Your donation can help feed and shelter them, and give them hope. Right now, donations are being matched dollar for dollar. Give today and love your neighbor in the most meaningful way. Field Is Required Select Gift Amount: One-timeMonthly $25 $25 $50 $50 $100 $100 $200 $200 $500 $500 $10 $10 $15 $15 $25 $25 $50 $50 $100 $100 Other Enter amount Make this a Monthly Gift. Your gift will be charged on a monthly basis. You may cancel at any time. Additional Amount: 1. BILLING INFORMATION First Name Last Name Street 1 Street 2 City State/Province AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming AS - American Samoa FM - Federated States of Micronesia GU - Guam MH - Marshall Islands MP - Northern Mariana Islands PR - Puerto Rico PW - Palau VI - Virgin Islands AA - Armed Forces Americas AE - Armed Forces AP - Armed Forces Pacific AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon None Required Zip/Postal Code Country United States Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivarian Republic of Venezuela Bonaire, Sint Eustatios and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic People's Republic of Korea The Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Federated States of Micronesia Fiji Finland The Former Yugoslav Republic of Macedonia France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Islamic Republic of Iran Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Plurinational State of Bolivia Poland Portugal Puerto Rico Qatar Republic of Korea Republic of Moldova Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles S. Georgia & S. Sandwich Isls. Sierra Leone Singapore Sint Maarten (Dutch) Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania Uruguay USA Minor Outlying Islands Uzbekistan Vanuatu Viet Nam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Required Phone Number Email Address If you donate and have not already registered, you will receive periodic updates and communications from Volunteers of America. You'll receive email updates from Volunteers of America. You can unsubscribe at any time. 2. PAYMENT DETAILS CREDIT CARD INFORMATION: Credit Card Type: * * * * Credit Card Number: CVV Number: What is this? Expiration Date: Be sure to edit this field to your card's actual expiration date! Select month of credit card Select Expiration Year 01 02 03 04 05 06 07 08 09 10 11 12 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 Add an additional 3% to offset fees? I'd like to help cover the 3% processing fee for my donation. DONATE $50.00 NATIONAL OFFICE Volunteers of America 1660 Duke Street, Alexandria, VA 22314 800-899-0089 OTHER WAYS TO GIVE Give Monthly A Planned Gift for the Greatest Impact Donate by Mail Give Stocks and Funds Personal Fundraising Workplace and CFC Giving Donate Your Vehicle © 2021 Volunteers of America — All Rights Reserved. We are designated tax-exempt under section 501(c)3 of the Internal Revenue Code. Your contributions are tax-deductible to the fullest extent of the law. Terms & Conditions Privacy Policy