hatzalahthon.com Open in urlscan Pro
188.114.97.3 Public Scan

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Submitted URL:
http://ourhatzolah.org/
Effective URL:
https://hatzalahthon.com/hcj/
Submission: On May 19 via api (May 19th 2024, 7:55:24 pm UTC) from BE — Scanned from DE

Form analysis
30 forms found in the DOM

<form class="flex items-center space-x-5 rtl:space-x-reverse">
  <div class="relative max-w-xs"><input type="text" placeholder="Search"
      class="w-full px-5 text-sm text-[color:var(--teams-donations-field-text)] placeholder-[color:var(--teams-donations-field-text)] border-none rounded-full h-9 bg-[color:var(--teams-donations-field-background)] focus:ring-[color:var(--teams-donations-field-border)] focus:ring-2"><button
      class="absolute top-0 flex items-center justify-center w-9 h-9 focus:outline-none text-[color:var(--teams-donations-field-icon)] hover:text-[color:var(--teams-donations-field-icon-hover)] right-0"><svg viewBox="0 0 124.524 124.524"
        class="w-4 h-4">
        <path fill="currentColor"
          d="M51 102.05c10.5 0 20.2-3.2 28.3-8.6l29.3 29.3c2.301 2.3 6.101 2.3 8.5 0l5.7-5.7c2.3-2.3 2.3-6.1 0-8.5l-29.4-29.2c5.399-8.1 8.6-17.8 8.6-28.3 0-28.1-22.9-51-51-51s-51 22.9-51 51c0 28.099 22.8 51 51 51zm0-82c17.1 0 31 13.9 31 31s-13.9 31-31 31-31-13.9-31-31 13.9-31 31-31z">
        </path>
      </svg></button></div>
  <div class="flex items-center max-w-xs"><span class="text-sm font-bold uppercase whitespace-nowrap text-[color:var(--teams-donations-field-label)]">Sort By</span><select name="sort"
      class="w-40 px-5 ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--teams-donations-field-text)] placeholder-[color:var(--teams-donations-field-text)] border-none rounded-full h-9 bg-[color:var(--teams-donations-field-background)] focus:ring-[color:var(--teams-donations-field-border)] focus:ring-2"
      style="">
      <option value="name">Team Name</option>
      <option value="biggest_goal">Highest Goal</option>
      <option value="smallest_goal">Lowest Goal</option>
      <option value="most_raised">Most Raised</option>
      <option value="least_raised">Least Raised</option>
      <option value="nearest_to_goal">Nearest to Goal</option>
      <option value="most_donors">Most Donors</option>
      <option value="least_donors">Least Donors</option>
    </select></div>
</form>

<form class="flex items-center space-x-5 rtl:space-x-reverse">
  <div class="relative w-7/12 max-w-xs"><input type="text" placeholder="Search"
      class="w-full px-5 text-sm text-[color:var(--teams-donations-field-text)] placeholder-[color:var(--teams-donations-field-text)] border-none rounded-full h-9 bg-[color:var(--teams-donations-field-background)] focus:ring-[color:var(--teams-donations-field-border)] focus:ring-2"><button
      class="absolute top-0 flex items-center justify-center w-9 h-9 focus:outline-none text-[color:var(--teams-donations-field-icon)] hover:text-[color:var(--teams-donations-field-icon-hover)] right-0"><svg viewBox="0 0 124.524 124.524"
        class="w-4 h-4">
        <path fill="currentColor"
          d="M51 102.05c10.5 0 20.2-3.2 28.3-8.6l29.3 29.3c2.301 2.3 6.101 2.3 8.5 0l5.7-5.7c2.3-2.3 2.3-6.1 0-8.5l-29.4-29.2c5.399-8.1 8.6-17.8 8.6-28.3 0-28.1-22.9-51-51-51s-51 22.9-51 51c0 28.099 22.8 51 51 51zm0-82c17.1 0 31 13.9 31 31s-13.9 31-31 31-31-13.9-31-31 13.9-31 31-31z">
        </path>
      </svg></button></div>
  <div class="flex items-center w-5/12 max-w-xs"><select name="sort"
      class="w-40 px-5 ml-2 text-sm text-[color:var(--teams-donations-field-text)] placeholder-[color:var(--teams-donations-field-text)] border-none rounded-full h-9 bg-[color:var(--teams-donations-field-background)] focus:ring-[color:var(--teams-donations-field-border)] focus:ring-2"
      style="">
      <option value="newest">Newest</option>
      <option value="oldest">Oldest</option>
      <option value="highest">Highest</option>
      <option value="lowest">Lowest</option>
    </select></div>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button></div>
    <div class="flex items-center justify-center mt-4"><button type="button"
        class="flex items-center text-sm font-black uppercase text-[color:var(--donate-product-load-more)] hover:text-[color:var(--donate-product-load-more-hover)] space-x-2 rtl:space-x-reverse"><span>Load More</span><svg viewBox="0 -93 512 512"
          xmlns="http://www.w3.org/2000/svg" class="w-3 h-3">
          <path fill="currentColor" d="M441.668 0 256 185.668 70.332 0 0 70.332l256 256 256-256zm0 0"></path>
        </svg></button></div>
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$0.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!----><!---->
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button></div>
    <div class="flex items-center justify-center mt-4"><button type="button"
        class="flex items-center text-sm font-black uppercase text-[color:var(--donate-product-load-more)] hover:text-[color:var(--donate-product-load-more-hover)] space-x-2 rtl:space-x-reverse"><span>Load More</span><svg viewBox="0 -93 512 512"
          xmlns="http://www.w3.org/2000/svg" class="w-3 h-3">
          <path fill="currentColor" d="M441.668 0 256 185.668 70.332 0 0 70.332l256 256 256-256zm0 0"></path>
        </svg></button></div>
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$0.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!----><!---->
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($90,000.00)</option>
              <option value="3">Divide donation by 3 months ($60,000.00)</option>
              <option value="4">Divide donation by 4 months ($45,000.00)</option>
              <option value="5">Divide donation by 5 months ($36,000.00)</option>
              <option value="6">Divide donation by 6 months ($30,000.00)</option>
              <option value="7">Divide donation by 7 months ($25,714.29)</option>
              <option value="8">Divide donation by 8 months ($22,500.00)</option>
              <option value="9">Divide donation by 9 months ($20,000.00)</option>
              <option value="10">Divide donation by 10 months ($18,000.00)</option>
              <option value="11">Divide donation by 11 months ($16,363.64)</option>
              <option value="12">Divide donation by 12 months ($15,000.00)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$180,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$180,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($18,000.00)</option>
              <option value="3">Divide donation by 3 months ($12,000.00)</option>
              <option value="4">Divide donation by 4 months ($9,000.00)</option>
              <option value="5">Divide donation by 5 months ($7,200.00)</option>
              <option value="6">Divide donation by 6 months ($6,000.00)</option>
              <option value="7">Divide donation by 7 months ($5,142.86)</option>
              <option value="8">Divide donation by 8 months ($4,500.00)</option>
              <option value="9">Divide donation by 9 months ($4,000.00)</option>
              <option value="10">Divide donation by 10 months ($3,600.00)</option>
              <option value="11">Divide donation by 11 months ($3,272.73)</option>
              <option value="12">Divide donation by 12 months ($3,000.00)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$36,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$36,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($1,800.00)</option>
              <option value="3">Divide donation by 3 months ($1,200.00)</option>
              <option value="4">Divide donation by 4 months ($900.00)</option>
              <option value="5">Divide donation by 5 months ($720.00)</option>
              <option value="6">Divide donation by 6 months ($600.00)</option>
              <option value="7">Divide donation by 7 months ($514.29)</option>
              <option value="8">Divide donation by 8 months ($450.00)</option>
              <option value="9">Divide donation by 9 months ($400.00)</option>
              <option value="10">Divide donation by 10 months ($360.00)</option>
              <option value="11">Divide donation by 11 months ($327.27)</option>
              <option value="12">Divide donation by 12 months ($300.00)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$3,600.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$3,600.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($187,500.00)</option>
              <option value="3">Divide donation by 3 months ($125,000.00)</option>
              <option value="4">Divide donation by 4 months ($93,750.00)</option>
              <option value="5">Divide donation by 5 months ($75,000.00)</option>
              <option value="6">Divide donation by 6 months ($62,500.00)</option>
              <option value="7">Divide donation by 7 months ($53,571.43)</option>
              <option value="8">Divide donation by 8 months ($46,875.00)</option>
              <option value="9">Divide donation by 9 months ($41,666.67)</option>
              <option value="10">Divide donation by 10 months ($37,500.00)</option>
              <option value="11">Divide donation by 11 months ($34,090.91)</option>
              <option value="12">Divide donation by 12 months ($31,250.00)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$375,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$375,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($60,000.00)</option>
              <option value="3">Divide donation by 3 months ($40,000.00)</option>
              <option value="4">Divide donation by 4 months ($30,000.00)</option>
              <option value="5">Divide donation by 5 months ($24,000.00)</option>
              <option value="6">Divide donation by 6 months ($20,000.00)</option>
              <option value="7">Divide donation by 7 months ($17,142.86)</option>
              <option value="8">Divide donation by 8 months ($15,000.00)</option>
              <option value="9">Divide donation by 9 months ($13,333.33)</option>
              <option value="10">Divide donation by 10 months ($12,000.00)</option>
              <option value="11">Divide donation by 11 months ($10,909.09)</option>
              <option value="12">Divide donation by 12 months ($10,000.00)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$120,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$120,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($25,000.00)</option>
              <option value="3">Divide donation by 3 months ($16,666.67)</option>
              <option value="4">Divide donation by 4 months ($12,500.00)</option>
              <option value="5">Divide donation by 5 months ($10,000.00)</option>
              <option value="6">Divide donation by 6 months ($8,333.33)</option>
              <option value="7">Divide donation by 7 months ($7,142.86)</option>
              <option value="8">Divide donation by 8 months ($6,250.00)</option>
              <option value="9">Divide donation by 9 months ($5,555.56)</option>
              <option value="10">Divide donation by 10 months ($5,000.00)</option>
              <option value="11">Divide donation by 11 months ($4,545.45)</option>
              <option value="12">Divide donation by 12 months ($4,166.67)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$50,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$50,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($17,500.00)</option>
              <option value="3">Divide donation by 3 months ($11,666.67)</option>
              <option value="4">Divide donation by 4 months ($8,750.00)</option>
              <option value="5">Divide donation by 5 months ($7,000.00)</option>
              <option value="6">Divide donation by 6 months ($5,833.33)</option>
              <option value="7">Divide donation by 7 months ($5,000.00)</option>
              <option value="8">Divide donation by 8 months ($4,375.00)</option>
              <option value="9">Divide donation by 9 months ($3,888.89)</option>
              <option value="10">Divide donation by 10 months ($3,500.00)</option>
              <option value="11">Divide donation by 11 months ($3,181.82)</option>
              <option value="12">Divide donation by 12 months ($2,916.67)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$35,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$35,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$20,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($10,000.00)</option>
              <option value="3">Divide donation by 3 months ($6,666.67)</option>
              <option value="4">Divide donation by 4 months ($5,000.00)</option>
              <option value="5">Divide donation by 5 months ($4,000.00)</option>
              <option value="6">Divide donation by 6 months ($3,333.33)</option>
              <option value="7">Divide donation by 7 months ($2,857.14)</option>
              <option value="8">Divide donation by 8 months ($2,500.00)</option>
              <option value="9">Divide donation by 9 months ($2,222.22)</option>
              <option value="10">Divide donation by 10 months ($2,000.00)</option>
              <option value="11">Divide donation by 11 months ($1,818.18)</option>
              <option value="12">Divide donation by 12 months ($1,666.67)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$20,000.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$20,000.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="space-y-7">
  <div>
    <div class="grid grid-cols-1 gap-2 px-5 md:grid-cols-2 md:px-10"><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/63dc70c9b1658ed37b28e4965ca63529/Equipment9.jpg" alt="Parnes Hashanah" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hashanah</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$180,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/9aca4bae7dbfe7768fbd1bcc2c9c241c/Equipment8.jpg" alt="Parnes Hachodesh" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hachodesh</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$36,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/a7fd39402a8856b4c9cbac429cbe4a62/Equipment7.jpg" alt="Parnes Hayom" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Parnes Hayom</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$3,600</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/06fb0a7943c2d9bf2cccd493de8e2119/Equipment.jpg" alt="Ambulance" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Ambulance</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$375,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/420987fe9ec51a17011e67518d0a302d/Equipment2.jpg" alt="Radio Tower" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Radio Tower</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$120,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/c39e050f5a38891a9e583733a7b30346/Equipment6.jpg" alt="Power Stretcher System" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Power Stretcher System</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$50,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/89698a898733bc145e67fc6055c2a0d5/Equipment4.jpg" alt="Lifepak 15" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Lifepak 15</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$35,000</p><!---->
        </div>
      </button><button type="button"
        class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse border-[color:var(--donate-product-border)] bg-[color:var(--donate-product-background)] hover:border-[color:var(--donate-product-border-hover)] hover:bg-[color:var(--donate-product-background-hover)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/3838875cdb07d622dc7a85f8da8784f5/Thumper.jpg" alt="Thumper" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)]">Thumper</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1">$20,000</p><!---->
        </div>
      </button><button type="button" class="flex p-3 space-x-3 border border-solid group rtl:space-x-reverse bg-[color:var(--donate-product-background-selected)] border-[color:var(--donate-product-border-selected)]">
        <div class="flex-shrink-0 w-12 h-12 overflow-hidden rounded-full"><img src="https://dkjwlbczp41r0.cloudfront.net/media/cd5568ea92b63e52fc5ea3fada0e854b/Equipment3.jpg" alt="EMT Bag" class="object-cover w-full h-full"></div>
        <div class="flex-1 ltr:text-left rtl:text-right">
          <h3 class="text-sm font-black text-[color:var(--donate-product-title)] text-[color:var(--donate-product-title-selected)]">EMT Bag</h3>
          <p class="text-[color:var(--donate-product-text)] font-light mt-1 text-[color:var(--donate-product-text-selected)]">$7,200</p><!---->
        </div>
      </button></div><!---->
  </div>
  <div class="bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] py-7 px-5 md:px-10">
    <div class="space-y-3 md:flex md:space-y-0 md:space-x-5 md:rtl:space-x-reverse">
      <div class="w-full md:w-1/2">
        <h3 class="text-xs font-bold text-center uppercase">Your Amount</h3>
        <div class="flex items-center h-16 mt-1 text-[color:var(--donate-amount-field-text)] bg-[color:var(--donate-amount-field-background)] rounded-md" dir="ltr">
          <div class="relative z-10 flex-shrink-0"><button type="button" class="flex items-center" disabled="" tabindex="-1">
              <div class="flex flex-col items-center justify-center w-16 h-16">
                <div class="text-3xl font-bold">$</div>
                <p class="text-xs uppercase text-light">USD</p>
              </div><!---->
            </button>
            <div class="absolute p-2 mt-1 space-y-2 bg-[color:var(--donate-amount-field-background)] rounded-md top-full shadow-box scale-100 translate-y-0 opacity-100" style="display: none;"><button type="button" tabindex="-1"
                class="flex w-full items-center px-2 py-2 space-x-2 rounded-md hover:bg-[color:var(--donate-amount-section-background)] text-[color:var(--donate-amount-section-text)] bg-[color:var(--donate-amount-section-background)]">
                <div class="text-xl font-bold">$</div>
                <p class="text-lg uppercase text-light">USD</p>
              </button></div>
          </div>
          <div class="flex-1 h-full"><input type="tel" class="w-full h-full pr-0 text-3xl text-right bg-transparent border-none outline-none focus:outline-none focus:ring-0 text-[color:var(--donate-amount-field-text)]" maxlength="7"></div>
          <div class="flex-shrink-0 pr-5 text-3xl">.00</div>
        </div><!----><!---->
        <div class="mt-5">
          <h3 class="text-xs font-bold text-center uppercase">Donate in Installments</h3>
          <div class="h-12 mt-1"><select class="w-full bg-[color:var(--donate-amount-field-background)] text-[color:var(--donate-amount-field-text)] border-none rounded-md focus:ring-0" style="">
              <option value="1">No Installments</option>
              <option value="2">Divide donation by 2 months ($3,600.00)</option>
              <option value="3">Divide donation by 3 months ($2,400.00)</option>
              <option value="4">Divide donation by 4 months ($1,800.00)</option>
              <option value="5">Divide donation by 5 months ($1,440.00)</option>
              <option value="6">Divide donation by 6 months ($1,200.00)</option>
              <option value="7">Divide donation by 7 months ($1,028.57)</option>
              <option value="8">Divide donation by 8 months ($900.00)</option>
              <option value="9">Divide donation by 9 months ($800.00)</option>
              <option value="10">Divide donation by 10 months ($720.00)</option>
              <option value="11">Divide donation by 11 months ($654.55)</option>
              <option value="12">Divide donation by 12 months ($600.00)</option>
            </select></div>
        </div><!---->
      </div>
      <div class="w-full md:w-1/2 overflow-hidden rounded-md bg-[color:var(--donate-organization-background)]">
        <p class="px-5 mt-6 text-lg text-center">Hatzolah of Central Jersey</p>
        <p class="px-5 mt-1 text-xs text-center">will receive</p>
        <div class="py-2 mt-2 text-center text-[color:var(--donate-amount-text)] bg-[color:var(--donate-amount-background)]">
          <div class="text-3xl font-bold text-white">$7,200.00 USD</div><!----><!---->
        </div><!---->
      </div>
    </div><!----><!---->
  </div><!---->
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="px-5 space-y-4 md:px-10">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="first_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">First Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="first_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="last_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Last Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="last_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="display_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Display Name <span class="text-[color:var(--field-label-star)]">*</span></label>
      <div class="relative mt-2"><!----><input type="text" inputmode="text" name="display_name"
          class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
      </div><!---->
    </div>
    <div><label dir="ltr" class="flex items-center cursor-pointer"><input type="checkbox" name="anonymous" class="w-4 h-4 bg-[color:var(--field-background)] border-0 rounded text-[color:var(--field-border)] focus:ring-0 focus:ring-offset-0"><span
          class="ltr:ml-2 rtl:mr-2 text-sm text-[color:var(--field-label)]">I would like to donate anonymously</span></label><!----></div>
    <div class="flex flex-col w-full"><label for="dedication_message" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Message or Dedication <!----></label><textarea name="dedication_message"
        placeholder="type your message or dedication"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div><!----><!---->
  </div>
  <div class="rounded-md bg-[color:var(--donate-teams-background)] p-6 space-y-3 mx-5 md:mx-10">
    <h4 class="text-lg text-center font-bold text-[color:var(--donate-teams-text)]">Team Donation</h4>
    <div class="space-y-2">
      <div class="relative flex flex-col md:flex-row md:space-x-2 rtl:space-x-reverse">
        <div class="flex-1 space-y-2"><label class="block text-xs font-bold text-[color:var(--donate-teams-text)] uppercase">I would like to donate to the following team</label>
          <div class="md:relative mt-2"><button type="button"
              class="w-full bg-[color:var(--donate-teams-field-background)] text-[color:var(-donate-teams-text)] border-none rounded-md focus:ring-0 flex items-center space-x-1 h-10 px-4 relative outline-none">
              <div class="relative flex-1 h-full text-left">
                <div class="absolute inset-0 flex items-center">
                  <div class="truncate">Select Team</div>
                </div>
              </div><svg viewBox="0 0 11 10" fill="none" xmlns="http://www.w3.org/2000/svg" class="w-4 h-4 transition-all">
                <path
                  d="M5.76657 7.8497C5.58735 7.8497 5.40816 7.78126 5.27152 7.64469L0.971743 3.34487C0.698221 3.07135 0.698221 2.62788 0.971743 2.35447C1.24515 2.08106 1.68853 2.08106 1.96208 2.35447L5.76657 6.15919L9.57109 2.35461C9.84461 2.08119 10.288 2.08119 10.5613 2.35461C10.835 2.62802 10.835 3.07148 10.5613 3.34501L6.26163 7.64483C6.12493 7.78142 5.94573 7.8497 5.76657 7.8497Z"
                  fill="currentColor"></path>
              </svg>
            </button>
            <div class="absolute mt-1 bg-[color:var(--donate-teams-field-background)] rounded-md top-full left-0 w-full shadow-box scale-100 translate-y-0 opacity-100 overflow-hidden flex flex-col max-h-72 z-10" style="display: none;">
              <div class="p-2.5 border-b border-solid border-[color:var(--donate-teams-search-border)]"><input type="text" placeholder="Search"
                  class="bg-[color:var(--donate-teams-search-field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--donate-teams-search-field-text)] placeholder-[color:var(--donate-teams-search-field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--donate-teams-search-field-border)]">
              </div>
              <div class="flex-1 overflow-auto">
                <div class="divide-y divide-solid divide-[color:var(--donate-teams-search-border)]">
                  <div><button type="button" class="flex w-full p-3 text-sm text-left bg-[color:var(--donate-teams-search-active-background)]">Uri &amp; Rikki Davidi (L-267)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yanky &amp; Neshie Gelbwachs (D-13)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yehoshua Leib &amp; Shoshana Lapides (L-265)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elimelech &amp; Malka Chaya Esterzohn (L-108)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Chaim &amp; Rena Zelmanowitz (L-262)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Seth &amp; Chana Haber (L-125)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Mutty &amp; Fraidy Leiser (L-53) Enclave/Fairways</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Elazar &amp; Bluma Fischer (L-289)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Yossi &amp; Rifky Mandel (S-35)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Itzi &amp; Shaindy Cinner (L-116)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Isaac &amp; Chanala Friedman (L-292)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Nuchi &amp; Shana Shapiro (L-65)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Tzvi &amp; Tehila Kaplovitz (L-288)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Moshe &amp; Scharon Hassan (Vaad)</button></div>
                  <div><button type="button" class="flex w-full p-3 text-sm text-left">Duvid'l &amp; Breindy Dembitzer (L-51)</button></div><button type="button"
                    class="flex w-full p-3 text-sm hover:bg-[color:var(--donate-teams-search-active-background)]">Load More</button>
                </div>
              </div>
            </div>
          </div>
        </div><!---->
      </div><button type="button" class="text-sm font-bold text-center uppercase text-[color:var(--donate-teams-button)] hover:text-[color:var(--donate-teams-button-hover)] flex mx-auto">Donate to multiple teams</button>
    </div>
  </div>
  <div class="mx-5 md:mx-10">
    <h4 class="block text-xs font-bold text-center text-[color:var(--donate-payment-methods-label)] uppercase">Payment Method</h4>
    <div class="flex flex-wrap justify-center gap-4 mt-1"><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background-selected)]">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/credit-card.svg" alt="Credit Card" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/thedonorsfund-logo.svg" alt="The Donors Fund"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/ojcfund-logo.svg" alt="OJCFund" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/pledger-logo.png" alt="Pledger Charitable"
            class="h-7 object-contain w-12"><!----></div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/paypal-logo.svg" alt="PayPal" class="h-7 object-contain w-12"><!---->
        </div>
      </button><button type="button" class="flex items-center justify-center w-20 rounded h-11 bg-[color:var(--donate-payment-methods-button-background)] hover:bg-[color:var(--donate-payment-methods-button-background-hover)] group">
        <div class="flex flex-col items-center justify-center"><img src="https://dfwbeatzwij0y.cloudfront.net/f2f6e914-5e0c-4090-b16a-8b33f6dd38f2/images/payment-gateway-logos/matbia-logo.svg" alt="Matbia" class="h-7 object-contain w-12"><!---->
        </div>
      </button><!----><!----></div>
    <div class="hidden"></div><!---->
  </div>
  <div class="px-5 space-y-4 md:px-10"><!---->
    <div class="space-y-4 md:flex md:space-y-0 md:space-x-4 md:rtl:space-x-reverse">
      <div class="md:w-1/2">
        <div class="flex flex-col w-full" limit="4"><label for="card_number" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Card Number <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="unknown" inputmode="unknown" name="card_number" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              limit="4"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse md:w-1/2">
        <div class="flex flex-col w-full"><label for="expiry" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Expiry <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="expiry" dir="ltr" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              placeholder="MM/YY"><!----><!----></div><!---->
        </div>
        <div class="flex flex-col w-full" pattern="[0-9]+"><label for="cvv" class="text-xs font-bold uppercase text-[color:var(--field-label)]">CVV <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="cvv" dir="ltr"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              maxlength="4" pattern="[0-9]+"><!----></div><!---->
        </div>
      </div>
    </div><!----><!----><!---->
    <div class="space-y-4">
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="w-2/3">
          <div class="flex flex-col w-full"><label for="street" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Street <span class="text-[color:var(--field-label-star)]">*</span></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="street"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
        <div class="w-1/3">
          <div class="flex flex-col w-full"><label for="apt" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Apt <!----></label>
            <div class="relative mt-2"><!----><input type="text" inputmode="text" name="apt"
                class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
            </div><!---->
          </div>
        </div>
      </div>
      <div class="flex space-x-4 rtl:space-x-reverse">
        <div class="flex flex-col w-full"><label for="city" class="text-xs font-bold uppercase text-[color:var(--field-label)]">City <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="city"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="state" class="text-xs font-bold uppercase text-[color:var(--field-label)]">State <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="state"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
        <div class="flex flex-col w-full"><label for="zip" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Zip <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="zip"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div><!---->
    <div currency="USD">
      <div>
        <h2 class="text-xl font-bold text-center">Summary</h2>
      </div>
      <div class="mt-2 space-y-2">
        <div class="flex justify-between text-sm">
          <div>Donation</div>
          <div>$7,200.00</div>
        </div>
      </div>
    </div>
  </div>
  <div class="text-center"></div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--donate-button-text)] hover:text-[color:var(--donate-button-text)] uppercase bg-[color:var(--donate-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--donate-button-background-hover)] md:text-2xl focus:outline-none">Submit
    Donation</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="">
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="space-y-4 px-7 md:px-10 mt-7">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-10 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="creator_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Your Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="creator_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Team Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-10 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="creator_email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Your Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="creator_email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="creator_phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Your Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="creator_phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-10 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full space-y-1">
        <div class="flex flex-col w-full" inputtype="decimal"><label for="goal" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Team Goal <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="goal" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              inputtype="decimal"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex flex-col w-full space-y-1">
        <div class="flex flex-col w-full"><label for="slug" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Team URL <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="slug"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="description" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Description <!----></label><textarea name="description"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div>
  </div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--create-team-button-text)] hover:text-[color:var(--create-team-button-text)] uppercase bg-[color:var(--create-team-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--create-team-button-background-hover)] md:text-2xl focus:outline-none">Create
    my Team</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

<form class="">
  <div class="border border-[color:var(--account-border)] rounded-md mx-5 md:mx-10 p-3 flex items-center justify-between">
    <p class="text-[color:var(--account-text)] font-medium md:text-lg">Already have an account?</p>
    <div><button class="w-full outline-none group" type="button">
        <div class="text-[color:var(--account-button)] hover:text-[color:var(--account-button-hover)] font-medium md:text-lg">Login</div>
      </button></div>
  </div>
  <div class="space-y-4 px-7 md:px-10 mt-7">
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-10 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="creator_name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Your Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="creator_name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="name" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Team Name <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="text" inputmode="text" name="name"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-10 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full"><label for="creator_email" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Your Email <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="email" inputmode="email" name="creator_email" dir="ltr"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
      <div class="flex flex-col w-full"><label for="creator_phone" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Your Phone <span class="text-[color:var(--field-label-star)]">*</span></label>
        <div class="relative mt-2"><!----><input type="tel" inputmode="tel" name="creator_phone"
            class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
        </div><!---->
      </div>
    </div>
    <div class="space-y-8 md:flex md:space-y-0 md:space-x-10 md:rtl:space-x-reverse">
      <div class="flex flex-col w-full space-y-1">
        <div class="flex flex-col w-full" inputtype="decimal"><label for="goal" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Team Goal <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><input type="text" inputmode="text" name="goal" required=""
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"
              inputtype="decimal"><!----><!----></div><!---->
        </div>
      </div>
      <div class="flex flex-col w-full space-y-1">
        <div class="flex flex-col w-full"><label for="slug" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Team URL <span class="text-[color:var(--field-label-star)]">*</span></label>
          <div class="relative mt-2"><!----><input type="text" inputmode="text" name="slug"
              class="bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-10 focus:ring-2 focus:ring-[color:var(--field-border)] focus-visible:outline-none peer"><!---->
          </div><!---->
        </div>
      </div>
    </div>
    <div class="flex flex-col w-full"><label for="description" class="text-xs font-bold uppercase text-[color:var(--field-label)]">Description <!----></label><textarea name="description"
        class="block mt-2 bg-[color:var(--field-background)] rounded border-0 border-none w-full px-3 text-[color:var(--field-text)] placeholder-[color:var(--field-placeholder)] text-sm h-20 focus:ring-2 focus:ring-[color:var(--field-border)]"></textarea><!---->
    </div>
  </div><button
    class="flex items-center px-10 mx-auto mt-10 text-lg font-black text-[color:var(--create-team-button-text)] hover:text-[color:var(--create-team-button-text)] uppercase bg-[color:var(--create-team-button-background)] rounded-full h-14 md:h-16 hover:bg-[color:var(--create-team-button-background-hover)] md:text-2xl focus:outline-none">Create
    my Team</button>
</form>

<form class="px-6 py-10 md:px-11">
  <h3 class="font-serif font-medium text-center text-[30px]">Sign in to RaiseThon</h3>
  <p class="mt-3 text-center text-brand-black">New Here? <a class="text-brand" target="_BLANK" href="https://hatzalahthon.com/register">Create an Account</a></p>
  <div class="mt-10 space-y-5">
    <div class="space-y-1 w-full" autocomplete="username">
      <div class="relative"><!----><input name="email" type="text" inputmode="text" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" placeholder="you@example.com" autocomplete="username"><!---->
      </div><!---->
    </div>
    <div class="space-y-1 w-full" autocomplete="current-password">
      <div class="relative"><!----><input name="password" type="password" inputmode="password" required=""
          class="w-full px-4 py-2 text-sm border rounded-sm outline-none bg-[#F0F1F3] h-14 border-[#F0F1F3] placeholder-text-dark/60 text-text-dark focus:border-brand-primary focus:ring-0" autocomplete="current-password">
        <div class="absolute top-0 flex items-center h-full right-4"><a href="" class="text-sm text-text-dark/60 hover:text-text-dark">Show</a></div>
      </div><!---->
    </div><label class="flex items-center"><input type="checkbox" class="border rounded border-grey-border-input text-brand focus:shadow-input focus:ring-transparent"><span class="ml-2 text-sm text-opacity-60">Remember me</span></label><button
      type="submit" class="flex items-center justify-center w-full text-sm font-bold text-black rounded px-[18px] h-[38px] bg-gradient-to-br from-brand-dark to-brand-light">Log in</button>
  </div>
</form>

Text Content

RAISETHON


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Share
Part of Hatzalah Thon #5

$1,518,270
out of$10 Millionraised

$296,510

29%
OF ORIGINAL GOAL
$1,000,000 Raised
Donate Now
Donate Now
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Campaign Ends In

0
8

Days

:
0
8

Hours

:
0
4

Minutes

:
3
7

Seconds

Corporate Sponsors



It’s not My Hatzolah. Or yours.  It’s ours. 

Our emergencies. Our members. Our ambulances. Sirens. Defibrillators.
Stretchers. Rescues.

We take it for granted that Hatzolah will be there, 24/7.  In minutes, or even
seconds. And we wouldn’t want it any other way. 

But it doesn’t happen on its own.

It’s Hatzolah’s Our of Need™.  And your chance to meet the moment.  Be there.
Save lives. Support the mainstay of life. 

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HATZOLAH OF CENTRAL JERSEY

Website:Hatzolahcj.org
Email:office@hatzolahcj.org
Phone:

732-363-5600

Tax ID:

22-3219824





SPONSORSHIP OPPORTUNITIES


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200




254 TEAMS

Create a Team
Sort ByTeam NameHighest GoalLowest GoalMost RaisedLeast RaisedNearest to
GoalMost DonorsLeast Donors
Create a Team
Uri & Rikki Davidi (L-267)

$21,005

of $26,000 Raised

68

Donors

Visit Team Page
Yanky & Neshie Gelbwachs (D-13)

$15,639

of $18,000 Raised

67

Donors

Visit Team Page
Yehoshua Leib & Shoshana Lapides (L-265)

$10,170

of $15,000 Raised

77

Donors

Visit Team Page
Elimelech & Malka Chaya Esterzohn (L-108)

$9,070

of $25,000 Raised

20

Donors

Visit Team Page
Chaim & Rena Zelmanowitz (L-262)

$7,335

of $10,000 Raised

25

Donors

Visit Team Page
Seth & Chana Haber (L-125)

$6,543

of $7,500 Raised

12

Donors

Visit Team Page
Mutty & Fraidy Leiser (L-53) Enclave/Fairways

$4,945

of $10,000 Raised

39

Donors

Visit Team Page
Elazar & Bluma Fischer (L-289)

$4,855

of $10,000 Raised

36

Donors

Visit Team Page
Yossi & Rifky Mandel (S-35)

$4,410

of $5,000 Raised

19

Donors

Visit Team Page
Itzi & Shaindy Cinner (L-116)

$4,380

of $5,000 Raised

41

Donors

Visit Team Page
Isaac & Chanala Friedman (L-292)

$4,172

of $4,500 Raised

24

Donors

Visit Team Page
Nuchi & Shana Shapiro (L-65)

$4,098

of $3,600 Raised

24

Donors

Visit Team Page
Tzvi & Tehila Kaplovitz (L-288)

$3,989

of $5,000 Raised

24

Donors

Visit Team Page
Moshe & Scharon Hassan (Vaad)

$3,980

of $26,000 Raised

4

Donors

Visit Team Page
Duvid'l & Breindy Dembitzer (L-51)

$3,807

of $2,500 Raised

17

Donors

Visit Team Page
Load More
2,058
DONORS

NewestOldestHighestLowest

MOSHE BENJAMIN

56 seconds ago

$18

With Tzvi & Shani Binet (L-281)

PLP💪

BEREL DONATH

1 minute ago

$125

With Moshe & Numi Neuberger (L-129)

BARUCH AND RACHEL LAPIDES

1 minute ago

$100

With Yehoshua Leib & Shoshana Lapides (L-265)

Happy Anniversary!!

YEHUDA KAHAN

2 minutes ago

$250

With Moshe & Aliza Orgel (L-121)

MOSHE KAUFMAN

2 minutes ago

$54

With Menachem & Gitty Kovalenko (L-61)

In honor of our chusheve Feter and selfless neighbor!

MORDY SILBERMAN

3 minutes ago

$100

With Kopy & Chaya Elbaum (L-56)

Thank you for posting my ad

SHOLOM Y. AND CHAVIE KATZ

3 minutes ago

$54

With Chaim & Esther Muschel (L-275)

What neighborhood do you cover?

ANONYMOUS

3 minutes ago

$180

With Chesky & Batsheva Abramsky (L-89)

SARI RIVLIN

3 minutes ago

$20

With Yechiel & Chani Rivlin (L-74)

BARUCH AND RACHEL LAPIDES

4 minutes ago

$100

With Yaakov & Shani Schechter (L-10)

ANONYMOUS

5 minutes ago

$72

With Yosef Boruch & Rivky Jacobovitch (L-34)

REGENCY ALUM

6 minutes ago

$36

With Shlomo & Sara Milworm (L-64)

YOSSIE & CHANA DINA ZUCKER

7 minutes ago

$360

With Aaron & Cheved Mueller (L-60)

PESHY ROSMARIN

7 minutes ago

$100

With Abraham & Leah Rosmarin (L-124)

For Abe and Leah - best siblings

ANONYMOUS

8 minutes ago

$100

With Eliezer & Pessy Ordentlich (L-118)

Load More


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PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000

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YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No Installments

Hatzolah of Central Jersey

will receive

$0.00 USD

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First Name *

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I would like to donate anonymously
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TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
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PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000

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YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No Installments

Hatzolah of Central Jersey

will receive

$0.00 USD

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Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
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PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($90,000.00)Divide donation by 3
months ($60,000.00)Divide donation by 4 months ($45,000.00)Divide donation by 5
months ($36,000.00)Divide donation by 6 months ($30,000.00)Divide donation by 7
months ($25,714.29)Divide donation by 8 months ($22,500.00)Divide donation by 9
months ($20,000.00)Divide donation by 10 months ($18,000.00)Divide donation by
11 months ($16,363.64)Divide donation by 12 months ($15,000.00)

Hatzolah of Central Jersey

will receive

$180,000.00 USD

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First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$180,000.00

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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($18,000.00)Divide donation by 3
months ($12,000.00)Divide donation by 4 months ($9,000.00)Divide donation by 5
months ($7,200.00)Divide donation by 6 months ($6,000.00)Divide donation by 7
months ($5,142.86)Divide donation by 8 months ($4,500.00)Divide donation by 9
months ($4,000.00)Divide donation by 10 months ($3,600.00)Divide donation by 11
months ($3,272.73)Divide donation by 12 months ($3,000.00)

Hatzolah of Central Jersey

will receive

$36,000.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$36,000.00

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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($1,800.00)Divide donation by 3
months ($1,200.00)Divide donation by 4 months ($900.00)Divide donation by 5
months ($720.00)Divide donation by 6 months ($600.00)Divide donation by 7 months
($514.29)Divide donation by 8 months ($450.00)Divide donation by 9 months
($400.00)Divide donation by 10 months ($360.00)Divide donation by 11 months
($327.27)Divide donation by 12 months ($300.00)

Hatzolah of Central Jersey

will receive

$3,600.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$3,600.00

Submit Donation



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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($187,500.00)Divide donation by 3
months ($125,000.00)Divide donation by 4 months ($93,750.00)Divide donation by 5
months ($75,000.00)Divide donation by 6 months ($62,500.00)Divide donation by 7
months ($53,571.43)Divide donation by 8 months ($46,875.00)Divide donation by 9
months ($41,666.67)Divide donation by 10 months ($37,500.00)Divide donation by
11 months ($34,090.91)Divide donation by 12 months ($31,250.00)

Hatzolah of Central Jersey

will receive

$375,000.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$375,000.00

Submit Donation



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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($60,000.00)Divide donation by 3
months ($40,000.00)Divide donation by 4 months ($30,000.00)Divide donation by 5
months ($24,000.00)Divide donation by 6 months ($20,000.00)Divide donation by 7
months ($17,142.86)Divide donation by 8 months ($15,000.00)Divide donation by 9
months ($13,333.33)Divide donation by 10 months ($12,000.00)Divide donation by
11 months ($10,909.09)Divide donation by 12 months ($10,000.00)

Hatzolah of Central Jersey

will receive

$120,000.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$120,000.00

Submit Donation



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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($25,000.00)Divide donation by 3
months ($16,666.67)Divide donation by 4 months ($12,500.00)Divide donation by 5
months ($10,000.00)Divide donation by 6 months ($8,333.33)Divide donation by 7
months ($7,142.86)Divide donation by 8 months ($6,250.00)Divide donation by 9
months ($5,555.56)Divide donation by 10 months ($5,000.00)Divide donation by 11
months ($4,545.45)Divide donation by 12 months ($4,166.67)

Hatzolah of Central Jersey

will receive

$50,000.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$50,000.00

Submit Donation



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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($17,500.00)Divide donation by 3
months ($11,666.67)Divide donation by 4 months ($8,750.00)Divide donation by 5
months ($7,000.00)Divide donation by 6 months ($5,833.33)Divide donation by 7
months ($5,000.00)Divide donation by 8 months ($4,375.00)Divide donation by 9
months ($3,888.89)Divide donation by 10 months ($3,500.00)Divide donation by 11
months ($3,181.82)Divide donation by 12 months ($2,916.67)

Hatzolah of Central Jersey

will receive

$35,000.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$35,000.00

Submit Donation



SIGN IN TO RAISETHON

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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($10,000.00)Divide donation by 3
months ($6,666.67)Divide donation by 4 months ($5,000.00)Divide donation by 5
months ($4,000.00)Divide donation by 6 months ($3,333.33)Divide donation by 7
months ($2,857.14)Divide donation by 8 months ($2,500.00)Divide donation by 9
months ($2,222.22)Divide donation by 10 months ($2,000.00)Divide donation by 11
months ($1,818.18)Divide donation by 12 months ($1,666.67)

Hatzolah of Central Jersey

will receive

$20,000.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$20,000.00

Submit Donation



SIGN IN TO RAISETHON

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Show
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DONATE NOW


PARNES HASHANAH

$180,000




PARNES HACHODESH

$36,000




PARNES HAYOM

$3,600




AMBULANCE

$375,000




RADIO TOWER

$120,000




POWER STRETCHER SYSTEM

$50,000




LIFEPAK 15

$35,000




THUMPER

$20,000




EMT BAG

$7,200


YOUR AMOUNT

$

USD

$

USD


.00


DONATE IN INSTALLMENTS

No InstallmentsDivide donation by 2 months ($3,600.00)Divide donation by 3
months ($2,400.00)Divide donation by 4 months ($1,800.00)Divide donation by 5
months ($1,440.00)Divide donation by 6 months ($1,200.00)Divide donation by 7
months ($1,028.57)Divide donation by 8 months ($900.00)Divide donation by 9
months ($800.00)Divide donation by 10 months ($720.00)Divide donation by 11
months ($654.55)Divide donation by 12 months ($600.00)

Hatzolah of Central Jersey

will receive

$7,200.00 USD

Already have an account?

Login
First Name *

Last Name *

Email *

Phone *

Display Name *

I would like to donate anonymously
Message or Dedication

TEAM DONATION

I would like to donate to the following team
Select Team
Uri & Rikki Davidi (L-267)
Yanky & Neshie Gelbwachs (D-13)
Yehoshua Leib & Shoshana Lapides (L-265)
Elimelech & Malka Chaya Esterzohn (L-108)
Chaim & Rena Zelmanowitz (L-262)
Seth & Chana Haber (L-125)
Mutty & Fraidy Leiser (L-53) Enclave/Fairways
Elazar & Bluma Fischer (L-289)
Yossi & Rifky Mandel (S-35)
Itzi & Shaindy Cinner (L-116)
Isaac & Chanala Friedman (L-292)
Nuchi & Shana Shapiro (L-65)
Tzvi & Tehila Kaplovitz (L-288)
Moshe & Scharon Hassan (Vaad)
Duvid'l & Breindy Dembitzer (L-51)
Load More
Donate to multiple teams

PAYMENT METHOD



Card Number *

Expiry *

CVV *

Street *

Apt

City *

State *

Zip *



SUMMARY

Donation
$7,200.00

Submit Donation



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CREATE A TEAM

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Your Name *

Team Name *

Your Email *

Your Phone *

Team Goal *

Team URL *

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hatzalahthon.com Open in urlscan Pro 188.114.97.3 Public Scan

Form analysis 30 forms found in the DOM

Text Content

hatzalahthon.com Open in urlscan Pro
188.114.97.3 Public Scan

Form analysis
30 forms found in the DOM