secure.americares.org
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74.123.153.76
Public Scan
Submitted URL: http://help.americares.org/site/R?i=aVTBsxupB5pHu-_pYt21QAn3QB9VCE41o90QlpeG7zV8dQh2gUJ-gw
Effective URL: https://secure.americares.org/site/Donation2;jsessionid=00000000.app20052b?df_id=28147&mfc_pref=T&28147.donation=form1&utm_sou...
Submission: On August 18 via manual from US — Scanned from DE
Effective URL: https://secure.americares.org/site/Donation2;jsessionid=00000000.app20052b?df_id=28147&mfc_pref=T&28147.donation=form1&utm_sou...
Submission: On August 18 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMName: process — POST https://secure.americares.org/site/Donation2
<form name="process" id="ProcessForm" action="https://secure.americares.org/site/Donation2" method="post" onsubmit="return checkDoubleClick();">
<div class="donation-form-container responsive">
<script type="text/javascript">
<!--
function reloadPage() {
window.location.reload(true);
}
function testAjax() {
var xmlHttp = null;
// Opera 8.0+, Firefox, Chrome, Safari
try {
xmlHttp = new XMLHttpRequest();
} catch (e) {
// Internet Explorer Browsers
try {
xmlHttp = new ActiveXObject("Msxml2.XMLHTTP");
} catch (e) {
try {
xmlHttp = new ActiveXObject("Microsoft.XMLHTTP");
} catch (e) {
return false;
}
}
}
xmlHttp.open('POST', 'AjaxHelper;jsessionid=00000000.app20052b?NONCE_TOKEN=2E8D0B2696F1EE94A60B475B21DD6704', true);
xmlHttp.send();
}
addOnLoadHandler(testAjax);
//
-->
</script>
<div class="donation-form-content">
<input type="hidden" name="user_donation_amt" id="user_donation_amt" value="">
<input type="hidden" name="company_min_matching_amt" id="company_min_matching_amt" value="">
<input type="hidden" name="currency_locale" id="currency_locale" value="en_US">
<div class="form-row">
<div class="html-caption-container">
<!--Header Image -->
<style type="text/css">
<!--
#header-background {
background-repeat: no-repeat;
background-position: center top;
background-size: cover;
background-image: url('https://mason-dixon.s3.amazonaws.com/pagecontent/20198/34f7672101adc923997031aa21562972.png');
min-height: 548px;
}
div#header-overlay-text {
font-size: 28px;
font-family: 'DIN', sans-serif !important;
line-height: 40px;
color: #FFFFFF !important;
font-weight: normal;
padding-top: 75px !important;
/* margin:auto !important; =============== */
margin: 0 auto !important;
text-align: left !important;
/* width:877px !important; ========= */
width: 860px;
vertical-align: middle;
-webkit-text-size-adjust: 100%;
}
.headline-10-400 {
width: 365px;
height: 8px;
height: auto;
margin-left: 0px;
}
@media screen and (max-width:1025px) {
div#header-overlay-text {
padding-top: 80px !important;
padding-left: 50px;
}
#header-background {
background-position: right;
height: auto !important;
height: auto !important;
width: 1025px !important;
margin: auto !important;
min-height: 500px;
}
.cn-mobile {
margin: auto !important;
}
}
@media screen and (max-width:961px) {
.header-overlay-innertext {
width: 90%;
}
div#header-overlay-text {
width: 95% !important;
/* =========== */
padding-top: 25px !important;
padding-left: 10px !important;
padding-bottom: 30px !important;
font-size: 14px !important;
line-height: 16px !important;
-webkit-text-size-adjust: 100% !important;
}
.header-overlay-text1-mobile {
font-size: 16px !important;
line-height: 20px !important;
-webkit-text-size-adjust: 100% !important;
padding-bottom: 5px !important;
}
.header-overlay-text2-mobile {
font-size: 30px !important;
line-height: 30px !important;
-webkit-text-size-adjust: 100% !important;
}
.header-overlay-text3-mobile {
xdisplay: none !important;
font-size: 14px !important;
line-height: 16px !important;
-webkit-text-size-adjust: 100% !important;
}
#header-background {
background-image: url('https://mason-dixon.s3.amazonaws.com/pagecontent/14492/532dc935f55b879e1ebdc72957e7fedc.png');
background-image: none !important;
background-position: right top;
background-size: 100% auto;
/* =========== */
background-color: #171217;
/* =========== */
height: auto !important;
width: 340px !important;
margin: auto !important;
min-height: 270px;
}
.headline-10-400 {
width: 175px;
height: auto;
margin-left: 0px;
margin-top: -10px;
xpadding-top: 70px;
}
.show {
display: inline !important;
}
.dn {
display: none !important;
}
.cn-mobile {
margin: auto !important;
}
}
-->
</style>
<script type="text/javascript">
// <![CDATA[
jQuery.noConflict();
(function($) {
$(document).ready(function() {
/* Change header background overlay text */
$('#header-overlay-text').html(
"<div style='line-height:34px; padding-bottom:120px;' class='header-overlay-text1-mobile'></div><img src='../images/content/pagebuilder/red_line.png' class='headline-10-400' style='clear:both; padding-bottom:3px;'/><div style='font-family:block, sans-serif; color:#FFFFFF; font-size:50px; font-weight:normal; line-height:50px;text-shadow: 1px 1px 5px #000;' class='header-overlay-text2-mobile'>Your Gift Matched 2x!</div><div class='header-overlay-innertext'><div style='font-family:DIN, Arial; font-size:18px; line-height:22px; font-weight:normal;padding-top:10px;' class='header-overlay-text3-mobile'><span style='color:#fcb831; font-weight:bold;text-shadow: 1px 1px 5px #000;'>Create brighter futures through better health!<br><br><span style='color:white; font-weight:bold;text-shadow: 1px 1px 5px #000;'>Make a lifelong impact by helping us deliver critical medicines, aid and supplies to those that have been impacted by extreme weather, poverty, disaster and more.</div> </div>"
);
/* Change Right Rail Text Below, between the quotes, HTML Tags are allowed between the double quotes, but please make sure to use single quotes inside of the double quotes if needed and don't use any line breaks. */
$('#sidebar').html(
"<p style='clear:both; color:#000000; font-size:20px !important; font-weight:bold !important; font-family:arial;'><strong>You Can Trust Us</p><div style=' width:190px; text-align:center;' class='cn-mobile'><img style='width: 110px; height: auto; display: inline; margin-right: 10px; padding-bottom:5px;' src='../images/content/pagebuilder/Charity-Navigator-Logo.gif' border='0' align='left' /><img style='width: 70px; height: auto; display: inline; padding-bottom:5px;' src='../images/content/pagebuilder/accredited-charity-logo-blue_hi_res.jpg' border='0' align='left' /></div><p style='clear:both; font-weight:normal !important; font-family:DIN, arial;'><span style='font-weight:normal !important;'>Donate with confidence.<br/>More than 98% of our resources support health programs. Less than 2% are used for administration and overhead.<br/><br/>For over four decades, Americares has been leading the charge to support accessible, reliable health care to people affected by poverty or disaster. But we would not be able to provide life-changing health programs, medicine and medical supplies to millions without your generous support. If you donate today your gift will be 2x matched to make a lifelong impact on underserved and underrepresented communities because better health makes everything possible.</span></p>"
);
$('.header-body-copy').html("Test Copy");
//------------------------------- START DONATION FOOTER INTEGRATION ----------------------------
console.log(window.location.href);
var donationAmount = 0;
var amountFound = false;
if (window.location.href.indexOf('amount') > -1) {
window.location.href.split('&').forEach(function(item) {
if (item.indexOf('amount') > -1) {
donationAmount = item.split('=')[1];
}
});
setTimeout(function() {
document.querySelectorAll('.newLevel').forEach(function(level) {
if (level.querySelector('.amountRadio') && level.querySelector('.amountRadio').value == donationAmount && level.querySelector('.amountRadio').getAttribute('id').indexOf('monthly') < 0) {
//level.querySelector('.amountRadio').checked = true;
level.querySelector('.newLevelAmount').click();
document.querySelectorAll('.newLevel').forEach(function(level2) {
//console.log(level2);
if (level2.querySelector('.newLevelAmount') && level != level2) {
//level2.querySelector('.newLevelAmount').classList.remove('active');
amountFound = true;
} else if (level2.querySelector('.newLevelAmount')) {
//level2.querySelector('.newLevelAmount').classList.add('active');
amountFound = true;
}
});
}
});
if (!amountFound) {
$('#level_singleOtherAmount')[0].click();
//$('#level_singleOtherAmount')[0].classList.add('active');
$('#level_singleOtherAmount')[0].value = donationAmount;
document.querySelectorAll('.newLevel').forEach(function(level2) {
if (level2.querySelector('.newLevelAmount')) {
level2.querySelector('.newLevelAmount').classList.remove('active');
}
});
}
}, 500);
}
//-------------------------------- END DONATION FOOTER INTEGRATION -----------------------------
});
})(jQuery);
// ]]>
</script>
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<!-- start dynamic gift string --> <!-- start dd monthly option test -->
<style type="text/css">
<!--
@media all and (-ms-high-contrast: none),
(-ms-high-contrast: active) {
.radio_spacer_0,
.radio_spacer_1 {
pointer-events: none !important;
}
}
@supports (-ms-ime-align: auto) {
.radio_spacer_0,
.radio_spacer_1 {
pointer-events: none !important;
}
}
input[type="checkbox"]#donor_email_opt_inname {
width: 18px !important;
}
label[for="donor_email_opt_inname"] {
margin-top: 26px !important;
margin-left: 5px !important;
}
}
input:focus,
select:focus {
outline-width: 2px !important;
}
input,
select,
option {
margin-left: 2px !important;
}
/*Email address shift up*/
div#donor_email_address_row {
position: relative;
top: -293px;
}
div#billing_first_name_row,
div#billing_last_name_row,
div#billing_addr_street1_row,
div#billing_addr_street2_row,
div#billing_addr_city_row,
div#billing_addr_state_row,
div#billing_addr_zip_row,
div#billing_addr_country_row {
position: relative;
top: 75px;
}
div.responsive input {
vertical-align: middle !important;
}
div.monthlyLevels {
vertical-align: middle !important;
}
.newLevel {
display: inline;
margin-right: 6px;
float: none;
}
div.singleLevels input {
display: inline;
}
div.monthlyLevels input {
display: inline;
}
div.newLevel label {
display: inline;
}
.amountRadio,
.otherRadio {
display: none !important;
}
label[for="level_singleOther"] {
display: none;
}
div.newLevel input#level_singleOtherAmount {
margin: 0em;
}
div.newLevel input#level_monthlyOtherAmount {
margin: 0em;
}
.newLevelAmount {
display: inline;
min-width: 65px;
width: 70px !important;
height: 45px !important;
text-align: center;
font-size: 14px;
font-weight: 700 !important;
padding: 15px 19px;
background: #e5f1f7 none repeat scroll 0 0
}
div.newLevelAmount.active {
background: #0562af;
color: #FFFFFF !important;
}
.otherInput.active {
background: #0562af !important;
background-color: #0562af !important;
color: #FFFFFF !important;
}
/* ==== */
input#level_singleOtherAmount.active::placeholder,
.otherInput.active::placeholder,
input#level_singleOtherAmount.active::-webkit-input-placeholder,
.otherInput.active::-webkit-input-placeholder,
input#level_singleOtherAmount.active::-moz-placeholder,
.otherInput.active::-moz-placeholder,
input#level_singleOtherAmount.active:-ms-input-placeholder,
.otherInput.active:-ms-input-placeholder {
color: #FFFFFF !important;
}
#giftSelectContain {
display: block;
margin-top: 10px;
margin-bottom: 10px;
}
#giftTypeIntro {
display: inline;
}
#giftSelector {
display: inline;
}
input[name='new_level_other'] {
width: 140px;
margin-left: 0px;
position: relative;
bottom: 0px;
font-family: DIN, 'Helvetica Neue', sans-serif;
font-size: 14px !important;
font-weight: 700 !important;
color: rgb(60, 60, 60);
text-align: center;
padding-left: 0px !important;
}
input[name='new_level_other']::placeholder {
font-family: DIN, 'Helvetica Neue', sans-serif;
font-size: 14px;
font-weight: 700 !important;
color: rgb(60, 60, 60);
}
input[name='new_level_other']::-webkit-input-placeholder {
font-family: DIN, 'Helvetica Neue', sans-serif;
font-size: 14px;
font-weight: 700 !important;
color: rgb(60, 60, 60);
}
input[name='new_level_other']::-moz-placeholder {
font-family: DIN, 'Helvetica Neue', sans-serif;
font-size: 14px;
font-weight: 700 !important;
color: rgb(60, 60, 60);
}
input[name='new_level_other']:-moz-placeholder {
font-family: DIN, 'Helvetica Neue', sans-serif;
font-size: 14px;
font-weight: 700 !important;
color: rgb(60, 60, 60);
}
input[name='new_level_other']:-ms-input-placeholder {
font-family: DIN, 'Helvetica Neue', sans-serif;
font-size: 14px;
font-weight: 700 !important;
color: rgb(60, 60, 60);
}
input#level_singleOtherAmount {
border: 0px !important;
}
input#giftTypeSelect_0,
input#giftTypeSelect_1 {
display: none;
}
.radio_spacer_0,
.radio_spacer_1 {
width: 260px;
height: 52px;
}
#giftTypeSelect_0+label {
width: 265px;
height: 53px;
background-size: 265px 53px;
background-image: url(../images/content/pagebuilder/Button_inactive_1x.png);
margin-right: 12px;
}
#giftTypeSelect_1+label {
width: 265px;
height: 53px;
background-size: 265px 53px;
background-image: url(../images/content/pagebuilder/Button_inactive_monthly.png);
}
#giftTypeSelect_0:checked+label {
width: 265px;
height: 53px;
background-size: 265px 53px;
background-image: url(../images/content/pagebuilder/Button_active_1x.png);
}
#giftTypeSelect_1:checked+label {
width: 265px;
height: 53px;
background-size: 265px 53px;
background-image: url(../images/content/pagebuilder/Button_active_monthly.png);
}
label {
cursor: pointer;
}
.sit_back {
width: 260px;
height: 64px;
margin-left: 150px;
margin-bottom: 15px;
margin-top: 5px;
}
.monthlyLevels {
xmargin-top: 15px;
}
input#level_monthlyOtherAmount {
position: relative;
xtop: -16px;
border: 0px !important;
}
@media (max-width: 1024px) {
.sit_back {
width: 200px;
height: 49px;
margin-left: 50px !important;
margin-top: 5px;
margin-bottom: 10px;
}
.radio_spacer_0,
.radio_spacer_1 {
width: 140px;
height: 28px;
}
#giftSelector {
display: block;
margin-left: 20px;
}
#giftTypeSelect_0+label {
margin-bottom: 5px;
}
div.newLevel {
margin-bottom: 22px;
}
-->
</style>
<script type="text/javascript">
// <![CDATA[
var jqdd = jQuery.noConflict();
function makeNumeric(theValue) {
if (typeof theValue === 'undefined') {
return 0.00;
}
/* ensure that it is a string */
var theValue = '' + theValue;
var deformatted = theValue.replace(/[^0-9\.]+/g, "");
var numericCurrency = 0.00;
if (!isNaN(deformatted)) {
deformatted = Number(deformatted);
numericCurrency = deformatted.toFixed(2);
}
return numericCurrency;
}
function getPageId() {
if (!window.currentPageId) {
var pageId = jqdd('input[id="df_id"]').val();
if (!pageId) {
pageId = "Donate"
}
window.currentPageId = 'AMC_' + pageId;
}
return window.currentPageId;
}
function generalRemember(key, value) {
newKey = getPageId() + '_' + key;
try {
sessionStorage.setItem(newKey, value);
} catch (err) {
if (err.name == 'QuotaExceededError') {
console.warn('UNABLE TO REMEMBER FIELD VALUES: ' + err.message + ' (normal for Safari Private Browsing)');
} else {
console.error(err.name + ': ' + err.message);
}
}
}
function generalRecall(key) {
newKey = getPageId() + '_' + key;
try {
value = sessionStorage.getItem(newKey);
} catch (err) {
if (err.name != 'QuotaExceededError') {
console.error(err.name + ': ' + err.message);
}
}
return value;
}
function generalForget(key) {
newKey = getPageId() + '_' + key;
try {
sessionStorage.removeItem(newKey);
} catch (err) {
if (err.name != 'QuotaExceededError') {
console.error(err.name + ': ' + err.message);
}
}
}
var jqam = jQuery.noConflict();
jqam(document).ready(function() {
function recordSelectedAmount(theValue) {
var cleanedAmount = makeNumeric(theValue);
var otherInput = jqam("div.donation-level-user-entered input[type='text']").eq(0);
otherInput.val(cleanedAmount);
otherInput.closest('div.donation-level-input-container').find("div.donation-level-label-input-container input[type='radio']").prop('checked', true).trigger('change');
generalRemember('selectedAmount_' + generalRecall('selectedFrequency'), cleanedAmount);
return cleanedAmount;
}
function chooseDefaultNewLevel(levelsContainerObj) {
var validLevels = levelsContainerObj.find("div.newLevel input[type=radio]");
if (validLevels.length >= 3) {
//select 2nd level if One Time Gift
if (jqam('input#giftTypeSelect_0').prop("checked")) {
validLevels.eq(1).click();
}
//select 3rd level if Monthly Gift
else {
validLevels.eq(2).click();
}
} else {
//select first level
validLevels.eq(0).click();
}
}
function selectSpecificAmount(amount, container) {
//console.log('FINDING AMOUNT ' + amount);
var amountFound = false;
var searchAmount = makeNumeric(amount);
container.find('input.amountRadio').each(function() {
var thisValue = jqam(this).val();
if (searchAmount === makeNumeric(thisValue)) {
jqam(this).prop('checked', true).trigger('change');
amountFound = true;
}
});
if (!amountFound) {
container.find('input.otherInput').val(searchAmount).trigger('click').trigger('change');
}
}
jqam("#level_standard_row").hide();
jqam("#monthGift").hide();
var newGiftString =
"<div id='giftSelectContain'><div id='giftTypeIntro'></div><div id='giftSelector'><input type='radio' name='giftTypeSelect' value='single' id='giftTypeSelect_0'><label for='giftTypeSelect_0'><img src='../images/content/pagebuilder/trans-spacer.gif' class='radio_spacer_0'/></label><input type='radio' name='giftTypeSelect' value='monthly' id='giftTypeSelect_1'><label for='giftTypeSelect_1'><img src='../images/content/pagebuilder/trans-spacer.gif' class='radio_spacer_1'/></label></div><div><img src='../images/content/pagebuilder/sit_back_arrow.png' class='sit_back'/></div></div>";
jqam(newGiftString).insertAfter("#secOneHeader");
var singleGiftLevels =
"<div class='singleLevels'><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='65' id='level_single65'><label for='level_single65'><div class='newLevelAmount'>$65</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='125' id='level_single125'><label for='level_single125'><div class='newLevelAmount'>$125</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='250' id='level_single250'><label for='level_single250'><div class='newLevelAmount'>$250</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='500' id='level_single500'><label for='level_single500'><div class='newLevelAmount'>$500</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='1000' id='level_single1000'><label for='level_single1000'><div class='newLevelAmount'>$1000</div></label></div><div class='newLevel'><input class='otherRadio' type='radio' name='new_level' value='other' id='level_singleOther'><label for='level_singleOther'><input class='otherInput' type='text' name='new_level_other' id='level_singleOtherAmount' placeholder='Enter gift amount' value='' size='12'></label></div></div>";
var monthlyGiftLevels =
"<div class='monthlyLevels'><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='100' id='level_monthly100'><label for='level_monthly100'><div class='newLevelAmount'>$100</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='50' id='level_monthly50'><label for='level_monthly50'><div class='newLevelAmount'>$50</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='35' id='level_monthly35'><label for='level_monthly35'><div class='newLevelAmount'>$35</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='25' id='level_monthly25'><label for='level_monthly25'><div class='newLevelAmount'>$25</div></label></div><div class='newLevel'><input class='amountRadio' type='radio' name='new_level' value='10' id='level_monthly10'><label for='level_monthly10'><div class='newLevelAmount'>$10</div></label></div><div class='newLevel'><input class='otherRadio' type='radio' name='new_level' value='other' id='level_monthlyOther'><label for='level_monthlyOther'><input class='otherInput' type='text' name='new_level_other' id='level_monthlyOtherAmount' placeholder='Enter gift amount' value='' size='12'></label></div></div>";
jqam(singleGiftLevels).insertAfter("#giftSelectContain");
jqam(monthlyGiftLevels).insertAfter("#giftSelectContain");
jqam("input[name='new_level']").on('change', function(event) {
var currentVal = jqam(this).val();
if (currentVal == "other") {
var getUserVal = jqam("input[name='new_level_other']").val();
recordSelectedAmount(getUserVal);
} else {
jqam("input[name='new_level_other']").val("");
recordSelectedAmount(currentVal);
}
});
jqam("input#level_singleOtherAmount, input#level_monthlyOtherAmount").on('change', function(event) {
var getUserVal = jqam(this).val();
var cleanedAmount = recordSelectedAmount(getUserVal);
jqam(this).val(cleanedAmount);
});
jqam("#level_singleOtherAmount").click(function() {
jqam("#level_singleOther").prop("checked", true).trigger('change');
});
jqam("#level_monthlyOtherAmount").click(function() {
jqam("#level_monthlyOther").prop("checked", true).trigger('change');
});
jqam("#level_singleOther").click(function() {
jqam("#level_singleOtherAmount").focus();
});
jqam("#level_monthlyOther").click(function() {
jqam("#level_monthlyOtherAmount").focus();
});
jqam('input#giftTypeSelect_0, input#giftTypeSelect_1').change(function() {
if (jqam('input#giftTypeSelect_1').prop("checked")) {
/* Recurring */
generalRemember('selectedFrequency', 'monthly');
jqam("#level_standardauto_repeatname").prop("checked", true);
jqam("div.singleLevels").hide();
jqam("div.monthlyLevels").show();
//jqam(".otherInput.active").css("color", "#FFFFFF");
var savedAmount = generalRecall('selectedAmount_monthly');
if (savedAmount) {
selectSpecificAmount(savedAmount, jqam("div.monthlyLevels"));
} else {
chooseDefaultNewLevel(jqam("div.monthlyLevels"));
}
} else {
/* Single */
generalRemember('selectedFrequency', 'single');
jqam("#giftTypeSelect_0").prop("checked", true);
jqam("#level_standardauto_repeatname").prop("checked", false);
jqam("div.singleLevels").show();
jqam("div.monthlyLevels").hide();
var savedAmount = generalRecall('selectedAmount_single');
if (savedAmount) {
selectSpecificAmount(savedAmount, jqam("div.singleLevels"));
} else {
chooseDefaultNewLevel(jqam("div.singleLevels"));
}
}
});
// recheck previous FREQUENCY selection, precheck single option as default
if (generalRecall('selectedFrequency') === 'monthly') {
jqam("input#giftTypeSelect_1").prop("checked", true).trigger('change');
} else {
jqam("input#giftTypeSelect_0").prop("checked", true).trigger('change');
}
});
// ]]>
</script>
<!-- end dd monthly option test --> <!-- end dynamic gift string -->
</div>
</div>
<div class="don-standard-levels form-row">
<div class="levels-label">
</div>
<div id="level_standard_row" class="form-row form-donation-level" style="display: none;">
<div class="form-content">
<span class="field-required"></span> <span class="aural-only">Field Is Required</span>
<span class="FormLabelText" style="display: none;">Enter A Gift Amount:</span>
<div class="donation-level-general-ask">
</div>
<div class="donation-levels">
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded97203" value="97203" onclick="evalMatchingGift('');
updateDonorCoverAmount('');">
</div>
<label for="level_standardexpanded97203" onclick="">
<div class="donation-level-label-container"> $10 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_97203expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded97205" value="97205" checked="checked" onclick="evalMatchingGift('');
updateDonorCoverAmount('');">
</div>
<label for="level_standardexpanded97205" onclick="">
<div class="donation-level-label-container"> $25 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_97205expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded97206" value="97206" onclick="evalMatchingGift('');
updateDonorCoverAmount('');">
</div>
<label for="level_standardexpanded97206" onclick="">
<div class="donation-level-label-container"> $50 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_97206expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded97207" value="97207" onclick="evalMatchingGift('');
updateDonorCoverAmount('');">
</div>
<label for="level_standardexpanded97207" onclick="">
<div class="donation-level-label-container"> $100 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_97207expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content">
<div class="donation-level-input-container form-input">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded97208" value="97208" onclick="evalMatchingGift('');
updateDonorCoverAmount('');">
</div>
<label for="level_standardexpanded97208" onclick="">
<div class="donation-level-label-container"> $250 </div>
</label>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_97208expandedsubmit" value="true">
</div>
</div>
<div class="donation-level-container">
<div class="form-content secondDLevelRow">
<div class="donation-level-input-container form-input newOtherLabel">
<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded97209" value="97209" onclick="evalMatchingGift(document.getElementById('level_standardexpanded97209amount').value);
updateDonorCoverAmount(document.getElementById('level_standardexpanded97209amount').value);">
</div>
<label for="level_standardexpanded97209" onclick="">
<div class="donation-level-label-container">Your most generous amount</div>
</label>
<div class="donation-level-user-entered">
<label for="level_standardexpanded97209amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded97209amount" id="level_standardexpanded97209amount" value="" size="12" maxlength="50"
onfocus="var el = document.getElementById ('level_standardexpanded97209');if (el) el.click(); fire_obs_comp_event('level_standardexpanded97209amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded97209amount', this, event);evalMatchingGift(value);" onkeyup="fire_obs_comp_event('level_standardexpanded97209amount', this, event);evalMatchingGift(value);"
onblur="fire_obs_comp_event('level_standardexpanded97209amount', this);updateDonorCoverAmount(value);" tabindex="1" placeholder="Enter gift amount">
</div>
</div>
<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_97209expandedsubmit" value="true">
</div>
</div>
</div>
</div>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observables
jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
var syncAction = function(obj) {
if (obj.is(':checked')) {
obj.closest('div.donation-level-container').addClass('selected');
} else {
obj.closest('div.donation-level-container').removeClass('selected');
};
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('div.donation-level-container').removeClass('selected');
syncAction(jQuery(this));
});
});
});
});
</script><noscript> </noscript>
</div>
<div class="levels-gift-aid">
</div>
<input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true">
<script type="text/javascript">
function updateDonorCoverAmount(gift) {
if (typeof updateAmount !== "undefined") {
updateAmount(gift);
}
};
function evalMatchingGift(gift) {}
</script><noscript> </noscript>
</div>
<div class="donation-level-container-generic-repeat form-input">
<div class="generic-repeat-label-checkbox-container">
<input type="checkbox" name="level_standardauto_repeatname" id="level_standardauto_repeatname" onclick="fire_obs_comp_event('level_standardauto_repeat', this);" onkeypress="fire_obs_comp_event('level_standardauto_repeat', this);">
<label for="level_standardauto_repeatname"> Yes, automatically repeat this gift every month. </label>
</div>
<input type="hidden" name="level_standardauto_repeatsubmit" id="level_standardauto_repeatsubmit" value="true">
</div>
<div class="form-row">
<div class="html-caption-container">
<style type="text/css">
<!--
@-moz-document url-prefix() {
#sidebar {
margin-top: -1283px !important;
}
label[for='billing_addr_state'] {
margin-top: -238px !important;
}
div#donor_email_address_row {
top: -300px !important;
}
@media screen and (max-width:1025px) {
label[for='billing_addr_state'] {
margin-top: 8px !important;
}
div#donor_email_address_row {
top: -475px !important;
}
}
}
/* Safari 10.1+ */
@media not all and (min-resolution:.001dpcm) {
@media {
#sidebar {
margin-top: -1267px !important;
}
@media screen and (max-width:1025px) {
div.donation-level-user-entered input {
margin-left: 25px !important;
}
div#donor_email_address_row {
top: -475px !important;
}
}
}
}
@media all and (-ms-high-contrast: none),
(-ms-high-contrast: active) {
select,
option {
padding-left: 17px !important;
}
#sidebar {
margin-top: 0px !important;
position: relative !important;
top: -1322px !important;
}
div#donor_email_address_row {
top: -325px !important;
}
#outer {
padding-bottom: 20px !important;
}
input[type="checkbox"]#donor_email_opt_inname {
width: 18input[type="checkbox"]#donor_email_opt_innamepx !important;
}
label[for="donor_email_opt_inname"] {
margin-top: 26px !important;
margin-left: 5px !important;
}
input {
height: 38px !important;
}
}
@supports (-ms-ime-align: auto) {
select,
option {
padding-left: 17px !important;
}
#sidebar {
margin-top: 0px !important;
position: relative !important;
top: -1322px !important;
}
div#donor_email_address_row {
top: -325px !important;
}
#outer {
padding-bottom: 20px !important;
}
input[type="checkbox"]#donor_email_opt_inname {
width: 18px !important;
}
label[for="donor_email_opt_inname"] {
margin-top: 26px !important;
margin-left: 5px !important;
}
input {
height: 38px !important;
}
}
/*Email address shift up*/
div#donor_email_address_row {
position: relative;
top: -290px;
}
div#billing_first_name_row,
div#billing_last_name_row,
div#billing_addr_street1_row,
div#billing_addr_street2_row,
div#billing_addr_city_row,
div#billing_addr_state_row,
div#billing_addr_zip_row,
div#billing_addr_country_row {
position: relative;
top: 75px;
}
.payment-type-selection-container {
color: #005984 !important;
}
div#outer-wrapper {
max-width: 874px;
width: auto;
margin: auto;
margin-top: 0px important;
xborder: 1px solid #FF0000 !important;
}
#reqNotice {
padding-top: 10px;
margin-top: 0px;
line-height: 10px;
}
div.donation-form-container.responsive {
width: 580px !important;
}
#secOneHeader {
padding-top: 5px;
padding-bottom: 5px;
line-height: 18px;
font-size: 18px !important;
max-width: 580px !important;
}
#sidebar {
display: inline-block !important;
background-color: #FFFFFF;
border-top: 8px solid #ef4323;
width: 203px;
xborder-left: 3px solid #dde9ee;
margin-top: -1277px;
margin-right: 0px;
padding-left: 20px;
padding-right: 20px;
padding-bottom: 20px;
position: initial;
z-index: 5000 !important;
-webkit-box-shadow: 0px 0px 25px 0px rgba(153, 153, 153, 0.5);
-moz-box-shadow: 0px 0px 25px 0px rgba(153, 153, 153, 0.5);
box-shadow: 0px 0px 25px 0px rgba(153, 153, 153, 0.5);
-webkit-text-size-adjust: 100%;
height: auto !important;
}
#sidebar p {
padding-top: 10px;
font-family: 'DIN';
font-size: 14px !important;
line-height: 16px;
padding-right: 0px;
color: #21252d;
text-align: left;
font-weight: normal;
-webkit-text-size-adjust: 100%;
}
#subGiftAmts {
margin-top: 10px;
}
#mem-link {
margin-left: 20px;
margin-right: 20px;
}
#level_standard_row {
width: 775px !important;
}
#newOptIn {
margin-top: 10px;
width: 100% !important;
margin-left: 0px !important;
}
div#billing_first_name_row,
div#billing_last_name_row,
input[type="text"]#billing_first_namename,
input[type="text"]#billing_last_namename {
display: inline !important;
width: 249px !important;
}
input[type="text"]#billing_addr_street1name,
input[type="text"]#billing_addr_street2name,
input[type="text"]#donor_email_addressname {
width: 528px !important;
}
div#billing_addr_country_row div.form-content {
margin-left: 0px !important;
}
select#billing_addr_country {
width: 553px !important;
}
div#billing_addr_city_row,
div#billing_addr_state_row,
input[type="text"]#billing_addr_cityname,
select#billing_addr_state,
input[type="text"]#billing_addr_zipname,
div#billing_addr_zip_row {
display: inline !important;
width: 165px !important;
}
div#responsive_payment_typecc_number_row,
input[type="text"]#responsive_payment_typecc_numbername {
width: 300px !important;
display: inline;
}
div#responsive_payment_typecc_type_row {
clear: both;
margin-bottom: 20px;
}
div#responsive_payment_typecc_exp_date_row {
width: 200px !important;
display: inline;
}
div.date-input-container {
margin-left: 0px !important;
}
input[type="text"]#responsive_payment_typecc_cvvname {
width: 100px !important;
}
select#responsive_payment_typecc_exp_date_MONTH {
width: 110px !important;
}
select#responsive_payment_typecc_exp_date_YEAR {
width: 110px !important;
}
img#responsive_payment_typecc_type_American_Express {
height: 21px !important;
}
img#responsive_payment_typecc_type_MasterCard {
margin-left: -6px !important;
}
#vSign {
float: none;
left: 300px;
}
label#cardsAccept {
display: none;
}
#DonorInfoSection {
xborder: 1px solid #000;
float: none;
width: 580px;
height: auto;
}
label[for="donor_email_opt_inname"] {
margin-top: 30px;
width: 340px !important;
margin-left: 5px !important;
}
#DonorInfoSection input {
float: left !important;
width: 22px !important;
}
input[type="checkbox"]#donor_email_opt_inname {
margin-top: 15px !important;
}
#PaymentInfoSection {
width: 580px;
xborder: 1px solid #000;
margin-top: 20px;
height: auto !important;
xfloat: none;
margin-left: 0px !important;
height: auto;
}
div.html-caption-container {
max-width: 1200px !important;
width: 1000px !important;
}
body,
#pagewrap,
#outer {
background-color: #FFFFFF !important;
}
#outer {
display: inline-block !important;
width: 620px;
margin-top: -60px;
margin-right: 260px;
height: auto !important;
margin-bottom: 50px !important;
border-top: 8px solid #ef4323;
-webkit-box-shadow: 0px 0px 25px 0px rgba(153, 153, 153, 0.5);
-moz-box-shadow: 0px 0px 25px 0px rgba(153, 153, 153, 0.5);
box-shadow: 0px 0px 25px 0px rgba(153, 153, 153, 0.5);
}
#ProcessForm {
xwidth: 420px;
padding-bottom: 0px;
padding-left: 10px;
padding-right20px;
}
.don-standard-levels {
margin-left: 18px;
}
div#responsive_payment_typecc_number_row label {
display: none;
}
div#billing_addr_street2_row div.form-content {
margin-left: 0px !important;
}
.field-required {
display: none !important;
}
a {
color: #0562af !important;
text-decoration: none !important;
}
.ddSectionHead {
font-size: 18px !important;
font-weight: 300 !important;
}
.donation-level-container {
display: inline !important;
padding-right: 5px !important;
padding-left: 0px !important;
margin-right: 0px !important;
}
div.donation-level-input-container.form-input {
width: 70px !important;
height: 45px !important;
margin-top: 0px !important;
}
div.donation-level-label-container {
padding-top: 15px !important;
font-size: 14px;
}
div.donation-level-label-container:hover {
color: #000000;
}
.lrgNum {
width: 71px !important;
}
.step-button,
.step-button:hover {
text-align: center !important;
color: #FFFFFF !important;
xbackground-color: #ef4123 !important;
background-color: transparent !important;
border-radius: 0px !important;
border: none !important;
float: none !important;
margin: 0px auto !important;
height: 56px;
font-size: 18px !important;
font-weight: bold !important;
width: 300px !important;
max-width: 300px !important;
height: 52px !important;
font-family: 'DIN', sans-serif !important;
white-space: nowrap !important;
background-image: url('../images/content/pagebuilder/Pointed_Button_Red_BG.png') !important;
background-size: 426px 52px !important;
background-position: right;
opacity: .7;
text-transform: uppercase;
}
.step-button:hover {
opacity: 1;
}
input {
height: 35px;
border-radius: 0px !important;
background: none !important;
background-color: #e5f1f7 !important;
border: 1px solid #dde9ee !important;
-moz-box-shadow: none !important;
-webkit-box-shadow: none !important;
box-shadow: none !important;
background-image: none !important;
padding-left: 15px !important;
margin-right: 0px !important;
webkit-apperance: none !important;
}
select,
option {
border: 0px solid #e5f1f7 !important;
border-radius: 0px !important;
color: #005984 !important;
background-color: #e5f1f7 !important;
height: 48px !important;
text-indent: 8px !important;
-moz-border-radius: 0px !important;
-webkit-border-radius: 0px !important;
}
input[type='checkbox'] {
margin-top: -5px !important;
background: none !important;
}
label[for='billing_first_namename'],
label[for='billing_last_namename'],
label[for='billing_addr_street1name'],
label[for='billing_addr_street2name'],
label[for='billing_addr_cityname'],
label[for='billing_addr_zipname'],
label[for='donor_phonename'],
label[for='donor_email_addressname'],
label[for='responsive_payment_typecc_numbername'],
label[for='responsive_payment_typecc_cvvname'],
label[for='responsive_payment_typecc_numbername'],
label[for='responsive_payment_typecc_exp_date_MONTH'],
label[for='responsive_payment_typecc_exp_date_YEAR'] {
display: none;
}
label[for='billing_addr_country'] {
position: absolute;
margin-top: 8px;
margin-left: 18px;
z-index: 1000;
color: #777777;
font-size: 9px;
}
label[for='billing_addr_state'] {
position: absolute;
margin-top: 8px;
margin-left: 18px;
z-index: 1000;
color: #777777;
font-size: 9px;
}
/***************Donation Levels***************/
div.donation-level-container {
border-radius: 0 !important;
float: left;
padding: 0px 20px;
margin-right: 0px;
color: #444444;
font-size: 16px;
font-weight: 600 !important;
font-family: 'DIN', sans-serif !important;
}
div.donation-level-container:last-child {
margin-right: 0 !important;
}
div.donation-level-container input[type="radio"] {
display: none;
}
div.donation-level-input-container {
height: 35px;
min-width: 65px;
text-align: center;
font-size: 16px;
font-weight: 600 !important;
padding: 10px 5px 0 5px;
margin-left: -15px !important;
background: #e5f1f7 none repeat scroll 0 0;
}
div.donation-level-container:last-child div.donation-level-input-container {
background: none;
border: 0 none;
position: relative;
padding: 0;
}
div.donation-level-input-container:last-child {
pading-left: 0;
}
div.donation-level-input-container.active {
background: #0562af;
color: #FFFFFF !important;
}
div.donation-level-label-container {
color: inherit;
}
div.donation-level-input-container label.active {
background-color: #0562af;
color: #FFFFFF !important;
border-color: #0562af;
}
div.donation-level-container:last-child div.donation-level-input-container label {
display: none;
}
div.donation-level-user-entered {
float: left !important;
display: block !important;
margin: 0 !important;
border: 0px !important;
}
div.donation-form-container.responsive div.donation-level-user-entered input[type="text"] {
margin-top: 3px;
border: 0px !important;
height: 45px !important;
width: 150px;
box-shadow: none !important;
border-radius: 0 !important;
background: #e5f1f7 none repeat scroll 0 0;
text-align: center;
padding: 0px 5px 0px 5px;
padding-left: 0px !important;
color: #444444 !important;
font-size: 16px !important;
font-weight: 600 !important;
opacity: 1 !important;
font-family: 'DIN', sans-serif !important;
}
div.donation-form-container.responsive div.donation-level-input-container div.donation-level-user-entered input[type="text"]::-webkit-input-placeholder {
color: #444444 !important;
opacity: 1 !important;
}
div.donation-form-container.responsive div.donation-level-input-container div.donation-level-user-entered input[type="text"]::-moz-placeholder {
color: #444444 !important;
opacity: 1 !important;
}
div.donation-form-container.responsive div.donation-level-input-container div.donation-level-user-entered input[type="text"]:-moz-placeholder {
color: #444444 !important;
opacity: 1 !important;
}
div.donation-form-container.responsive div.donation-level-input-container div.donation-level-user-entered input[type="text"]:-ms-input-placeholder {
color: #444444 !important;
opacity: 1 !important;
}
div.donation-form-container.responsive div.donation-level-input-container div.donation-level-user-entered input[type="text"]::placeholder {
color: #444444 !important;
opacity: 1 !important;
}
div.donation-form-container.responsive div.donation-level-input-container.active div.donation-level-user-entered input[type="text"] {
background: #0562af !important;
color: #ffffff !important;
opacity: 1 !important;
}
div.donation-form-container.responsive div.donation-level-input-container.active div.donation-level-user-entered input[type="text"]::-webkit-input-placeholder {
color: #FFFFFF !important;
opacity: .3 !important;
}
div.donation-form-container.responsive div.donation-level-input-container.active div.donation-level-user-entered input[type="text"]::-moz-placeholder {
color: #FFFFFF !important;
opacity: .3 !important;
}
div.donation-form-container.responsive div.donation-level-input-container.active div.donation-level-user-entered input[type="text"]:-moz-placeholder {
color: #FFFFFF !important;
opacity: .3 !important;
}
div.donation-form-container.responsive div.donation-level-input-container.active div.donation-level-user-entered input[type="text"]:-ms-input-placeholder {
color: #FFFFFF !important;
opacity: .3 !important;
}
div.donation-level-amount-container+div.donation-level-label-container,
div.donation-level-label-input-container {
display: none;
}
.donation-level-container-generic-repeat {
display: none;
}
@media screen and (max-width:1025px) {
/*Email address shift up*/
div#donor_email_address_row {
top: -465px;
}
label[for="donor_email_opt_inname"] {
margin-top: 28px;
width: 280px !important;
}
div.donation-level-input-container.form-input {
margin-top: 5px !important;
}
#sidebar {
display: block !important;
clear: both !important;
float: right !important;
background: #FFFFFF !important;
margin-left: 0px !important;
margin-top: 0px !important;
height: auto !important;
border-left: 0px !important;
position: relative !important;
top: 0px !important;
}
#DonorInfoSection {
display: block !important;
float: left !important;
}
#PaymentInfoSection {
height: auto !important;
display: block !important;
float: left !important;
clear: both !important;
}
#ProcessForm {
width: 100% !important;
margin: auto !important;
xborder: 1px solid #FF0000 !important;
}
#level_standard_row {
width: 320px !important;
margin: auto !important;
}
#reqNotice {
margin-top: 0px !important;
padding-top: 0px !important;
}
div#outer-wrapper {
width: 340px !important;
margin: auto;
}
div.donation-form-container.responsive {
width: 300px !important;
}
#subGiftAmts {
margin-top: 15px;
}
#mem-link {
margin-left: 0px;
}
#sidebar {
margin-top: 0px !important;
margin-left: -40px !important;
margin-right: -2px !important;
width: 301px !important;
}
#sidebar p {
padding-top: 15px !important;
text-align: center !important;
}
div#billing_first_name_row,
div#billing_last_name_row,
input[type="text"]#billing_first_namename,
input[type="text"]#billing_last_namename {
display: block !important;
width: 280px !important;
}
input[type="text"]#billing_addr_street1name,
input[type="text"]#billing_addr_street2name,
input[type="text"]#donor_email_addressname {
width: 280px !important;
}
select#billing_addr_country,
select#billing_addr_state {
width: 300px !important;
}
div#billing_addr_city_row,
div#billing_addr_state_row,
input[type="text"]#billing_addr_cityname,
input[type="text"]#billing_addr_zipname,
div#billing_addr_zip_row {
display: block !important;
width: 280px !important;
}
div#responsive_payment_typecc_number_row,
input[type="text"]#responsive_payment_typecc_numbername {
width: 300px !important;
display: block;
}
div#responsive_payment_typecc_exp_date_row {
width: 280px !important;
}
input[type="text"]#responsive_payment_typecc_cvvname {
width: 100px !important;
}
select#responsive_payment_typecc_exp_date_MONTH {
width: 110px !important;
}
select#responsive_payment_typecc_exp_date_YEAR {
width: 110px !important;
}
img#responsive_payment_typecc_type_American_Express {
height: 21px !important;
}
img#responsive_payment_typecc_type_MasterCard {
margin-left: -6px !important;
}
#vSign {}
div.html-caption-container {
max-width: 320px !important;
width: 100% !important;
}
body,
#pagewrap,
#outer {
background-color: #FFFFFF !important;
}
#ProcessForm {
padding-left: 0px !important;
padding-right: 0px !important;
xwidth: 320px !important;
margin: auto !important;
}
#outer {
margin: auto !important;
width: 340px !important;
height: auto !important;
}
.don-standard-levels {
margin-left: 18px;
}
div#responsive_payment_typecc_number_row label {
display: none;
}
div#billing_addr_street2_row div.form-content {
margin-left: 0px !important;
}
#level_standard_row {
width: 320px !important;
}
div.donation-level-container {
width: 70px !important;
margin-right: 0px !important;
}
div.donation-level-user-entered {
margin-top: -20px !important;
xmargin-left: -25px !important;
}
#newOptIn {
margin-top: 10px;
width: 300px !important;
margin-left: 0px !important;
}
#mem-link {
display: block;
}
#mem-link {
display: block;
}
.step-button,
.step-button:hover {
width: 210px !important;
height: 40px !important;
}
#vSign {
left: 190px;
bottom: 55px;
}
#vSign img {
width: 60% !important;
height: auto;
}
}
@media screen and (max-width:1025px) {
/*Email address shift up*/
div#donor_email_address_row {
top: -465px;
}
#reqNotice {
margin-top: 0px !important;
padding-top: 0px !important;
}
div#outer-wrapper {
width: 340px !important;
margin: auto;
}
div.donation-form-container.responsive {
width: 300px !important;
}
#subGiftAmts {
margin-top: 0px;
padding-top: 0px;
}
#mem-link {
margin-left: 0px;
}
#sidebar {
margin-top: 0px !important;
margin-left: -30px !important;
margin-right: 0px !important;
width: 300px !important;
}
#sidebar p {
padding-top: 15px !important;
}
div#billing_first_name_row,
div#billing_last_name_row,
input[type="text"]#billing_first_namename,
input[type="text"]#billing_last_namename {
display: block !important;
width: 280px !important;
}
input[type="text"]#billing_addr_street1name,
input[type="text"]#billing_addr_street2name,
input[type="text"]#donor_email_addressname {
width: 280px !important;
}
select#billing_addr_country,
select#billing_addr_state {
width: 300px !important;
}
div#billing_addr_city_row,
div#billing_addr_state_row,
input[type="text"]#billing_addr_cityname,
input[type="text"]#billing_addr_zipname,
div#billing_addr_zip_row {
display: block !important;
width: 280px !important;
}
div#responsive_payment_typecc_number_row,
input[type="text"]#responsive_payment_typecc_numbername {
width: 300px !important;
display: block;
}
div#responsive_payment_typecc_exp_date_row {
width: 280px !important;
}
input[type="text"]#responsive_payment_typecc_cvvname {
width: 100px !important;
}
select#responsive_payment_typecc_exp_date_MONTH {
width: 110px !important;
}
select#responsive_payment_typecc_exp_date_YEAR {
width: 110px !important;
}
img#responsive_payment_typecc_type_American_Express {
height: 21px !important;
}
img#responsive_payment_typecc_type_MasterCard {
margin-left: -6px !important;
}
#vSign {}
div.html-caption-container {
max-width: 320px !important;
width: 100% !important;
}
body,
#pagewrap,
#outer {
background-color: #FFFFFF !important;
}
#ProcessForm {
padding-left: 0px !important;
padding-right: 0px !important;
xwidth: 320px !important;
margin: auto !important;
}
#outer {
margin: auto !important;
width: 340px !important;
height: auto !important;
}
.don-standard-levels {
margin-left: 18px;
}
div#responsive_payment_typecc_number_row label {
display: none;
}
div#billing_addr_street2_row div.form-content {
margin-left: 0px !important;
}
#level_standard_row {
width: 320px !important;
}
div.donation-level-container {
width: 70px !important;
margin-right: 0px !important;
}
div.donation-level-user-entered {
margin-top: -20px !important;
margin-left: -25px !important;
}
#newOptIn {
margin-top: 10px;
width: 300px !important;
margin-left: 0px !important;
}
#mem-link {
display: block;
}
#mem-link {
display: block;
}
.step-button,
.step-button:hover {
width: 210px !important;
height: 40px !important;
}
#vSign {
left: 190px;
bottom: 55px;
}
#vSign img {
width: 60% !important;
height: auto;
}
}
-->
</style>
<script type="text/javascript">
// <![CDATA[
jQuery.noConflict();
(function($) {
$(document).ready(function() {
//set tab order
$('.donation-level-user-entered input').attr('tabindex', 1);
$('#donor_email_addressname').attr('tabindex', 2);
$('#billing_first_namename').attr('tabindex', 3);
$('#billing_last_namename').attr('tabindex', 4);
$('#billing_addr_street1name').attr('tabindex', 5);
$('#billing_addr_street2name').attr('tabindex', 6);
$('#billing_addr_cityname').attr('tabindex', 7);
$('#billing_addr_state').attr('tabindex', 8);
$('#billing_addr_zipname').attr('tabindex', 9);
$('#billing_addr_country').attr('tabindex', 10);
$('#donor_email_opt_inname').attr('tabindex', 11);
$('.payment-type-label').attr('tabindex', 12);
$('#responsive_payment_typecc_numbername').attr('tabindex', 13);
$('#responsive_payment_typecc_exp_date_MONTH').attr('tabindex', 14);
$('#responsive_payment_typecc_exp_date_YEAR').attr('tabindex', 15);
$('#responsive_payment_typecc_cvvname').attr('tabindex', 16);
$('#captcha_text').attr('tabindex', 17);
$('#pstep_finish').attr('tabindex', 18);
//set placeholder text for other amount field on donation form
$('.donation-level-user-entered input').attr('placeholder', 'Enter gift amount');
$('#billing_first_namename').attr('placeholder', '*First Name');
$('#billing_last_namename').attr('placeholder', '*Last Name');
$('#billing_addr_street1name').attr('placeholder', '*Street 1');
$('#billing_addr_street2name').attr('placeholder', 'Street 2');
$('#billing_addr_cityname').attr('placeholder', '*City');
$('#billing_addr_zipname').attr('placeholder', '*ZIP/Postal Code');
$('#donor_phonename').attr('placeholder', '*Phone Number');
$('#donor_email_addressname').attr('placeholder', '*Email Address');
$('#responsive_payment_typecc_numbername').attr('placeholder', '*Credit Card Number');
$('#responsive_payment_typecc_cvvname').attr('placeholder', '*CVV Number');
$('#billing_addr_country').attr('placeholder', '*Country');
//Add class to monthly giving levels
$('.donation-level-input-container .donation-level-label-container:contains("Other")').parent().parent().parent().parent().removeClass('one-time-level');
//Select Monthly Button by default
//$( "input#giftTypeSelect_1" ).prop( "checked", true ).trigger('change');
//Selects $100 amount as the default value
if ($("#giftTypeSelect_0").is(":checked")) {
//$('.otherInput').val('');
//$( "input[id='level_single100']" ).prop( "checked", true );
$("label[for='level_single50'] div").removeClass("active");
$("label[for='level_single250'] div").removeClass("active");
$("label[for='level_single500'] div").removeClass("active");
$("label[for='level_single1000'] div").removeClass("active");
$("label[for='level_single100'] div").addClass("active");
}
if ($("#giftTypeSelect_1").is(":checked")) {
//$('.otherInput').val('');
//$( "input[id='level_monthly35']" ).prop( "checked", true );
$("label[for='level_monthly50'] div").removeClass("active");
$("label[for='level_monthly100'] div").removeClass("active");
$("label[for='level_monthly10'] div").removeClass("active");
$("label[for='level_monthly25'] div").removeClass("active");
$("label[for='level_monthly35'] div").addClass("active");
}
$('#giftTypeSelect_0').click(function() {
//$('.otherInput').val('');
//$( "input[id='level_single100']" ).prop( "checked", true );
$("label[for='level_single50'] div").removeClass("active");
$("label[for='level_single250'] div").removeClass("active");
$("label[for='level_single500'] div").removeClass("active");
$("label[for='level_single1000'] div").removeClass("active");
$("label[for='level_single100'] div").addClass("active");
});
$('#giftTypeSelect_1').click(function() {
//$('.otherInput').val('');
//$( "input[id='level_monthly35']" ).prop( "checked", true );
$("label[for='level_monthly50'] div").removeClass("active");
$("label[for='level_monthly100'] div").removeClass("active");
$("label[for='level_monthly10'] div").removeClass("active");
$("label[for='level_monthly25'] div").removeClass("active");
$("label[for='level_monthly35'] div").addClass("active");
});
//Add class to selected donation level
$('.newLevelAmount').click(function() {
$(".otherInput.active").removeClass("active");
$(".newLevelAmount.active").removeClass("active");
$(this).addClass('active');
if (!$('.otherInput').parent().hasClass('active')) {
$('.otherInput input[type="text"]').val('');
}
});
//for captcha
$('#captcha_row').appendTo('.payment-type-element-container');
$('.otherInput').click(function() {
$(".newLevelAmount.active").removeClass("active");
$(this).addClass('active');
if (!$('.otherInput').parent().hasClass('active')) {
$('.otherInput input[type="text"]').val('');
}
});
//add $ to other amount
$('.otherInput').change(function() {
var thisAmt = $(this).val();
console.log(thisAmt);
if (thisAmt.toString().indexOf('$') == -1) {
$(".otherInput").val("$" + thisAmt);
}
if (thisAmt < 5) {
alert("$5.00 Minimum is required.")
$(".otherInput").val('$5.00').trigger('change');
}
});
// $('#donor_email_addressname').keyup(function() {
// var textarea_value = $("#donor_email_addressname").val();
// if(textarea_value=='yopmail') {
// $('#pstep_finish').prop("disabled", true);
// }
// });
// $('#donor_email_addressname').keyup(function() {
// $('#donor_email_addressname:contains(opmail)').css("display", "none");
//
// });
});
})(jQuery);
// ]]>
</script>
<h2 id="secOneHeader" class="ddSectionHead section-header-font">Choose your donation amount and it can be matched up to our goal of $500,000!</h2>
<div id="giftSelectContain">
<div id="giftTypeIntro"></div>
<div id="giftSelector"><input type="radio" name="giftTypeSelect" value="single" id="giftTypeSelect_0"><label for="giftTypeSelect_0"><img src="../images/content/pagebuilder/trans-spacer.gif" class="radio_spacer_0"></label><input
type="radio" name="giftTypeSelect" value="monthly" id="giftTypeSelect_1"><label for="giftTypeSelect_1"><img src="../images/content/pagebuilder/trans-spacer.gif" class="radio_spacer_1"></label></div>
<div><img src="../images/content/pagebuilder/sit_back_arrow.png" class="sit_back"></div>
</div>
<div class="monthlyLevels" style="display: none;">
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="100" id="level_monthly100"><label for="level_monthly100">
<div class="newLevelAmount">$100</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="50" id="level_monthly50"><label for="level_monthly50">
<div class="newLevelAmount">$50</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="35" id="level_monthly35"><label for="level_monthly35">
<div class="newLevelAmount">$35</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="25" id="level_monthly25"><label for="level_monthly25">
<div class="newLevelAmount">$25</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="10" id="level_monthly10"><label for="level_monthly10">
<div class="newLevelAmount">$10</div>
</label></div>
<div class="newLevel"><input class="otherRadio" type="radio" name="new_level" value="other" id="level_monthlyOther"><label for="level_monthlyOther"><input class="otherInput" type="text" name="new_level_other" id="level_monthlyOtherAmount"
placeholder="Enter gift amount" value="" size="12"></label></div>
</div>
<div class="singleLevels">
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="65" id="level_single65"><label for="level_single65">
<div class="newLevelAmount">$65</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="125" id="level_single125"><label for="level_single125">
<div class="newLevelAmount">$125</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="250" id="level_single250"><label for="level_single250">
<div class="newLevelAmount">$250</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="500" id="level_single500"><label for="level_single500">
<div class="newLevelAmount">$500</div>
</label></div>
<div class="newLevel"><input class="amountRadio" type="radio" name="new_level" value="1000" id="level_single1000"><label for="level_single1000">
<div class="newLevelAmount">$1000</div>
</label></div>
<div class="newLevel"><input class="otherRadio" type="radio" name="new_level" value="other" id="level_singleOther"><label for="level_singleOther"><input class="otherInput active" type="text" name="new_level_other"
id="level_singleOtherAmount" placeholder="Enter gift amount" value="" size="12"></label></div>
</div>
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<div>
<div id="subGiftAmts">Or: <table style="display: inline;" border="0" cellspacing="0" cellpadding="0">
<tbody>
<tr>
<td style="line-height: 18px; display: inline;">
<a id="mem-link" href="Donation2?df_id=26737&mfc_pref=T&26737.donation=form1">Make a memorial or tribute gift</a><a id="corp-link" href="Donation2?df_id=10239&10239.donation=form1">Give on behalf of a corporation</a>
</td>
</tr>
</tbody>
</table>
</div>
<p id="reqNotice"><br>*Indicates a required field.</p>
</div>
<!-- start personal info section -->
<div id="DonorInfoSection">
<h2 class="ddSectionHead" style="color: #0562af;">Billing Information</h2>
<div id="billing_first_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name:</label>
<input type="text" name="billing_first_namename" id="billing_first_namename" value="" maxlength="50" tabindex="3" placeholder="*First Name">
<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_last_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name:</label>
<input type="text" name="billing_last_namename" id="billing_last_namename" value="" maxlength="50" tabindex="4" placeholder="*Last Name">
<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_addr_street1_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street 1:</label>
<input type="text" name="billing_addr_street1name" id="billing_addr_street1name" value="" maxlength="50" tabindex="5" placeholder="*Street 1">
<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_addr_street2_row" class="form-row form-text">
<div class="form-content" style="margin-left: 9px;">
<label for="billing_addr_street2name">Street 2:</label>
<input type="text" name="billing_addr_street2name" id="billing_addr_street2name" value="" maxlength="50" tabindex="6" placeholder="Street 2">
<input type="hidden" name="billing_addr_street2submit" id="billing_addr_street2submit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_addr_city_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City:</label>
<input type="text" name="billing_addr_cityname" id="billing_addr_cityname" value="" maxlength="50" tabindex="7" placeholder="*City">
<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_addr_state_row" class="form-row form-selectlist">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_state">*State/Province:</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" onchange="fire_obs_comp_event('billing_addr_state', this)" tabindex="8">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option selected="selected" value="None">None</option>
</select>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_addr_zip_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">ZIP/Postal Code:</label>
<input type="text" name="billing_addr_zipname" id="billing_addr_zipname" value="" maxlength="50" tabindex="9" placeholder="*ZIP/Postal Code">
<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="billing_addr_country_row" class="form-row form-selectlist">
<div class="form-content" style="margin-left: 9px;">
<label class="FormLabel" for="billing_addr_country">*Country:</label>
<select name="billing_addr_country" id="billing_addr_country" size="1" onchange="fire_obs_comp_event('billing_addr_country', this)" tabindex="10" placeholder="*Country">
<option></option>
<option selected="selected" value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivarian Republic of Venezuela">Bolivarian Republic of Venezuela</option>
<option value="Bonaire, Sint Eustatios and Saba">Bonaire, Sint Eustatios and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Democratic People's Republic of Korea">Democratic People's Republic of Korea</option>
<option value="The Democratic Republic of the Congo">The Democratic Republic of the Congo</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="The Former Yugoslav Republic of Macedonia">The Former Yugoslav Republic of Macedonia</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Islamic Republic of Iran">Islamic Republic of Iran</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos People's Democratic Republic">Laos People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Plurinational State of Bolivia">Plurinational State of Bolivia</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Korea">Republic of Korea</option>
<option value="Republic of Moldova">Republic of Moldova</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French)">Saint Martin (French)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls.</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch)">Sint Maarten (Dutch)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United Republic of Tanzania">United Republic of Tanzania</option>
<option value="Uruguay">Uruguay</option>
<option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_countrysubmit" id="billing_addr_countrysubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="donor_email_address_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">Email Address:</label>
<input type="text" name="donor_email_addressname" id="donor_email_addressname" value="" maxlength="255" tabindex="2" placeholder="*Email Address">
<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div class="form-row form-checkbox" id="donor_email_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="checkbox" name="donor_email_opt_inname" id="donor_email_opt_inname" onclick="fire_obs_comp_event('donor_email_opt_in', this);" tabindex="11">
<label for="donor_email_opt_inname"> Yes, I would like to receive communication from this organization. </label>
<noscript> </noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true">
</div>
</div>
<div id="donor_remember_me_row" class="form-row form-checkbox">
<div class="form-content">
<input type="checkbox" name="donor_remember_mename" id="donor_remember_mename" checked="checked" onclick="fire_obs_comp_event('donor_remember_me', this);">
<label for="donor_remember_mename">Remember Me</label>
<input type="hidden" name="donor_remember_mesubmit" id="donor_remember_mesubmit" value="true">
<noscript> </noscript>
</div>
</div>
</div>
<!-- end personal info section --> <!-- start payment info section -->
<div id="PaymentInfoSection">
<h2 id="paySectionHead" class="ddSectionHead">Payment Information</h2>
<div class="payment-type-element-container">
<div class="payment-type-selection-container payment-field-container">
<label>Method of Payment</label>
<div id="responsive_payment_typepay_typeradio_row" class="form-row">
<div class="form-content">
<div class="payment-type-selections" id="responsive_payment_typepay_typeradio_payment_types">
<span class="internal-payment"><span class="payment-type-option selected"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiocredit" value="credit" checked="checked"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiocredit"><a href="javascript:void(0);" class="payment-type-label" tabindex="12">Credit Card</a></label><noscript> </noscript></span></span>
<span class="external-payment"><span class="payment-type-option"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiopaypal" value="paypal"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiopaypal"><a href="javascript:void(0);" class="payment-type-label" tabindex="12"><img src="../images/payment/paypal-logo.png" alt="Pay with Paypal"></a></label><noscript> </noscript></span></span>
</div>
<input type="hidden" name="responsive_payment_typepay_typeradiosubmit" id="responsive_payment_typepay_typeradiosubmit" value="true">
<noscript> </noscript>
</div>
</div>
</div>
<div id="payment_cc_container" class="payment-field-container">
<label id="cardsAccept">Cards Accepted:</label>
<div id="responsive_payment_typecc_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="responsive_payment_typecc_type_Discover" id="responsive_payment_typecc_type_Discover">
</li>
<li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="responsive_payment_typecc_type_American_Express" id="responsive_payment_typecc_type_American_Express">
</li>
<li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="responsive_payment_typecc_type_MasterCard" id="responsive_payment_typecc_type_MasterCard">
</li>
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="responsive_payment_typecc_type_Visa" id="responsive_payment_typecc_type_Visa">
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_typesubmit" id="responsive_payment_typecc_typesubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label>Card Number:</label>
<input type="text" name="responsive_payment_typecc_numbername" id="responsive_payment_typecc_numbername" value="" maxlength="22" autocomplete="off" tabindex="13" placeholder="*Credit Card Number">
<input type="hidden" name="responsive_payment_typecc_numbersubmit" id="responsive_payment_typecc_numbersubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_exp_date_row" class="form-row form-date">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_exp_date_MONTH">
<span class="label-text">Expiration Date:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="responsive_payment_typecc_exp_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<fieldset class="cardExpGroup">
<select name="responsive_payment_typecc_exp_date_MONTH" id="responsive_payment_typecc_exp_date_MONTH" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_MONTH', this)" tabindex="14">
<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" selected="selected">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="responsive_payment_typecc_exp_date_YEAR" id="responsive_payment_typecc_exp_date_YEAR" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_YEAR', this)" tabindex="15">
<option value="2022" selected="selected">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
</select>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_exp_date_DAY" id="responsive_payment_typecc_exp_date_DAY" value="1">
<noscript> </noscript>
</div>
<input type="hidden" name="responsive_payment_typecc_exp_datesubmit" id="responsive_payment_typecc_exp_datesubmit" value="true">
<noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_cvv_row" class="form-row form-text cvv-input">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_cvvname">
<span class="FormLabelText">CVV Number:</span>
</label>
<input type="text" name="responsive_payment_typecc_cvvname" id="responsive_payment_typecc_cvvname" value="" maxlength="4" autocomplete="cc-csc" tabindex="16" placeholder="*CVV Number">
<input type="hidden" name="responsive_payment_typecc_cvvsubmit" id="responsive_payment_typecc_cvvsubmit" value="true">
<noscript> </noscript>
</div>
<a href="http://help.convio.net/site/PageServer?s_site=amca&pagename=user_donation_cvv" class="HelpLink ccHelp" title="What is this? Opens new window.">What is this?</a>
</div>
</div>
<div id="payment_check_container" class="payment-field-container" style="display: none;">
<h3>Check Information</h3>
</div>
<input type="hidden" name="responsive_payment_typesubmit" id="responsive_payment_typesubmit" value="true">
<noscript> </noscript>
</div>
<div class="button-container clearfix">
<div class="button-sub-container">
<button class="step-button action-button finish-step" type="submit" id="pstep_finish" name="pstep_finish" value="Donate Today" tabindex="18">Donate Today</button>
</div>
</div>
<div id="vSign">
<div id="vs_seal">
<br>
</div>
</div>
</div>
<!-- end payment info section --><!-- start dd other label swap -->
<style type="text/css">
<!--
label[for='level_standardauto_repeatname'] {
font-size: 0;
}
label[for='level_standardauto_repeatname']:before {
content: "Yes, I want to help throughout the year. Make my gift monthly!";
font-size: 13px;
}
-->
</style>
<p>
<style type="text/css">
/* start test for global other amount label swap found in dd_global_other_label_patch reus comp */
div.donation-level-user-entered input {
position: relative;
bottom: 3px !important;
}
div.donation-level-input-container.form-input {
width: 333px;
}
#level_standard_row label {
margin-right: 0px !important;
}
label+div.donation-level-user-entered {
right: 0px;
bottom: 0px;
}
@media (min-width: 320px) {
div.donation-level-user-entered input {
width: 192px;
float: left;
right: 0px;
margin-left: 25px;
margin-top: 10px;
}
div.donation-level-container {
width: 95px;
}
div.donation-level-container:last-child {
width: 299px;
}
}
@media (min-width: 961px) {
div.donation-level-user-entered input {
width: 48px;
float: right;
right: 0px;
margin-left: 0px;
margin-top: 0px;
}
div.donation-level-container {
width: 85px;
}
div.donation-level-container:last-child {
width: 331px;
}
}
@media (min-width: 1025px) {
#AmountSection {
width: 719px;
}
div.donation-level-user-entered input {
width: 48px;
float: right;
margin-right: 14px;
margin-left: 0px;
margin-top: 0px;
}
div.donation-level-container {
width: 72px;
}
.lrgform {
width: 720px !important;
}
div.donation-level-container:last-child {
width: 331px;
}
}
/* end test for global other amount label swap */
</style>
<script type="text/javascript">
var jqos = jQuery.noConflict();
jqos(document).ready(function() {
jqos("div.donation-level-user-entered").closest("div.donation-level-input-container.form-input").addClass("newOtherLabel");
jqos("div.donation-level-input-container.form-input.newOtherLabel div.donation-level-label-container").html("Your most generous amount");
});
</script>
</p>
<p> </p>
<p> </p>
<!-- end dd other label swap -->
</div>
</div>
<div class="form-row">
<div class="html-caption-container">
<h3>Individual gifts under $10,000 are eligible to be matched.</h3>
</div>
</div>
<input type="hidden" name="idb" id="idb" value="1004672706">
<input type="hidden" name="df_id" id="df_id" value="28147">
<input type="hidden" name="mfc_pref" id="mfc_pref" value="T">
</div>
<input type="hidden" name="28147.donation" id="28147.donation" value="form1">
</div>
<script type="text/javascript">
var submitted = false;
function checkDoubleClick() {
var elCheck = '';
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Need help with your transaction? Our support team would love to assist you. Please call 800-905-1082 or email us at info@americares.org. Your Gift Matched 2x! Create brighter futures through better health! Make a lifelong impact by helping us deliver critical medicines, aid and supplies to those that have been impacted by extreme weather, poverty, disaster and more. Field Is Required Enter A Gift Amount: $10 $25 $50 $100 $250 Your most generous amount Enter amount Yes, automatically repeat this gift every month. CHOOSE YOUR DONATION AMOUNT AND IT CAN BE MATCHED UP TO OUR GOAL OF $500,000! $100 $50 $35 $25 $10 $65 $125 $250 $500 $1000 Or: Make a memorial or tribute giftGive on behalf of a corporation *Indicates a required field. 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Georgia & S. Sandwich Isls. Sierra Leone Singapore Sint Maarten (Dutch) Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania Uruguay USA Minor Outlying Islands Uzbekistan Vanuatu Viet Nam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Required Email Address: Yes, I would like to receive communication from this organization. Remember Me PAYMENT INFORMATION Method of Payment Credit Card Cards Accepted: Credit Card Type: * * * * Card Number: Expiration Date:Select month of credit card Select Expiration Year 01 02 03 04 05 06 07 08 09 10 11 12 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 CVV Number: What is this? CHECK INFORMATION Donate Today INDIVIDUAL GIFTS UNDER $10,000 ARE ELIGIBLE TO BE MATCHED. You Can Trust Us Donate with confidence. More than 98% of our resources support health programs. Less than 2% are used for administration and overhead. For over four decades, Americares has been leading the charge to support accessible, reliable health care to people affected by poverty or disaster. But we would not be able to provide life-changing health programs, medicine and medical supplies to millions without your generous support. If you donate today your gift will be 2x matched to make a lifelong impact on underserved and underrepresented communities because better health makes everything possible. Americares respects your privacy and works to ensure your information is kept confidential. By making a donation to Americares, you are giving your consent to share your name, email and/or postal address with other similar charitable non-profit organizations through third-party fundraising vendors, to whom we will also provide additional information regarding your digital donation history. Should you not wish your information to be shared with other organizations at any time, please email info@americares.org and we will ensure your name, email and/or postal address is not shared. For more information, please see the following section of our Privacy Policy and our website’s Terms of Use. About Us | Privacy Policy | Contact Us | Frequently Asked Questions | Legal Disclosures 88 Hamilton Avenue, Stamford, CT 06902 (800) 486‑HELP · (203) 658‑9500 info@americares.org Americares is approved by the Internal Revenue Service as a 501(c)(3) tax-exempt organization, and all donations are tax deductible to the extent provided by law. Americares Federal Identification Number (EIN) is 061008595. Health Is On The Way is a trademark of Tandigm Health, LLC. Americares is a Member of Reuters Alertnet. © 2022 Americares. All Rights Reserved. BACK To Homepage