www.newbrunswickpc.ca
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162.159.128.45
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URL:
https://www.newbrunswickpc.ca/
Submission: On May 25 via api from US — Scanned from CA
Submission: On May 25 via api from US — Scanned from CA
Form analysis 1 forms found in the DOM
POST /forms/donations
<form id="donate_page_new_donation_form" class="donation_form" method="POST" action="/forms/donations"><input name="authenticity_token" type="hidden" value="rURssNJcIwGLviaJl2yxtsLyOyh9QvZhbZlfmL8i1EE="><input name="page_id" type="hidden"
value="36"><input name="return_to" type="hidden" value="https://www.newbrunswickpc.ca/">
<div class="email_address_form" style="display:none;" aria-hidden="true">
<p><label for="email_address">Optional email code</label><br><input name="email_address" type="text" class="text" id="email_address" autocomplete="off"></p>
</div>
<div class="form-errors">
</div>
<h3 class="h4 mt-3">Select an amount</h3>
<div class="donation-v2-occurence-radio my-4">
<div class="form-group">
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_donation_occurrence_one_time" type="radio" name="donation[donation_occurrence]" class="custom-control-input donation_amount_option" value="one-time" checked="checked">
<label class="custom-control-label radio" for="donation_donation_occurrence_one_time"> One-time </label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_donation_occurrence_monthly" type="radio" name="donation[donation_occurrence]" class="custom-control-input donation_amount_option" value="monthly">
<label class="custom-control-label radio" for="donation_donation_occurrence_monthly"> Monthly </label>
</div>
</div>
</div>
<div class="form-group donation-v2-amount">
<div id="donation-v2-amounts" class="donation-v2-amounts btn-group-toggle">
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_15" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="15">
<label for="donation_amount_15" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$15</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_35" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="35">
<label for="donation_amount_35" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$35</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_70" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="70">
<label for="donation_amount_70" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$70</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_150" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="150">
<label for="donation_amount_150" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$150</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_500" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="500">
<label for="donation_amount_500" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$500</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_1500" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="1500">
<label for="donation_amount_1500" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$1,500</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_3000" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option" value="3000" checked="checked">
<label for="donation_amount_3000" class="custom-control-label radio btn btn-color-2 mb-3 p-3 mr-sm-3">$3,000</label>
</div>
<div class="custom-control custom-radio custom-control-inline">
<input id="donation_amount_other" type="radio" name="donation[amount_option]" class="custom-control-input donation_amount_option">
<label for="donation_amount_other" class="custom-control-label radio">Other amount:</label>
</div>
</div>
</div>
<div class="form-group mt-n2">
<div class="form-row">
<div class="col-12 col-md-6">
<div class="input-group donation-other-input-container">
<div class="input-group-prepend">
<span class="input-group-text currency-symbol">$</span>
</div>
<input id="donation_amount_other_input" type="text" name="donation[amount]" class="form-control text nb_donation_v2_amount" value="3000.00">
</div>
</div>
</div>
</div>
<hr class="my-4 mx-n5">
<h3 class="h4 pb-2">Pay With</h3>
<div id="payment-methods" class="form-row" style="display: none;">
<div id="donation-v2-payment-request"></div>
<div id="cc-request-button">
<button type="button" class="btn btn-lg btn-block btn-primary"><i id="credit-card-icon"></i>Credit Card</button>
</div>
<div id="apple-pay-notice" class="pt-2">
<p class="small">If you use Apple Pay, your confirmation prompt may refer to our payment processor, "NationBuilder"</p>
</div>
</div>
<div id="selected-payment-method" class="form-row" style="display: none;">
<div class="pt-2">
<i id="payment-method-icon"></i><a href="#" class="change-payment-method">Change payment method</a>
</div>
<p>You're almost done! Submit donation below.</p>
</div>
<div id="submitted-payment-method" class="form-row" style="display: none;">
<div class="col-sm-12">
<p>Payment method information has been saved. <a href="#" class="change-submitted-payment-method">Change payment method</a></p>
</div>
</div>
<div id="cc-info" class="form-row" style="display: block;">
<div class="col-sm-12">
<div class="form-row">
<div class="form-group col-12">
<div class="card-field">
<div class="payment-input payment-toggle-view StripeElement StripeElement--empty" data-payments-element-type="card" data-error-container=".payment-input + div.card-error-container">
<div class="__PrivateStripeElement"
style="margin: 0px !important; padding: 0px !important; border: none !important; display: block !important; background: transparent !important; position: relative !important; opacity: 1 !important; --stripeElementWidth: 572px;">
<iframe name="__privateStripeFrame5503" frameborder="0" allowtransparency="true" scrolling="no" role="presentation" allow="payment *"
src="https://js.stripe.com/v3/elements-inner-card-096eafd0ef3b3eb02abd81b1c21169a5.html#locale=auto&wait=false&mids[guid]=NA&mids[muid]=NA&mids[sid]=NA&hidePostalCode=true&style[base][fontFamily]=%22Helvetica+Neue%22%2C+Helvetica%2C+sans-serif&style[base][fontSize]=16px&rtl=false&componentName=card&keyMode=live&apiKey=pk_live_1TjMHnI0fp51k3hKVhJEpm6D&referrer=https%3A%2F%2Fwww.newbrunswickpc.ca%2F&controllerId=__privateStripeController5501"
title="Secure card payment input frame"
style="border: 0px !important; margin-top: 0.703125px; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding: 0px !important; width: 1px !important; min-width: 100% !important; overflow: hidden !important; display: block !important; user-select: none !important; transform: translate(0px) !important; color-scheme: light only !important; height: 19.2px;"></iframe><input
class="__PrivateStripeElement-input" aria-hidden="true" aria-label=" " autocomplete="false" maxlength="1"
style="border: none !important; display: block !important; position: absolute !important; height: 1px !important; top: -1px !important; left: 0px !important; padding: 0px !important; margin: 0px !important; width: 100% !important; opacity: 0 !important; background: transparent !important; pointer-events: none !important; font-size: 16px !important;">
</div>
</div>
<div class="card-error-container"></div>
</div>
</div>
</div>
<p class="padtop text-center">
<a href="#" class="change-payment-method" style="display: none;">Change payment method</a>
</p>
</div>
</div>
<div id="your-info" style="display: block;">
<h3 class="h4 pt-3">Your Information</h3>
<div id="demographics-read-only" style="display: none;">
<span id="demographics-name"></span><a href="#" id="edit-demographics">Edit</a><br>
<span id="demographics-email"></span><br>
<span id="demographics-phone"></span>
</div>
<div id="demographics-info">
<div class="form-row">
<div class="form-group col-md">
<div class="form-control-material">
<label for="donation_first_name" class="floating-label">First Name*</label>
<input required="required" class="text form-control" id="donation_first_name" name="donation[first_name]" type="text">
</div>
</div>
<div class="form-group col-md">
<div class="form-control-material">
<label for="donation_last_name" class="floating-label">Last Name*</label>
<input required="required" class="text form-control" id="donation_last_name" name="donation[last_name]" type="text">
</div>
</div>
</div>
<div class="form-row">
<div class="form-group col-md">
<div class="form-control-material">
<label for="donation_email" class="floating-label">Email*</label>
<input required="required" class="text form-control" id="donation_email" name="donation[email]" type="email">
</div>
</div>
<div class="form-group col-md">
<div class="form-control-material">
<label for="donation_billing_address_phone_number" class="floating-label">Phone number*</label>
<input required="required" class="text form-control" id="donation_billing_address_phone_number" name="donation[billing_address_attributes][phone_number]" type="tel">
</div>
</div>
</div>
</div> <!-- /#demographics-info -->
<div class="form-group custom-control custom-checkbox">
<input name="donation[email_opt_in]" type="hidden" value="0"><input class="custom-control-input checkbox" checked="checked" id="donation_email_opt_in" name="donation[email_opt_in]" type="checkbox" value="1">
<label class="custom-control-label checkbox" for="donation_email_opt_in">Send email updates</label>
</div>
<div id="address-read-only" style="display: none;">
<span class="address-line">
<span id="address-line1"></span><a href="#" id="edit-address">Edit</a>
</span>
<span class="address-line">
<span id="address-line2"></span>
</span>
<span class="address-line">
<span id="address-city"></span>, <span id="address-state"></span> <span id="address-zip"></span>
</span>
<span class="address-line">
<span id="address-country"></span>
</span>
</div>
<div id="address-info">
<div class="form-group">
<div class="form-control-material">
<label for="donation_billing_address_address1" class="floating-label">Address line 1*</label>
<input required="required" class="text form-control" id="donation_billing_address_address1" name="donation[billing_address_attributes][address1]" type="text">
</div>
</div>
<div class="form-group mt-n2">
<div class="form-control-material">
<label for="donation_billing_address_address2" class="floating-label">Address line 2</label>
<input class="text form-control" id="donation_billing_address_address2" name="donation[billing_address_attributes][address2]" type="text">
</div>
</div>
<div class="form-group mt-n2 not-us-or-canada hide" style="display: none;">
<div class="form-control-material">
<label for="donation_billing_address_address3" class="floating-label">Address line 3</label>
<input class="text not-us-or-canada hide form-control" id="donation_billing_address_address3" name="donation[billing_address_attributes][address3]" type="text" style="display: none;">
</div>
</div>
<div class="form-group">
<div class="form-control-material form-control-material-custom-select">
<label for="donation_billing_address_country_code" class="floating-label floating-label-select floating-label--float-above">Country</label>
<select id="donation_billing_address_country_code" name="donation[billing_address_attributes][country_code]" class="custom-select">
<option value="AF">Afghanistan</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia</option>
<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet Island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA" selected="selected">Canada</option>
<option value="CV">Cape Verde</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CG">Congo</option>
<option value="CD">Congo, the Democratic Republic of the</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curaçao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="CI">Côte d'Ivoire</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran, Islamic Republic of</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IM">Isle of Man</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JE">Jersey</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macao</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="KP">North Korea</option>
<option value="MK">North Macedonia, Republic of</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestine, State of</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="RO">Romania</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda</option>
<option value="RE">Réunion</option>
<option value="BL">Saint Barthélemy</option>
<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="MF">Saint Martin (French part)</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SX">Sint Maarten (Dutch part)</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="KR">South Korea</option>
<option value="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SZ">Swaziland</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam</option>
<option value="VG">Virgin Islands, British</option>
<option value="VI">Virgin Islands, U.S.</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
<option value="AX">Åland Islands</option>
</select>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-4">
<div class="form-control-material">
<label for="donation_billing_address_city" class="floating-label">City*</label>
<input required="required" class="text form-control" id="donation_billing_address_city" name="donation[billing_address_attributes][city]" type="text">
</div>
</div>
<div id="state" class="form-group col-md-4 us-or-canada us-only hide" style="display: none;">
<div class="form-control-material">
<label for="donation_billing_address_state" class="floating-label floating-label-select floating-label--float-above">Province*</label>
<select id="donation_billing_address_state" name="donation[billing_address_attributes][state]" class="custom-select" disabled="disabled">
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="AA">Armed Forces Americas</option>
<option value="AE">Armed Forces Europe</option>
<option value="AP">Armed Forces Pacific</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FM">Federated States of Micronesia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MH">Marshall Islands</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PW">Palau</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VI">Virgin Island</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
</div>
</div>
<div id="province" class="form-group col-md-4 us-or-canada canada-only">
<div class="form-control-material">
<label for="donation_billing_address_state" class="floating-label">Province*</label>
<input required="" class="text form-control" id="donation_billing_address_state" name="donation[billing_address_attributes][state]" type="text">
</div>
</div>
<div class="form-group col-md-4">
<div class="form-control-material">
<label for="donation_billing_address_zip" class="floating-label">Postal Code*</label>
<input required="required" class="text form-control" id="donation_billing_address_zip" name="donation[billing_address_attributes][zip]" type="text">
</div>
</div>
</div>
</div> <!-- /#address-info -->
<hr class="my-4 mx-n5">
<div class="form-group">
<label for="merchant_account_contribution_rules"><strong>Contribution rules:</strong></label>
<div class="mb-1">Donations must be made through personal resources; no union or corporate donations. Maximum of $3000 per person. Each contributor will receive an official receipt in the form required by Elections New Brunswick. Contributions
of money will be eligible for the New Brunswick Political Contributions Tax Credit available to residents of New Brunswick under the New Brunswick Income Tax Act. </div>
<div class="custom-control custom-checkbox">
<input name="donation[is_confirmed]" type="hidden" value="0"><input class="custom-control-input checkbox" id="donation_is_confirmed" name="donation[is_confirmed]" type="checkbox" value="1" required="">
<label for="donation_is_confirmed" class="custom-control-label checkbox">I confirm that the above statements are true and accurate</label>
</div>
</div>
<div class="form-group submit-container donation-v2-amount">
<span>
<span>$</span><span class="nb_donation_v2_amount">3000.00</span>
<span class="nb_donation_v2_interval small mt-n2 " data-placeholder="paid monthly"></span>
</span>
</div>
<div id="recaptcha-input">
<script src="https://www.recaptcha.net/recaptcha/api.js?render=6LekWdoZAAAAAA61Owqhdq5e8IIQEfJbEOs8IT8T"></script>
<script>
// Define function so that we can call it again later if we need to reset it
// This executes reCAPTCHA and then calls our callback.
function executeRecaptchaForDonate() {
grecaptcha.ready(function() {
grecaptcha.execute('6LekWdoZAAAAAA61Owqhdq5e8IIQEfJbEOs8IT8T', {
action: 'donate'
}).then(function(token) {
setInputWithRecaptchaResponseTokenForDonate('g-recaptcha-response-data-donate', token)
});
});
};
// Invoke immediately
executeRecaptchaForDonate()
// Async variant so you can await this function from another async function (no need for
// an explicit callback function then!)
// Returns a Promise that resolves with the response token.
async function executeRecaptchaForDonateAsync() {
return new Promise((resolve, reject) => {
grecaptcha.ready(async function() {
resolve(await grecaptcha.execute('6LekWdoZAAAAAA61Owqhdq5e8IIQEfJbEOs8IT8T', {
action: 'donate'
}))
});
})
};
var setInputWithRecaptchaResponseTokenForDonate = function(id, token) {
var element = document.getElementById(id);
element.value = token;
}
</script>
<input type="hidden" name="g-recaptcha-response-data[donate]" id="g-recaptcha-response-data-donate" data-sitekey="6LekWdoZAAAAAA61Owqhdq5e8IIQEfJbEOs8IT8T" class="g-recaptcha g-recaptcha-response " style=""
value="03AFcWeA4xJVkdBtS-WBTYQ0OSsQteSys1N0ApEoBctbn0RavjHRkvSMG0nPAV5k3kqjQdo85Ccz5yRpMqpyXI9OPiFfGe-4_UneU8AmUmhEfY-AjQJhcwcL1RiD-0CBgtcHx7k0CJQyHC84EU09NDMUGClPFDjT7G4e7mtp1fI3kJjcQ2Qmbo0Npj654Uq5Nz4O5xX-LifJMtwXj24Wi42EQYOKuOt4CAzUaH9ZgJCAYqA7KArgfEXWy3ml3LMi56AabBmkK2RRh7uyt1D8KVE8Y4mnHuospIbFbd3z_heGE09bHE_W5rHLP5D41aZjb74Ah0ynILW4THoULSJ9c7KafOiWosUYYctgkxlTlF-EQguiTQBvIJ2jjyl0bXCEEhphdrdbawVAnkqIfDhf9M5u-Izl17gCfD0wjrovBdB0MY25CPId7-CO8QtRwdAZL63cNnIp9SUbk1clP5rWqybyuhehfnURgCnXLnnvWdWYNOjCkziyxqk73TFreU3ORkF5tcy5bvI1N5MQaupH8e-OlRXvZl2Yb5JNvB0yptHt8dnlqPW2k3P8n24Fc5eZ_n8NmX-OfHKE3XiULEdYQ6Tz7n_2Fyv3c8Qg8l3mm3roY4bPRsDOqBceKUR3Gkqbqri3HWUxJL8p3B3CpOfQd1lFWzVQwQ6X2TLby0ilQGrX9GXgKhyyEFkNc">
<script>
const clientKey = '6LekWdoZAAAAAA61Owqhdq5e8IIQEfJbEOs8IT8T'
grecaptcha.ready(function() {
var $badge = $('.grecaptcha-badge');
if ($badge.length === 1) {
if ($('#cd-nav, #control-panel-nav').length === 1) {
$badge.css("bottom", "84px")
}
$badge.css("z-index", "9994")
$badge.find('iframe').css("margin", "0");
}
setInterval(function() {
grecaptcha.execute(clientKey, {
action: 'donate'
}).then(function(token) {
if ($("#g-recaptcha-response-data-donate").length) {
$("#g-recaptcha-response-data-donate").val(token);
}
})
}, 90000)
});
</script>
</div>
<div class="form-group mt-5">
<input class="btn btn-lg btn-block btn-primary submit-button" type="submit" name="commit" value="Process Payment">
<div class="form-submit"></div>
</div>
</div> <!-- /#your-info -->
</form>Text Content
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Maximum of $3000 per person. Each contributor will receive an official receipt in the form required by Elections New Brunswick. Contributions of money will be eligible for the New Brunswick Political Contributions Tax Credit available to residents of New Brunswick under the New Brunswick Income Tax Act. I confirm that the above statements are true and accurate $3000.00 CONTACT US • NOUS JOINDRE Tel • Tél : 1 (506) 453-3456 Email • Courriel : info@pcnb.ca 364 rue York St. Suite 215, Fredericton, NB E3B 3P7 Copyright © 2023-2024 The Progressive Conservative Party of New Brunswick / Tous droits réservés © 2023-2024 le Parti progressiste-conservateur du Nouveau-Brunswick Authorized by the Authorized Representative for the PCNB / Autorisé par le représentant autorisé du PCNB Just made a donation to PCNB Donate Just made a donation to PCNB SIGN IN TO YOUR ACCOUNT Sign in with Facebook Sign in with Email or click here to create an account