recurring-test.greenpeace.in Open in urlscan Pro
64.13.224.130 Public Scan

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URL:
https://recurring-test.greenpeace.in/
Submission: On June 20 via api (June 20th 2024, 3:56:29 pm UTC) from US — Scanned from DE

Form analysis
1 forms found in the DOM

POST https://recurring-test.greenpeace.in/index.php/donation

<form action="https://recurring-test.greenpeace.in/index.php/donation" class="form-sample" method="post" accept-charset="utf-8">
  <h2 class="green-text mb-4"> Donate Now! </h2>
  <p class="card-description"> Choose the frequency of your donation </p>
  <div class="row">
    <div class="form-group row">
      <script type="text/javascript" src="//ajax.googleapis.com/ajax/libs/jquery/1.8.3/jquery.min.js"></script>
      <script language="JavaScript" type="text/javascript">
        $(function() {
          /*   $("input[name='donation_frequency']").change(function () {
										if ($("#recurring").is(":checked")) {
											var element = document.getElementById("recurring_amt");
											element.classList.remove("d-none");
											var element2 = document.getElementById("one_time_amt");
											element2.classList.add("d-none");
										}
										else if ($("#one-time").is(":checked")){
											var element = document.getElementById("one_time_amt");
											element.classList.remove("d-none");
											var element2 = document.getElementById("recurring_amt");
											element2.classList.add("d-none");
										}
                                    });*/
          $("input[name='donation_amount']").click(function() {
            if ($("#amount_other").is(":checked")) {
              $("#amount_other_text").removeAttr("disabled");
              $("#amount_other_text").focus();
            } else {
              $("#amount_other_text").attr("disabled", "disabled");
              $("checked") = false;
            }
          });
          $("input[name='donation_amount']").change(function() {
            if ($("#amount_other2").is(":checked")) {
              $("#amount_other_text2").removeAttr("disabled");
              $("#amount_other_text2").focus();
            } else {
              $("#amount_other_text2").attr("disabled", "disabled");
              $("checked") = false;
            }
          });
        });
      </script>
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" class="form-check-input" name="donation_frequency" id="recurring" value="monthly" required="" checked="true"> Monthly <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-2">
        <label class="form-check-label">
          <!--	<input type="radio" class="form-check-input" name="donation_frequency" id="one-time" value="one-time" required> One Time-->
          <i class="input-helper"></i></label>
      </div>
    </div>
  </div>
  <p class="card-description"> Choose the amount of your donation </p>
  <div class="row">
    <div class="form-group row">
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_2" class="form-check-input" name="donation_amount" value="800" required="" checked="true"> 800 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_1" class="form-check-input" name="donation_amount" value="1200" required=""> 1200 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_3" class="form-check-input" name="donation_amount" value="1800" required=""> 1800 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_other" class="form-check-input" name="donation_amount" required="">
          <i class="input-helper"></i></label>
      </div>
      <div class="form-group">
        <input type="text" id="amount_other_text" name="donation_amount" class="pt-10 form-control" placeholder="Other" disabled="disabled" onfocus="(this.type='number')">
      </div>
    </div>
  </div>
  <div class="row d-none" id="one_time_amt">
    <div class="form-group row">
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_1" class="form-check-input" name="donation_amount" value="2000" required=""> 2000 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_2" class="form-check-input" name="donation_amount" value="5000" required=""> 5000 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-3">
        <label class="form-check-label">
          <input type="radio" id="amount_3" class="form-check-input" name="donation_amount" value="7000" required=""> 7000 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-2">
        <label class="form-check-label">
          <input type="radio" id="amount_4" class="form-check-input" name="donation_amount" value="10000" required=""> 10000 <i class="input-helper"></i></label>
      </div>
      <div class="form-radio ml-2">
        <label class="form-check-label">
          <input type="radio" id="amount_other2" class="form-check-input" name="donation_amount" required="">
          <i class="input-helper"></i></label>
      </div>
      <div class="form-group">
        <input type="text" id="amount_other_text2" name="donation_amount" class="pt-10 form-control" placeholder="Other" disabled="disabled">
      </div>
    </div>
  </div>
  <input type="hidden" name="geocode_location" id="location">
  <script>
    $(document).ready(function() {
      if (navigator.geolocation) {
        navigator.geolocation.getCurrentPosition(showLocation);
      } else {
        $('#location').html('Geolocation is not supported by this browser.');
      }
    });

    function showLocation(position) {
      var latitude = position.coords.latitude;
      var longitude = position.coords.longitude;
      $.ajax({
        type: 'POST',
        url: "https://recurring-test.greenpeace.in/get_location",
        data: 'latitude=' + latitude + '&longitude=' + longitude,
        success: function(msg) {
          if (msg) {
            document.getElementById("location").value = msg;
            // $("#location").html(msg);
          } else {
            $("#location").html('Not Available');
          }
        }
      });
    }
  </script>
  <p class="card-description"> Who is making this donation? </p>
  <div class="row">
    <div class="col-md-2">
      <div class="form-group row">
        <div class="col-sm-12">
          <select name="title" class="form-control dropdown">
            <option value="Mr.">Mr.</option>
            <option value="Ms.">Ms.</option>
            <option value="Others">Others</option>
          </select>
        </div>
      </div>
    </div>
    <div class="col-md-5">
      <div class="form-group row">
        <div class="col-sm-12">
          <input type="text" name="first_name" value="" id="first_name" class="form-control" placeholder="First Name *" required="true">
        </div>
      </div>
    </div>
    <div class="col-md-5">
      <div class="form-group row">
        <div class="col-sm-12">
          <input type="text" name="last_name" value="" id="last_name" class="form-control" required="true" placeholder="Last Name *">
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12">
          <input type="email" name="email" value="" id="email" required="true" class="form-control" placeholder="Email ID *">
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12">
          <input type="text" name="mobile" value="" id="mobile_num" minlength="10" maxlength="10" pattern="^[6-9][0-9]{9}$" required="true" class="form-control" placeholder="Mobile Number *">
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12">
          <script>
            var datefield = document.createElement("input")
            datefield.setAttribute("type", "date")
            if (datefield.type != "date") { //if browser doesn't support input type="date", load files for jQuery UI Date Picker
              document.write('<link rel="stylesheet" href="https://ajax.googleapis.com/ajax/libs/jqueryui/1.12.1/themes/smoothness/jquery-ui.css">\n')
              document.write('<script src="http://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"><\/script>\n')
              document.write('<script src="https://ajax.googleapis.com/ajax/libs/jqueryui/1.12.1/jquery-ui.min.js"><\/script>\n')
            }
            if (datefield.type != "date") { //if browser doesn't support input type="date", initialize date picker widget:
              jQuery(function($) { //on document.ready
                $('#dob').datepicker();
              })
            }
          </script>
          <input type="text" name="dob" value="" id="dob" required="true" class="form-control" onfocus="(this.type='date')" placeholder="Date of Birth *">
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12">
          <input type="text" name="recruiter_id" value="" id="recruiter_id" class="form-control" placeholder="Recruiter ID (For Office Use Only)">
        </div>
      </div>
    </div>
  </div>
  <script>
    $(document).ready(function() {
      $('#uid').change(function() {
        // $(this).val() == "E-Mandate" ? $('#banklist').show() : $('#banklist').hide();
        if ($(this).val() == "PAN_card") {
          $('#pan_field').show();
          $('#pan').attr('required', true);
          $('#aadhar_field').hide();
          $('#aadhar').removeAttr('required', true);
        } else if ($(this).val() == "Aadhar_card") {
          $('#pan_field').hide();
          $('#pan').removeAttr('required', true);
          $('#aadhar_field').show();
          $('#aadhar').attr('required', true);
        }
      });
    });
  </script>
  <div class="row">
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12">
          <label>Select Unique Identification*</label> <select name="unique_identification_number" class="form-control" ,="" id="uid" required=""> "true",&gt; <option value="PAN_card">PAN Card</option>
            <option value="Aadhar_card">Aadhar Card</option>
          </select>
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12" id="pan_field">
          <label>Enter your PAN</label> <input type="text" name="pan" value="" id="pan" class="form-control" required="true" placeholder="Enter your PAN*" pattern="^[A-Z]{5}[0-9]{4}[A-Z]{1}$">
        </div>
        <div class="col-sm-12 hiddenField" id="aadhar_field">
          <label>Enter your Aadhar Number</label> <input type="text" name="aadhar" value="" id="aadhar" class="form-control" pattern="^[0-9]{12}$" placeholder="Enter your Aadhar Number*">
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-12">
      <div class="form-group row">
        <div class="col-sm-12">
          <textarea name="address" cols="40" rows="4" id="address" required="true" class="form-control" placeholder="Address *"></textarea>
        </div>
      </div>
    </div>
  </div>
  <p class="card-description"> Payment Information </p>
  <style>
    .hiddenField {
      display: none;
    }

    .hiddenField2 {
      display: none;
    }

    .showfields {
      display: block;
    }
  </style>
  <script>
    $(document).ready(function() {
      $('#donationmode').change(function() {
        // $(this).val() == "E-Mandate" ? $('#banklist').show() : $('#banklist').hide();
        if ($(this).val() == "E-Mandate") {
          $('#banklist').show();
          $('#ifsc').show();
          $('#account_type').show();
          $('#account_number').show();
          $('#auth_type').show();
        } else {
          $('#banklist').hide();
          $('#ifsc').hide();
          $('#account_type').hide();
          $('#account_number').hide();
          $('#auth_type').hide();
        }
      });
    });
  </script>
  <div class="row">
    <div class="col-md-6">
      <div class="form-group row">
        <div class="col-sm-12">
          <label>Please Select Donation Mode</label> <select name="donationmode" class="form-control" ,="" id="donationmode" required=""> "true",&gt; <option value="E-Mandate">E-Mandate</option>
          </select>
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <!--<div class="form-group row hiddenField" id="banklist">-->
      <div class="form-group row " id="banklist">
        <div class="col-sm-12">
          <label for="sel1">Please Select Your Bank </label>
          <select class="form-control" name="bank">
            <option value="1">AXIS BANK</option>
            <option value="2">BANK OF BARODA</option>
            <option value="4">CENTRAL BANK OF INDIA</option>
            <option value="6">HDFC BANK LTD</option>
            <option value="7">ICICI BANK LTD</option>
            <option value="8">IDBI BANK</option>
            <option value="10">INDIAN OVERSEAS BANK</option>
            <option value="11">PUNJAB NATIONAL BANK</option>
            <option value="15">YES BANK</option>
            <option value="24">BANK OF MAHARASHTRA</option>
            <option value="29">CANARA BANK</option>
            <option value="33">CITY UNION BANK LTD</option>
            <option value="37">DEUTSCHE BANK AG</option>
            <option value="44">INDUSIND BANK</option>
            <option value="50">KARNATAKA BANK LTD</option>
            <option value="52">KOTAK MAHINDRA BANK LTD</option>
            <option value="69">THE SOUTH INDIAN BANK LIMITED</option>
            <option value="70">STANDARD CHARTERED BANK</option>
            <option value="77">TAMILNAD MERCANTILE BANK LTD</option>
            <option value="82">FEDERAL BANK</option>
            <option value="91">RBL BANK LIMITED</option>
            <option value="247">IDFC FIRST BANK LTD</option>
            <option value="284">EQUITAS SMALL FINANCE BANK LTD</option>
            <option value="328">PAYTM PAYMENTS BANK LTD</option>
            <option value="347">AU SMALL FINANCE BANK</option>
            <option value="634">STATE BANK OF INDIA</option>
            <option value="635">BANK OF INDIA</option>
            <option value="638">INDIAN BANK</option>
            <option value="639">AIRTEL PAYMENTS BANK LTD</option>
            <option value="640">ANDHRA PRAGATHI GRAMEENA BANK</option>
            <option value="641">BANDHAN BANK LTD</option>
            <option value="642">CITIBANK N A</option>
            <option value="643">CAPITAL SMALL FINANCE BANK LTD</option>
            <option value="644">THE CHEMBUR NAGARIK SAHAKARI BANK</option>
            <option value="645">THE COSMOS CO-OPERATIVE BANK LTD</option>
            <option value="646">THE CATHOLIC SYRIAN BANK</option>
            <option value="647">DBS BANK INDIA LTD</option>
            <option value="648">DCB BANK LTD</option>
            <option value="649">DHANALAXMI BANK</option>
            <option value="650">THE HONGKONG AND SHANGHAI BANKING CORPORATION LTD</option>
            <option value="651">JANA SMALL FINANCE BANK LTD</option>
            <option value="652">KURLA NAGARIK SAHAKARI BANK LTD</option>
            <option value="653">KARUR VYSA BANK</option>
            <option value="654">KARNATAKA VIKAS GRAMEENA BANK</option>
            <option value="655">MAHESH SAHAKARI BANK LTD PUNE</option>
            <option value="656">THE NATIONAL CO OP BANK LTD</option>
            <option value="657">PUNJAB AND SIND BANK</option>
            <option value="658">SHIVALIK SMALL FINANCE BANK LTD</option>
            <option value="659">UNION BANK OF INDIA</option>
            <option value="660">THE VARACHHA CO OP BANK LTD</option>
            <option value="661">THE ZOROASTRIAN CO OP BANK LTD</option>
          </select>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-6">
      <!--<div class="form-group row hiddenField2" id="ifsc">-->
      <div class="form-group row " id="ifsc">
        <div class="col-sm-12">
          <label>Please Add your Bank's IFSC Code</label> <input type="text" name="ifsc_code" value="" id="ifsc_code" class="form-control" placeholder="IFSC Code">
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <!--<div class="form-group row hiddenField2" id="account_type">-->
      <div class="form-group row " id="account_type">
        <div class="col-sm-12">
          <label>Please Select your Account Type</label> <select name="account_type" class="form-control">
            <option value="savings">Savings</option>
          </select>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-6">
      <!--<div class="form-group row hiddenField2" id="account_number">-->
      <div class="form-group row " id="account_number">
        <div class="col-sm-12">
          <label>Please Add your Account Number</label> <input type="text" name="account_number" value="" id="account_number" class="form-control" placeholder="Account Number">
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <!--<div class="form-group row hiddenField2" id="account_number">-->
      <div class="form-group row " id="account_number_confirm">
        <div class="col-sm-12">
          <label>Please Confirm your Account Number</label> <input type="text" name="account_number_confirm" value="" id="account_number_confirm" class="form-control" placeholder="Account Number">
        </div>
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-group row hiddenField2" id="auth_type">
        <div class="col-sm-12">
          <label>Auth Type</label> <select name="auth_type" class="form-control">
            <option value="D">Debit Card</option>
            <option value="N">Net Banking</option>
          </select>
        </div>
      </div>
    </div>
  </div>
  <input type="hidden" name="active_pg_for_credit_card" value="Billdesk ">
  <input type="hidden" name="active_pg_for_emandate" value="NUPAY ">
  <div class="row">
    <div class="col-md-12">
      <div class="form-group row">
        <div class="col-sm-12">
          <input type="checkbox" name="terms_and_conditions" value="Declaration Read &amp; Accepted" class="checkbox" ,="" id="tnc" required="true">
          <label for="tnc" style="display:inline; line-height:1.8">I am an Indian Citizen and I have read and understood the
          </label><label><a href="https://www.greenpeace.org/india/en/about/our-finances/greenpeace-environment-trust/" target="_blank" style="color:#66cc00;cursor:pointer;line-height:1.8"> declaration.</a></label>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-12">
      <div class="form-group row">
        <div class="col-sm-12">
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-md-6">
      <label for="">First Collection Date</label>
      <input type="date" name="frst_colltn_dt" required="">
    </div>
    <div class="col-md-6">
      <label for="">Last Collection Date</label>
      <input type="date" name="fnl_colltn_dt" required="">
    </div>
  </div>
  <div class="row">
    <div class="col-md-12">
      <div class="form-group row">
        <input type="submit" name="submit" value="Proceed to Verify Details" class="btn-block btn-primary p-2">
      </div>
    </div>
  </div>
</form>

Text Content

I DECLARE THAT

×
 1. I am an Indian national.
 2. The particulars given to GPET (Greenpeace Environment Trust) are true,
    correct and complete, if any transaction is delayed or not affected at all
    for the reasons of incomplete or incorrect information, I shall not hold
    GPET responsible for any loss/damage/inconvenience arising out of the same.
 3. If there is any change in donation amount or frequency the same will be
    communicated by letter, SMS or email.
 4. I agree to GPET communicating to me via telephone calls, SMS or electronic
    mail and such communications shall not be considered unsolicited.
 5. I also understand I can withdraw from this commitment whenever I wish; all I
    have to do is inform GPET in writing through email, letter to stop my
    contribution.
 6. In view of GPET undertaking not to share my above personal details with
    anyone except their authorized Agents and service providers (including but
    not limited to Direct Dialogue Initiatives India Pvt Ltd) or when it is
    mandated by regulatory authorities or by myself, I hereby permit GPET for
    such limited sharing.
 7. Donations to GPET are eligible for exemption u/s 80G of Income Tax Act.
    1961. I understand that GPET will send a consolidated receipt and tax
    exemption certificate at the end of the financial year.

Close


DONATE NOW!

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Who is making this donation?

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Select Unique Identification* "true",> PAN Card Aadhar Card
Enter your PAN
Enter your Aadhar Number


Payment Information

Please Select Donation Mode "true",> E-Mandate
Please Select Your Bank AXIS BANK BANK OF BARODA CENTRAL BANK OF INDIA HDFC BANK
LTD ICICI BANK LTD IDBI BANK INDIAN OVERSEAS BANK PUNJAB NATIONAL BANK YES BANK
BANK OF MAHARASHTRA CANARA BANK CITY UNION BANK LTD DEUTSCHE BANK AG INDUSIND
BANK KARNATAKA BANK LTD KOTAK MAHINDRA BANK LTD THE SOUTH INDIAN BANK LIMITED
STANDARD CHARTERED BANK TAMILNAD MERCANTILE BANK LTD FEDERAL BANK RBL BANK
LIMITED IDFC FIRST BANK LTD EQUITAS SMALL FINANCE BANK LTD PAYTM PAYMENTS BANK
LTD AU SMALL FINANCE BANK STATE BANK OF INDIA BANK OF INDIA INDIAN BANK AIRTEL
PAYMENTS BANK LTD ANDHRA PRAGATHI GRAMEENA BANK BANDHAN BANK LTD CITIBANK N A
CAPITAL SMALL FINANCE BANK LTD THE CHEMBUR NAGARIK SAHAKARI BANK THE COSMOS
CO-OPERATIVE BANK LTD THE CATHOLIC SYRIAN BANK DBS BANK INDIA LTD DCB BANK LTD
DHANALAXMI BANK THE HONGKONG AND SHANGHAI BANKING CORPORATION LTD JANA SMALL
FINANCE BANK LTD KURLA NAGARIK SAHAKARI BANK LTD KARUR VYSA BANK KARNATAKA VIKAS
GRAMEENA BANK MAHESH SAHAKARI BANK LTD PUNE THE NATIONAL CO OP BANK LTD PUNJAB
AND SIND BANK SHIVALIK SMALL FINANCE BANK LTD UNION BANK OF INDIA THE VARACHHA
CO OP BANK LTD THE ZOROASTRIAN CO OP BANK LTD
Please Add your Bank's IFSC Code
Please Select your Account Type Savings
Please Add your Account Number
Please Confirm your Account Number
Auth Type Debit Card Net Banking
I am an Indian Citizen and I have read and understood the declaration.

First Collection Date
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EMAIL: SUPPORTER.SERVICES.IN@GREENPEACE.ORG

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recurring-test.greenpeace.in Open in urlscan Pro 64.13.224.130 Public Scan

Form analysis 1 forms found in the DOM

POST https://recurring-test.greenpeace.in/index.php/donation

Text Content

recurring-test.greenpeace.in Open in urlscan Pro
64.13.224.130 Public Scan

Form analysis
1 forms found in the DOM