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Submitted URL: http://donation.foxonjohn.ca/
Effective URL: https://form.jotform.com/212496990647268
Submission: On January 05 via api from US — Scanned from US
Effective URL: https://form.jotform.com/212496990647268
Submission: On January 05 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
Name: form_212496990647268 — POST https://submit.jotform.com/submit/212496990647268/
<form class="jotform-form" action="https://submit.jotform.com/submit/212496990647268/" method="post" name="form_212496990647268" id="212496990647268" accept-charset="utf-8" autocomplete="on" novalidate="true">
<input type="hidden" name="formID" value="212496990647268">
<input type="hidden" id="JWTContainer" value="">
<input type="hidden" id="cardinalOrderNumber" value="">
<div role="main" class="form-all">
<div class="formLogoWrapper Center">
<img loading="lazy" class="formLogoImg" src="https://www.jotform.com/uploads/Market_hello/form_files/FOX LOGO BLACK HQ.60be598461ed30.62563287.png" height="140" width="110">
</div>
<style>
.formLogoWrapper {
display: inline-block;
position: absolute;
width: 100%;
}
.form-all:before {
background: none !important;
}
.formLogoWrapper.Center {
top: -150px;
text-align: center;
}
</style>
<ul class="form-section page-section">
<li class="form-line jf-required" data-type="control_textbox" id="id_3">
<label class="form-label form-label-left form-label-auto" id="label_3" for="input_3"> Donor: <span class="form-required"> * </span>
</label>
<div id="cid_3" class="form-input jf-required" data-layout="half">
<input type="text" id="input_3" name="q3_donor3" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" style="width:20px" size="20" value="" data-component="textbox" aria-labelledby="label_3" required="">
</div>
</li>
<li class="form-line jf-required" data-type="control_email" id="id_35">
<label class="form-label form-label-left form-label-auto" id="label_35" for="input_35"> Email: <span class="form-required"> * </span>
</label>
<div id="cid_35" class="form-input jf-required" data-layout="half">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="email" id="input_35" name="q35_email35" class="form-textbox validate[required, Email]" data-defaultvalue="" style="width:310px" size="310" value="" data-component="email" aria-labelledby="label_35 sublabel_input_35"
required="">
<label class="form-sub-label" for="input_35" id="sublabel_input_35" style="min-height:13px" aria-hidden="false"> example@example.com </label>
</span>
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_4">
<label class="form-label form-label-left form-label-auto" id="label_4" for="input_4"> Address: <span class="form-required"> * </span>
</label>
<div id="cid_4" class="form-input jf-required" data-layout="half">
<input type="text" id="input_4" name="q4_address4" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" style="width:20px" size="20" value="" data-component="textbox" aria-labelledby="label_4" required="">
</div>
</li>
<li class="form-line jf-required" data-type="control_textbox" id="id_5">
<label class="form-label form-label-left form-label-auto" id="label_5" for="input_5"> Donation: <span class="form-required"> * </span>
</label>
<div id="cid_5" class="form-input jf-required" data-layout="half">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_5" name="q5_donation5" data-type="input-textbox" class="form-textbox validate[required, Numeric]" data-defaultvalue="" style="width:20px" size="20" value="" data-component="textbox"
aria-labelledby="label_5 sublabel_input_5" required="">
<label class="form-sub-label" for="input_5" id="sublabel_input_5" style="min-height:13px" aria-hidden="false"> Example: 36 </label>
</span>
</div>
</li>
<li class="form-line" data-type="control_datetime" id="id_6">
<label class="form-label form-label-left form-label-auto" id="label_6" for="lite_mode_6"> Date Received: </label>
<div id="cid_6" class="form-input" data-layout="half">
<div data-wrapper-react="true">
<div style="display:none">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="tel" class="form-textbox validate[limitDate]" id="month_6" name="q6_dateReceived6[month]" size="2" data-maxlength="2" data-age="" maxlength="2" value="" autocomplete="section-input_6 off"
aria-labelledby="label_6 sublabel_6_month" inputmode="numeric">
<span class="date-separate" aria-hidden="true"> / </span>
<label class="form-sub-label" for="month_6" id="sublabel_6_month" style="min-height:13px" aria-hidden="false"> Month </label>
</span>
<span class="form-sub-label-container" style="vertical-align:top">
<input type="tel" class="form-textbox validate[limitDate]" id="day_6" name="q6_dateReceived6[day]" size="2" data-maxlength="2" data-age="" maxlength="2" value="" autocomplete="section-input_6 off"
aria-labelledby="label_6 sublabel_6_day" inputmode="numeric">
<span class="date-separate" aria-hidden="true"> / </span>
<label class="form-sub-label" for="day_6" id="sublabel_6_day" style="min-height:13px" aria-hidden="false"> Day </label>
</span>
<span class="form-sub-label-container" style="vertical-align:top">
<input type="tel" class="form-textbox validate[limitDate]" id="year_6" name="q6_dateReceived6[year]" size="4" data-maxlength="4" data-age="" maxlength="4" value="" autocomplete="section-input_6 off"
aria-labelledby="label_6 sublabel_6_year">
<label class="form-sub-label" for="year_6" id="sublabel_6_year" style="min-height:13px" aria-hidden="false"> Year </label>
</span>
</div>
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" class="form-textbox validate[limitDate, validateLiteDate]" id="lite_mode_6" size="12" data-maxlength="12" data-age="" value="" data-format="mmddyyyy" data-seperator="/" placeholder="MM/DD/YYYY"
autocomplete="section-input_6 off" aria-labelledby="label_6 sublabel_6_litemode" inputmode="numeric">
<img class=" newDefaultTheme-dateIcon icon-liteMode" alt="Pick a Date" id="input_6_pick" src="https://cdn.jotfor.ms/images/calendar.png" data-component="datetime" aria-hidden="true" data-allow-time="No" data-version="v2">
<label class="form-sub-label" for="lite_mode_6" id="sublabel_6_litemode" style="min-height:13px" aria-hidden="false"> Date </label>
</span>
</div>
</div>
</li>
<li class="form-line jf-required" data-type="control_radio" id="id_39">
<label class="form-label form-label-left form-label-auto" id="label_39" for="input_39"> Payment <span class="form-required"> * </span>
</label>
<div id="cid_39" class="form-input jf-required" data-layout="full">
<div class="form-single-column" role="group" aria-labelledby="label_39" data-component="radio">
<span class="form-radio-item" style="clear:left">
<span class="dragger-item">
</span>
<input type="radio" aria-describedby="label_39" class="form-radio validate[required]" id="input_39_0" name="q39_payment" value="Cash" required="">
<label id="label_input_39_0" for="input_39_0"> Cash </label>
</span>
<span class="form-radio-item" style="clear:left">
<span class="dragger-item">
</span>
<input type="radio" aria-describedby="label_39" class="form-radio validate[required]" id="input_39_1" name="q39_payment" value="Card" required="">
<label id="label_input_39_1" for="input_39_1"> Card </label>
</span>
<span class="form-radio-item formRadioOther" style="clear:left">
<input type="radio" class="form-radio-other form-radio validate[required]" name="q39_payment" id="other_39" value="other" tabindex="0" aria-label="Other">
<label id="label_other_39" style="text-indent:0" for="other_39"> Other </label>
<span id="other_39_input" class="other-input-container is-none" style="">
<input type="text" class="form-radio-other-input form-textbox" name="q39_payment[other]" data-otherhint="Other" size="15" id="input_39" data-placeholder="Please type another option here" placeholder="Please type another option here">
</span>
</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_textbox" id="id_37">
<label class="form-label form-label-left form-label-auto" id="label_37" for="input_37"> Server Name: </label>
<div id="cid_37" class="form-input" data-layout="half">
<input type="text" id="input_37" name="q37_serverName" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" value="" data-component="textbox" aria-labelledby="label_37">
</div>
</li>
<li class="form-line" data-type="control_radio" id="id_36">
<label class="form-label form-label-left form-label-auto" id="label_36" for="input_36"> Open Bar? </label>
<div id="cid_36" class="form-input" data-layout="full">
<div class="form-single-column" role="group" aria-labelledby="label_36" data-component="radio">
<span class="form-radio-item" style="clear:left">
<span class="dragger-item">
</span>
<input type="radio" aria-describedby="label_36" class="form-radio" id="input_36_0" name="q36_openBar" value="Yes">
<label id="label_input_36_0" for="input_36_0"> Yes </label>
</span>
<span class="form-radio-item" style="clear:left">
<span class="dragger-item">
</span>
<input type="radio" aria-describedby="label_36" class="form-radio" id="input_36_1" name="q36_openBar" value="No">
<label id="label_input_36_1" for="input_36_1"> No </label>
</span>
</div>
</div>
</li>
<li class="form-line" data-type="control_button" id="id_8">
<div id="cid_8" class="form-input-wide" data-layout="full">
<div data-align="auto" class="form-buttons-wrapper form-buttons-auto jsTest-button-wrapperField">
<button id="input_8" type="submit" class="form-submit-button submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content=""> Submit </button>
</div>
</div>
</li>
<li style="display:none"> Should be Empty: <input type="text" name="website" value="">
</li>
</ul>
</div>
<script>
JotForm.showJotFormPowered = "0";
</script>
<script>
JotForm.poweredByText = "Powered by Jotform";
</script>
<input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="212496990647268-212496990647268">
<script type="text/javascript">
var all_spc = document.querySelectorAll("form[id='212496990647268'] .si" + "mple" + "_spc");
for (var i = 0; i < all_spc.length; i++) {
all_spc[i].value = "212496990647268-212496990647268";
}
</script>
<input type="hidden" id="input_34" name="q34_uniqueId" class="form-textbox form-hidden" data-defaultvalue="0008" value="0008" data-component="autoincrement">
<input type="hidden" name="event_id" value="1672919469043_212496990647268_mLsv6iY">
</form>Text Content
* Donor: * * Email: * example@example.com * Address: * * Donation: * Example: 36 * Date Received: / Month / Day Year Date * Payment * Cash Card Other * Server Name: * Open Bar? Yes No * Submit * Should be Empty: January‹› 2023«» January 2023TodaySMTWTFS12345678910111213141516171819202122232425262728293031123456789101112131415161718