davismemorialfund.org Open in urlscan Pro
188.114.96.3  Public Scan

Submitted URL: https://www.supportdmf.com/
Effective URL: https://davismemorialfund.org/donate/
Submission: On June 23 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

POST /donate/

<form method="post" enctype="multipart/form-data" id="gform_37" action="/donate/" novalidate="">
  <div class="gform_body gform-body">
    <ul id="gform_fields_37" class="gform_fields top_label form_sublabel_below description_below">
      <li id="field_37_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_1"><label class="gfield_label gfield_label_before_complex">Name<span
            class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name" id="input_37_1">
          <span id="input_37_1_3_container" class="name_first">
            <input type="text" name="input_1.3" id="input_37_1_3" value="" aria-required="true">
            <label for="input_37_1_3">First</label>
          </span>
          <span id="input_37_1_6_container" class="name_last">
            <input type="text" name="input_1.6" id="input_37_1_6" value="" aria-required="true">
            <label for="input_37_1_6">Last</label>
          </span>
        </div>
      </li>
      <li id="field_37_2" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_2"><label class="gfield_label gfield_label_before_complex">Address<span
            class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address" id="input_37_2">
          <span class="ginput_full address_line_1 ginput_address_line_1" id="input_37_2_1_container">
            <input type="text" name="input_2.1" id="input_37_2_1" value="" aria-required="true">
            <label for="input_37_2_1" id="input_37_2_1_label">Street Address</label>
          </span><span class="ginput_full address_line_2 ginput_address_line_2" id="input_37_2_2_container">
            <input type="text" name="input_2.2" id="input_37_2_2" value="" aria-required="false">
            <label for="input_37_2_2" id="input_37_2_2_label">Address Line 2</label>
          </span><span class="ginput_left address_city ginput_address_city" id="input_37_2_3_container">
            <input type="text" name="input_2.3" id="input_37_2_3" value="" aria-required="true">
            <label for="input_37_2_3" id="input_37_2_3_label">City</label>
          </span><span class="ginput_right address_state ginput_address_state" id="input_37_2_4_container">
            <input type="text" name="input_2.4" id="input_37_2_4" value="" aria-required="true">
            <label for="input_37_2_4" id="input_37_2_4_label">State / Province / Region</label>
          </span><span class="ginput_left address_zip ginput_address_zip" id="input_37_2_5_container">
            <input type="text" name="input_2.5" id="input_37_2_5" value="" aria-required="true">
            <label for="input_37_2_5" id="input_37_2_5_label">ZIP / Postal Code</label>
          </span><span class="ginput_right address_country ginput_address_country" id="input_37_2_6_container">
            <select name="input_2.6" id="input_37_2_6" aria-required="true">
              <option value="" selected="selected"></option>
              <option value="Afghanistan">Afghanistan</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="Bolivia">Bolivia</option>
              <option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius 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 Islands">Cocos Islands</option>
              <option value="Colombia">Colombia</option>
              <option value="Comoros">Comoros</option>
              <option value="Congo, Democratic Republic of the">Congo, Democratic Republic of the</option>
              <option value="Congo, Republic of the">Congo, Republic of the</option>
              <option value="Cook Islands">Cook Islands</option>
              <option value="Costa Rica">Costa Rica</option>
              <option value="Croatia">Croatia</option>
              <option value="Cuba">Cuba</option>
              <option value="Curaçao">Curaçao</option>
              <option value="Cyprus">Cyprus</option>
              <option value="Czech Republic">Czech Republic</option>
              <option value="Côte d'Ivoire">Côte d'Ivoire</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="Eswatini (Swaziland)">Eswatini (Swaziland)</option>
              <option value="Ethiopia">Ethiopia</option>
              <option value="Falkland Islands">Falkland Islands</option>
              <option value="Faroe Islands">Faroe Islands</option>
              <option value="Fiji">Fiji</option>
              <option value="Finland">Finland</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 and McDonald Islands">Heard and McDonald Islands</option>
              <option value="Holy See">Holy See</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="Iran">Iran</option>
              <option value="Iraq">Iraq</option>
              <option value="Ireland">Ireland</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="Macau">Macau</option>
              <option value="Macedonia">Macedonia</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="Micronesia">Micronesia</option>
              <option value="Moldova">Moldova</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="North Korea">North Korea</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="Palestine, State of">Palestine, State of</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="Poland">Poland</option>
              <option value="Portugal">Portugal</option>
              <option value="Puerto Rico">Puerto Rico</option>
              <option value="Qatar">Qatar</option>
              <option value="Romania">Romania</option>
              <option value="Russia">Russia</option>
              <option value="Rwanda">Rwanda</option>
              <option value="Réunion">Réunion</option>
              <option value="Saint Barthélemy">Saint Barthélemy</option>
              <option value="Saint Helena">Saint Helena</option>
              <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
              <option value="Saint Lucia">Saint Lucia</option>
              <option value="Saint Martin">Saint Martin</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="Sierra Leone">Sierra Leone</option>
              <option value="Singapore">Singapore</option>
              <option value="Sint Maarten">Sint Maarten</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 Georgia">South Georgia</option>
              <option value="South Korea">South Korea</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 Islands">Svalbard and Jan Mayen Islands</option>
              <option value="Sweden">Sweden</option>
              <option value="Switzerland">Switzerland</option>
              <option value="Syria">Syria</option>
              <option value="Taiwan">Taiwan</option>
              <option value="Tajikistan">Tajikistan</option>
              <option value="Tanzania">Tanzania</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="US Minor Outlying Islands">US Minor Outlying Islands</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 States">United States</option>
              <option value="Uruguay">Uruguay</option>
              <option value="Uzbekistan">Uzbekistan</option>
              <option value="Vanuatu">Vanuatu</option>
              <option value="Venezuela">Venezuela</option>
              <option value="Vietnam">Vietnam</option>
              <option value="Virgin Islands, British">Virgin Islands, British</option>
              <option value="Virgin Islands, U.S.">Virgin Islands, U.S.</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>
              <option value="Åland Islands">Åland Islands</option>
            </select>
            <label for="input_37_2_6" id="input_37_2_6_label">Country</label>
          </span>
          <div class="gf_clear gf_clear_complex"></div>
        </div>
      </li>
      <li id="field_37_3" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_3"><label class="gfield_label" for="input_37_3">Email<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_3" id="input_37_3" type="email" value="" class="medium" aria-required="true" aria-invalid="false">
        </div>
      </li>
      <li id="field_37_4" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_4"><label class="gfield_label" for="input_37_4">Phone<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_4" id="input_37_4" type="tel" value="" class="medium" aria-required="true" aria-invalid="false"></div>
      </li>
      <li id="field_37_19" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_19"><label class="gfield_label" for="input_37_19">Memo</label>
        <div class="ginput_container ginput_container_text"><input name="input_19" id="input_37_19" type="text" value="" class="large" aria-invalid="false"> </div>
      </li>
      <li id="field_37_20" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_20"><label class="gfield_label" for="input_37_20">Fund<span
            class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_20" id="input_37_20" class="large gfield_select" aria-required="true" aria-invalid="false">
            <option value="DAVIS MEMORIAL FUND">DAVIS MEMORIAL FUND</option>
            <option value="BE'ER MIRIAM MARRIAGE FUND">BE'ER MIRIAM MARRIAGE FUND</option>
            <option value="LEON LEIF CHILDREN'S FUND">LEON LEIF CHILDREN'S FUND</option>
          </select></div>
      </li>
      <li id="field_37_7" class="gfield gfield_price gfield_price_37_7 gfield_product_37_7 gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_7"><label class="gfield_label"
          for="input_37_7">Donation Amount<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_product_price">
          <input name="input_7" id="input_37_7" type="text" value="" class="medium ginput_amount" aria-required="true" aria-invalid="false">
        </div>
      </li>
      <li id="field_37_17" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_17"><label class="gfield_label gfield_label_before_complex">Make this a Monthly
          Donation</label>
        <div class="ginput_container ginput_container_checkbox">
          <ul class="gfield_checkbox" id="input_37_17">
            <li class="gchoice gchoice_37_17_1">
              <input class="gfield-choice-input" name="input_17.1" type="checkbox" value="Yes" id="choice_37_17_1">
              <label for="choice_37_17_1" id="label_37_17_1">Yes</label>
            </li>
          </ul>
        </div>
      </li>
      <li id="field_37_18" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_18" style="display: none;"><label class="gfield_label"
          for="input_37_18">How many Months<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_18" id="input_37_18" type="number" step="any" value="" class="large" aria-required="true" aria-invalid="false" disabled="disabled"></div>
      </li>
      <li id="field_37_11" class="gfield field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_11"><label class="gfield_label screen-reader-text gfield_label_before_complex"></label>
        <div class="ginput_container ginput_container_checkbox">
          <ul class="gfield_checkbox" id="input_37_11">
            <li class="gchoice gchoice_37_11_1">
              <input class="gfield-choice-input" name="input_11.1" type="checkbox" value="Let my donation go further by covering the credit card convenience/processing fee" id="choice_37_11_1">
              <label for="choice_37_11_1" id="label_37_11_1">Let my donation go further by covering the credit card convenience/processing fee</label>
            </li>
          </ul>
        </div>
      </li>
      <li id="field_37_13" class="gfield gfield_price gfield_price_37_13 gfield_product_37_13 gfield_calculation field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_13" style="display: none;"><label
          class="gfield_label gfield_label_before_complex" for="input_37_13_1">Fee</label>
        <div class="ginput_container ginput_container_product_calculation">
          <input type="hidden" name="input_13.1" value="Fee" class="gform_hidden" disabled="disabled">
          <span class="ginput_product_price_label">Price:</span>
          <span class="ginput_product_price" id="input_37_13">$0.00</span>
          <input type="hidden" name="input_13.2" id="ginput_base_price_37_13" class="gform_hidden" value="$0.00" disabled="disabled">
          <input type="hidden" name="input_13.3" value="1" class="ginput_quantity_37_13 gform_hidden" disabled="disabled">
        </div>
      </li>
      <li id="field_37_8" class="gfield gfield_price gfield_price_37_ gfield_total gfield_total_37_ field_sublabel_below field_description_below gfield_visibility_visible" aria-atomic="true" aria-live="polite" data-js-reload="field_37_8"><label
          class="gfield_label" for="input_37_8">Total</label>
        <div class="ginput_container ginput_container_total">
          <span class="ginput_total ginput_total_37">$0.00</span>
          <input type="hidden" name="input_8" id="input_37_8" class="gform_hidden" value="0">
        </div>
      </li>
      <li id="field_37_9" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_37_9"><label class="gfield_label gfield_label_before_complex" for="input_37_9_1">Credit
          Card<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_complex ginput_container ginput_container_creditcard" id="input_37_9"><span class="ginput_full" id="input_37_9_1_container">
            <div class="gform_card_icon_container">
              <div class="gform_card_icon gform_card_icon_amex">American Express</div>
              <div class="gform_card_icon gform_card_icon_discover">Discover</div>
              <div class="gform_card_icon gform_card_icon_mastercard">MasterCard</div>
              <div class="gform_card_icon gform_card_icon_visa">Visa</div><span class="screen-reader-text" id="field_37_9_supported_creditcards">Supported Credit Cards: American Express, Discover, MasterCard, Visa</span>
            </div>
            <input type="text" name="input_9.1" id="input_37_9_1" value="" onchange="gformMatchCard(&quot;input_37_9_1&quot;);" onkeyup="gformMatchCard(&quot;input_37_9_1&quot;);" autocomplete="off" pattern="[0-9]*" title="Only digits are allowed"
              aria-required="true">
            <label for="input_37_9_1" id="input_37_9_1_label">Card Number</label>
          </span><span class="ginput_full ginput_cardextras" id="input_37_9_2_container">
            <span class="ginput_cardinfo_left" id="input_37_9_2_cardinfo_left">
              <span class="ginput_card_expiration_container ginput_card_field">
                <select name="input_9.2[]" id="input_37_9_2_month" class="ginput_card_expiration ginput_card_expiration_month" aria-required="true">
                  <option value="">Month</option>
                  <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">12</option>
                </select>
                <select name="input_9.2[]" id="input_37_9_2_year" class="ginput_card_expiration ginput_card_expiration_year" aria-required="true">
                  <option value="">Year</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>
                  <option value="2032">2032</option>
                  <option value="2033">2033</option>
                  <option value="2034">2034</option>
                  <option value="2035">2035</option>
                  <option value="2036">2036</option>
                  <option value="2037">2037</option>
                  <option value="2038">2038</option>
                  <option value="2039">2039</option>
                  <option value="2040">2040</option>
                  <option value="2041">2041</option>
                  <option value="2042">2042</option>
                  <option value="2043">2043</option>
                </select>
              </span>
              <label for="input_37_9_2_month">Expiration Date</label>
            </span><span class="ginput_cardinfo_right" id="input_37_9_2_cardinfo_right">
              <input type="text" name="input_9.3" id="input_37_9_3" class="ginput_card_security_code" value="" autocomplete="off" pattern="[0-9]*" title="Only digits are allowed" aria-required="true">
              <span class="ginput_card_security_code_icon">&nbsp;</span>
              <label for="input_37_9_3">Security Code</label>
            </span>
          </span><span class="ginput_full" id="input_37_9_5_container">
            <input type="text" name="input_9.5" id="input_37_9_5" value="" aria-required="false">
            <label for="input_37_9_5" id="input_37_9_5_label">Cardholder Name</label>
          </span> </div>
      </li>
    </ul>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_37" class="gform_button button" value="Submit"
      onclick="if(window[&quot;gf_submitting_37&quot;]){return false;}  if( !jQuery(&quot;#gform_37&quot;)[0].checkValidity || jQuery(&quot;#gform_37&quot;)[0].checkValidity()){window[&quot;gf_submitting_37&quot;]=true;}  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_37&quot;]){return false;} if( !jQuery(&quot;#gform_37&quot;)[0].checkValidity || jQuery(&quot;#gform_37&quot;)[0].checkValidity()){window[&quot;gf_submitting_37&quot;]=true;}  jQuery(&quot;#gform_37&quot;).trigger(&quot;submit&quot;,[true]); }">
    <input type="hidden" class="gform_hidden" name="is_submit_37" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="37">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_37" value="WyJbXSIsIjQ0OTg3YTcyZGU1MDJkYTM1NGYzYTAzOTMwNzUxYmYzIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_37" id="gform_target_page_number_37" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_37" id="gform_source_page_number_37" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

Text Content

The Davis Memorial Fund
 * Home
 * Programs
 * Thank You’s
 * Contact
 * Donate


 * Name*
   First Last
 * Address*
   Street Address Address Line 2 City State / Province / Region ZIP / Postal
   Code AfghanistanAlbaniaAlgeriaAmerican
   SamoaAndorraAngolaAnguillaAntarcticaAntigua and
   BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire,
   Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet
   IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina
   FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African
   RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo,
   Democratic Republic of theCongo, Republic of theCook IslandsCosta
   RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte
   d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl
   SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland
   IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench
   Southern
   TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard
   and McDonald IslandsHoly SeeHondurasHong
   KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of
   ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao
   People's Democratic
   RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall
   IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew
   CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth
   KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State
   ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto
   RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts
   and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and
   the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi
   ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint
   MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth
   KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen
   IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad
   and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor
   Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited
   StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin
   Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands
   Country
   
 * Email*
   
 * Phone*
   
 * Memo
   
 * Fund*
   DAVIS MEMORIAL FUNDBE'ER MIRIAM MARRIAGE FUNDLEON LEIF CHILDREN'S FUND
 * Donation Amount*
   
 * Make this a Monthly Donation
    * Yes

 * How many Months*
   
 *  * Let my donation go further by covering the credit card
      convenience/processing fee

 * Fee
   Price: $0.00
 * Total
   $0.00
 * Credit Card*
   American Express
   Discover
   MasterCard
   Visa
   Supported Credit Cards: American Express, Discover, MasterCard, Visa
   Card Number Month010203040506070809101112
   Year20242025202620272028202920302031203220332034203520362037203820392040204120422043
   Expiration Date   Security Code Cardholder Name




Tax ID #04-3720418    |     © 2024 The Davis Memorial Fund    |     25 Lawrence
Avenue, Lawrence, NY 11559    |    516.295.0296    | 
  Office@DavisMemorialFund.org

Notifications



BDOW!