americaneedsfatima.org Open in urlscan Pro
2606:4700:20::681a:d5e  Public Scan

Form analysis
4 forms found in the DOM

https://americaneedsfatima.org/search/results

<form action="https://americaneedsfatima.org/search/results">
  <input class="form-control" type="text" name="search" placeholder="Search...">
</form>

https://americaneedsfatima.org/search/results

<form action="https://americaneedsfatima.org/search/results">
  <input class="form-control" type="text" name="search" placeholder="Search...">
  <button type="submit"><i class="fa fa-search" aria-hidden="true"></i></button>
</form>

POST

<form class="c-form c-donate-form c-donate-form--full js-form js-currency" method="POST">
  <input type="hidden" name="action" value="ippay/default/process-donation">
  <input type="hidden" name="entryId" value="21804">
  <input type="hidden" name="currentUrl" value="donate">
  <input type="hidden" name="pkg" value="WEBDON">
  <input type="hidden" name="donorType" value="RPPMDCW038">
  <input type="hidden" name="CRAFT_CSRF_TOKEN" value="9IHt0jaDIVAGohOVEhM_JEqReU_Ob3KZMQyBLt1VAYjZ4kCmBYKINMfynYAGzmkqf8R51GVgZhEA1SggjDgU_kVvx03uNED-hqMRl2Dz3F0=">
  <label for="areYouHumanField" id="areYouHumanLabel">If you see this field please don't fill it, this is just to understand if you are a human</label>
  <input type="text" id="areYouHumanField" name="areYouHumanField">
  <div class="c-donate-form__group">
    <h2 class="c-donate-form__group__headline">Choose Amount</h2>
    <ul class="c-donate-form__preset-amounts">
      <li class="c-donate-form__preset-amounts__amount">
        <a class="js-currency__preset" href="#" data-val="25">$25</a>
      </li>
      <li class="c-donate-form__preset-amounts__amount">
        <a class="js-currency__preset" href="#" data-val="50">$50</a>
      </li>
      <li class="c-donate-form__preset-amounts__amount">
        <a class="js-currency__preset" href="#" data-val="100">$100</a>
      </li>
      <li class="c-donate-form__preset-amounts__amount">
        <a class="js-currency__preset" href="#" data-val="250">$250</a>
      </li>
      <li class="c-donate-form__preset-amounts__amount">
        <a class="js-currency__preset" href="#" data-val="1000">$1000</a>
      </li>
      <li class="c-donate-form__preset-amounts__amount is-active"><a class="js-currency__preset js-currency__preset--other" href="#" data-val="other">Other</a></li>
    </ul>
    <hr class="c-hr c-hr--large">
    <div class="c-donate-form__custom-amount">
      <p class="c-donate-form__custom-amount__label">Amount</p>
      <div class="c-input-group c-donate-form__custom-amount__input">
        <i class="fa fa-dollar" aria-hidden="true"></i>
        <input class="c-textinput form-control  js-currency__custom" type="text" placeholder="" name="amount" value="" required="">
      </div>
      <ul class="c-donate-form__custom-amount__frequency">
        <li class="c-donate-form__custom-amount__frequency__field">
          <fieldset class="c-radio js-radio">
            <span class="fs-checkbox-element_placeholder"></span>
            <div class="fs-checkbox fs-light  fs-checkbox-radio fs-checkbox-checked">
              <div class="fs-checkbox-marker" aria-hidden="true">
                <div class="fs-checkbox-flag"></div><input class="form-control fs-checkbox-element" type="radio" name="recurring" value="0" checked="">
              </div>
            </div>
            <label for="recurring">One Time</label>
          </fieldset>
        </li>
        <li class="c-donate-form__custom-amount__frequency__field">
          <fieldset class="c-radio js-radio">
            <span class="fs-checkbox-element_placeholder"></span>
            <div class=" fs-checkbox fs-light  fs-checkbox-radio">
              <div class="fs-checkbox-marker" aria-hidden="true">
                <div class="fs-checkbox-flag"></div><input class="form-control fs-checkbox-element" type="radio" name="recurring" value="1">
              </div>
            </div>
            <label for="recurring">Monthly</label>
          </fieldset>
        </li>
      </ul>
      <h3 class="c-payment-form__total c-payment-form__total--custom">Total: $<span class="js-currency__total"></span></h3>
    </div>
    <hr class="c-hr c-hr--large">
  </div>
  <div class="c-donate-form__group">
    <div class="c-donate-form__subgroup">
      <h4 class="c-donate-form__subgroup__headline">Billing Information</h4>
      <div class="c-input-group c-input-group--personal">
        <select class="c-select form-control c-input-group--personal__title" name="treatment" required="">
          <option value="" disabled="" selected="">Title *</option>
          <option value="Mr.">Mr.</option>
          <option value="Mrs.">Mrs.</option>
          <option value="Miss">Miss</option>
          <option value="Ms.">Ms.</option>
          <option value="Dr.">Dr.</option>
          <option value="Fr.">Fr.</option>
          <option value="Sr.">Sr.</option>
          <option value="Br.">Br.</option>
          <option value="Rev.">Rev.</option>
          <option value="Deacon">Deacon</option>
        </select>
        <input class="c-textinput form-control c-input-group--personal__firstName " type="text" placeholder="First Name *" name="firstName" value="" required="">
        <input class="c-textinput form-control c-input-group--personal__lastName " type="text" placeholder="Last Name *" name="lastName" value="" required="">
      </div>
      <div class="c-input-group">
        <input class="c-textinput form-control " type="email" placeholder="Email *" name="email" value="" required="">
      </div>
      <div class="c-input-group">
        <input class="c-textinput form-control  c-textinput form-control " type="tel" placeholder="Phone" name="cellPhone" value="">
      </div>
      <div class="c-input-group">
        <input class="c-textinput form-control " type="text" placeholder="Address *" name="address" value="" required="">
      </div>
      <div class="c-input-group c-input-group--address">
        <input class="c-input-group--address__city c-textinput form-control " type="text" placeholder="City *" name="city" value="" required="">
        <input class="c-input-group--address__state c-textinput form-control " type="text" placeholder="State *" name="state" value="" required="">
        <input class="c-input-group--address__zip c-textinput form-control " type="text" placeholder="Zip *" name="zip" value="" required="">
      </div>
      <div class="c-input-group">
        <select class="c-textinput form-control  c-select" name="country" required="">
          <option value="" disabled="" required="" selected=""> Country * </option>
          <option value="USA" selected="">United States</option>
          <option value="CAN">Canada</option>
          <option value="GBR">United Kingdom</option>
          <option value="AUS">Australia</option>
          <option value="IRL">Ireland</option>
          <option value="ABW">Aruba</option>
          <option value="AFG">Afghanistan</option>
          <option value="AGO">Angola</option>
          <option value="AIA">Anguilla</option>
          <option value="ALA">Åland Islands</option>
          <option value="ALB">Albania</option>
          <option value="AND">Andorra</option>
          <option value="ANT">Netherlands Antilles</option>
          <option value="ARE">United Arab Emirates</option>
          <option value="ARG">Argentina</option>
          <option value="ARM">Armenia</option>
          <option value="ASM">American Samoa</option>
          <option value="ATA">Antarctica</option>
          <option value="ATF">French Southern Territories</option>
          <option value="ATG">Antigua and Barbuda</option>
          <option value="AUT">Austria</option>
          <option value="AZE">Azerbaijan</option>
          <option value="BDI">Burundi</option>
          <option value="BEL">Belgium</option>
          <option value="BEN">Benin</option>
          <option value="BFA">Burkina Faso</option>
          <option value="BGD">Bangladesh</option>
          <option value="BGR">Bulgaria</option>
          <option value="BHR">Bahrain</option>
          <option value="BHS">Bahamas</option>
          <option value="BIH">Bosnia and Herzegovina</option>
          <option value="BLM">Saint Barthélemy</option>
          <option value="BLR">Belarus</option>
          <option value="BLZ">Belize</option>
          <option value="BMU">Bermuda</option>
          <option value="BOL">Bolivia, Plurinational State of</option>
          <option value="BRA">Brazil</option>
          <option value="BRB">Barbados</option>
          <option value="BRN">Brunei Darussalam</option>
          <option value="BTN">Bhutan</option>
          <option value="BVT">Bouvet Island</option>
          <option value="BWA">Botswana</option>
          <option value="CAF">Central African Republic</option>
          <option value="CCK">Cocos (Keeling) Islands</option>
          <option value="CHE">Switzerland</option>
          <option value="CHL">Chile</option>
          <option value="CHN">China</option>
          <option value="CIV">Côte d'Ivoire</option>
          <option value="CMR">Cameroon</option>
          <option value="COD">Congo, the Democratic Republic of the</option>
          <option value="COG">Congo</option>
          <option value="COK">Cook Islands</option>
          <option value="COL">Colombia</option>
          <option value="COM">Comoros</option>
          <option value="CPV">Cape Verde</option>
          <option value="CRI">Costa Rica</option>
          <option value="CUB">Cuba</option>
          <option value="CXR">Christmas Island</option>
          <option value="CYM">Cayman Islands</option>
          <option value="CYP">Cyprus</option>
          <option value="CZE">Czech Republic</option>
          <option value="DEU">Germany</option>
          <option value="DJI">Djibouti</option>
          <option value="DMA">Dominica</option>
          <option value="DNK">Denmark</option>
          <option value="DOM">Dominican Republic</option>
          <option value="DZA">Algeria</option>
          <option value="ECU">Ecuador</option>
          <option value="EGY">Egypt</option>
          <option value="ERI">Eritrea</option>
          <option value="ESH">Western Sahara</option>
          <option value="ESP">Spain</option>
          <option value="EST">Estonia</option>
          <option value="ETH">Ethiopia</option>
          <option value="FIN">Finland</option>
          <option value="FJI">Fiji</option>
          <option value="FLK">Falkland Islands (Malvinas)</option>
          <option value="FRA">France</option>
          <option value="FRO">Faroe Islands</option>
          <option value="FSM">Micronesia, Federated States of</option>
          <option value="GAB">Gabon</option>
          <option value="GEO">Georgia</option>
          <option value="GGY">Guernsey</option>
          <option value="GHA">Ghana</option>
          <option value="GIB">Gibraltar</option>
          <option value="GIN">Guinea</option>
          <option value="GLP">Guadeloupe</option>
          <option value="GMB">Gambia</option>
          <option value="GNB">Guinea-Bissau</option>
          <option value="GNQ">Equatorial Guinea</option>
          <option value="GRC">Greece</option>
          <option value="GRD">Grenada</option>
          <option value="GRL">Greenland</option>
          <option value="GTM">Guatemala</option>
          <option value="GUF">French Guiana</option>
          <option value="GUM">Guam</option>
          <option value="GUY">Guyana</option>
          <option value="HKG">Hong Kong</option>
          <option value="HMD">Heard Island and McDonald Islands</option>
          <option value="HND">Honduras</option>
          <option value="HRV">Croatia</option>
          <option value="HTI">Haiti</option>
          <option value="HUN">Hungary</option>
          <option value="IDN">Indonesia</option>
          <option value="IMN">Isle of Man</option>
          <option value="IND">India</option>
          <option value="IOT">British Indian Ocean Territory</option>
          <option value="IRN">Iran, Islamic Republic of</option>
          <option value="IRQ">Iraq</option>
          <option value="ISL">Iceland</option>
          <option value="ISR">Israel</option>
          <option value="ITA">Italy</option>
          <option value="JAM">Jamaica</option>
          <option value="JEY">Jersey</option>
          <option value="JOR">Jordan</option>
          <option value="JPN">Japan</option>
          <option value="KAZ">Kazakhstan</option>
          <option value="KEN">Kenya</option>
          <option value="KGZ">Kyrgyzstan</option>
          <option value="KHM">Cambodia</option>
          <option value="KIR">Kiribati</option>
          <option value="KNA">Saint Kitts and Nevis</option>
          <option value="KOR">Korea, Republic of</option>
          <option value="KWT">Kuwait</option>
          <option value="LAO">Lao People's Democratic Republic</option>
          <option value="LBN">Lebanon</option>
          <option value="LBR">Liberia</option>
          <option value="LBY">Libyan Arab Jamahiriya</option>
          <option value="LCA">Saint Lucia</option>
          <option value="LIE">Liechtenstein</option>
          <option value="LKA">Sri Lanka</option>
          <option value="LSO">Lesotho</option>
          <option value="LTU">Lithuania</option>
          <option value="LUX">Luxembourg</option>
          <option value="LVA">Latvia</option>
          <option value="MAC">Macao</option>
          <option value="MAF">Saint Martin (French part)</option>
          <option value="MAR">Morocco</option>
          <option value="MCO">Monaco</option>
          <option value="MDA">Moldova, Republic of</option>
          <option value="MDG">Madagascar</option>
          <option value="MDV">Maldives</option>
          <option value="MEX">Mexico</option>
          <option value="MHL">Marshall Islands</option>
          <option value="MKD">Macedonia, the former Yugoslav Republic of</option>
          <option value="MLI">Mali</option>
          <option value="MLT">Malta</option>
          <option value="MMR">Myanmar</option>
          <option value="MNE">Montenegro</option>
          <option value="MNG">Mongolia</option>
          <option value="MNP">Northern Mariana Islands</option>
          <option value="MOZ">Mozambique</option>
          <option value="MRT">Mauritania</option>
          <option value="MSR">Montserrat</option>
          <option value="MTQ">Martinique</option>
          <option value="MUS">Mauritius</option>
          <option value="MWI">Malawi</option>
          <option value="MYS">Malaysia</option>
          <option value="MYT">Mayotte</option>
          <option value="NAM">Namibia</option>
          <option value="NCL">New Caledonia</option>
          <option value="NER">Niger</option>
          <option value="NFK">Norfolk Island</option>
          <option value="NGA">Nigeria</option>
          <option value="NIC">Nicaragua</option>
          <option value="NIU">Niue</option>
          <option value="NLD">Netherlands</option>
          <option value="NOR">Norway</option>
          <option value="NPL">Nepal</option>
          <option value="NRU">Nauru</option>
          <option value="NZL">New Zealand</option>
          <option value="OMN">Oman</option>
          <option value="PAK">Pakistan</option>
          <option value="PAN">Panama</option>
          <option value="PCN">Pitcairn</option>
          <option value="PER">Peru</option>
          <option value="PHL">Philippines</option>
          <option value="PLW">Palau</option>
          <option value="PNG">Papua New Guinea</option>
          <option value="POL">Poland</option>
          <option value="PRI">Puerto Rico</option>
          <option value="PRK">Korea, Democratic People's Republic of</option>
          <option value="PRT">Portugal</option>
          <option value="PRY">Paraguay</option>
          <option value="PSE">Palestinian Territory, Occupied</option>
          <option value="PYF">French Polynesia</option>
          <option value="QAT">Qatar</option>
          <option value="REU">Réunion</option>
          <option value="ROU">Romania</option>
          <option value="RUS">Russian Federation</option>
          <option value="RWA">Rwanda</option>
          <option value="SAU">Saudi Arabia</option>
          <option value="SDN">Sudan</option>
          <option value="SEN">Senegal</option>
          <option value="SGP">Singapore</option>
          <option value="SGS">South Georgia and the South Sandwich Islands</option>
          <option value="SHN">Saint Helena, Ascension and Tristan da Cunha</option>
          <option value="SJM">Svalbard and Jan Mayen</option>
          <option value="SLB">Solomon Islands</option>
          <option value="SLE">Sierra Leone</option>
          <option value="SLV">El Salvador</option>
          <option value="SMR">San Marino</option>
          <option value="SOM">Somalia</option>
          <option value="SPM">Saint Pierre and Miquelon</option>
          <option value="SRB">Serbia</option>
          <option value="STP">Sao Tome and Principe</option>
          <option value="SUR">Suriname</option>
          <option value="SVK">Slovakia</option>
          <option value="SVN">Slovenia</option>
          <option value="SWE">Sweden</option>
          <option value="SWZ">Swaziland</option>
          <option value="SYC">Seychelles</option>
          <option value="SYR">Syrian Arab Republic</option>
          <option value="TCA">Turks and Caicos Islands</option>
          <option value="TCD">Chad</option>
          <option value="TGO">Togo</option>
          <option value="THA">Thailand</option>
          <option value="TJK">Tajikistan</option>
          <option value="TKL">Tokelau</option>
          <option value="TKM">Turkmenistan</option>
          <option value="TLS">Timor-Leste</option>
          <option value="TON">Tonga</option>
          <option value="TTO">Trinidad and Tobago</option>
          <option value="TUN">Tunisia</option>
          <option value="TUR">Turkey</option>
          <option value="TUV">Tuvalu</option>
          <option value="TWN">Taiwan, Province of China</option>
          <option value="TZA">Tanzania, United Republic of</option>
          <option value="UGA">Uganda</option>
          <option value="UKR">Ukraine</option>
          <option value="UMI">United States Minor Outlying Islands</option>
          <option value="URY">Uruguay</option>
          <option value="UZB">Uzbekistan</option>
          <option value="VAT">Holy See (Vatican City State)</option>
          <option value="VCT">Saint Vincent and the Grenadines</option>
          <option value="VEN">Venezuela, Bolivarian Republic of</option>
          <option value="VGB">Virgin Islands, British</option>
          <option value="VIR">Virgin Islands, U.S.</option>
          <option value="VNM">Viet Nam</option>
          <option value="VUT">Vanuatu</option>
          <option value="WLF">Wallis and Futuna</option>
          <option value="WSM">Samoa</option>
          <option value="YEM">Yemen</option>
          <option value="ZAF">South Africa</option>
          <option value="ZMB">Zambia</option>
          <option value="ZWE">Zimbabwe</option>
        </select>
      </div>
    </div>
  </div>
  <div class="c-donate-form__subgroup">
    <h4 class="c-donate-form__subgroup__headline">Payment Information</h4>
    <div class="c-input-group">
      <input id="creditCardNumberInput" class="c-textinput form-control " type="tel" placeholder="Card Number *" name="cardNum" value="" required="">
    </div>
    <div class="c-input-group">
      <div class="row">
        <div class="col-xs-8 col-md-6 u-p-r-sm">
          <div class="c-input-group c-input-group--multiple">
            <select class="c-textinput form-control  c-select" name="cardExpMonth" required="">
              <option value="" disabled="" required="" selected=""> Month * </option>
              <option value="01">01</option>
              <option value="02">02</option>
              <option value="03">03</option>
              <option value="04">04</option>
              <option value="05">05</option>
              <option value="06">06</option>
              <option value="07">07</option>
              <option value="08">08</option>
              <option value="09">09</option>
              <option value="10">10</option>
              <option value="11">11</option>
              <option value="12">12</option>
            </select>
            <select class="c-textinput form-control  c-select" name="cardExpYear" required="">
              <option value="" disabled="" required="" selected=""> Year * </option>
              <option value="22">22</option>
              <option value="23">23</option>
              <option value="24">24</option>
              <option value="25">25</option>
              <option value="26">26</option>
              <option value="27">27</option>
              <option value="28">28</option>
              <option value="29">29</option>
              <option value="30">30</option>
              <option value="31">31</option>
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          </div>
        </div>
        <div class="col-xs-4 col-md-3 u-pull-right u-p-l-sm">
          <input class="c-textinput form-control " type="tel" placeholder="CVV *" name="cardCode" value="" required="">
        </div>
      </div>
    </div>
    <div class="c-input-group">
      <input class="btn orange" type="submit" value="Donate">
      <p class="c-donate-form__disclosure"> Contributions are 100% tax-deductible. Please see our <a href="https://americaneedsfatima.org/full-financial-disclosure">financial disclosure</a> page for more information. </p>
      <p class="c-donate-form__disclosure">
        <a href="https://americaneedsfatima.org/ways-to-give">Looking for other ways to donate?</a>
      </p>
      <p>&nbsp;</p>
    </div>
  </div>
</form>

POST

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  <select class="form-control" name="signeeTitlePick" id="newsletter-signup-form--title">
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    <option value="Mr.">Mr.</option>
    <option value="Mrs.">Mrs.</option>
    <option value="Miss">Miss</option>
    <option value="Ms.">Ms.</option>
    <option value="Dr.">Dr.</option>
    <option value="Fr.">Fr.</option>
    <option value="Sr.">Sr.</option>
    <option value="Br.">Br.</option>
    <option value="Rev.">Rev.</option>
    <option value="Deacon">Deacon</option>
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