Stanford University | Make a Gift

<!DOCTYPE html> <html lang="en"> <head> <title>Stanford University | Make a Gift</title> <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta name="description" content=""> <meta name="author" content=""> <meta name="apple-mobile-web-app-capable" content="yes" /> <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no">  <link href='/give/give2/assets/css/webfonts/crimson_webfont/crimson.css' rel='stylesheet'> <link href="/give/give2/assets/libraries/bootstrap.min.css" rel="stylesheet"> <style> body { padding-top: 110px; /* 60px to make the container go all the way to the bottom of the topbar */ } </style> <link href="/give/give2/assets/libraries/bootstrap-responsive.min.css" rel="stylesheet"> <link href="/give/give2/assets/css/application.css" rel="stylesheet"> <link href="/give/give2/assets/css/application-responsive.css" 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navbar-fixed-top"> <div class="navbar-inner"> <div class="global"> <div class="container"><a class="stanford-logo" href="http://www.stanford.edu"><img src="/give/give2/assets/img/su-brandbar.png"></a></div> </div> <div class="subnav"> <div class="container"> <div class="blurb hidden-phone pull-right"><a href="http://giving.stanford.edu/how-to-give/phone-check" target="_blank">Prefer to call us or mail a check? <i class="icon-chevron-right icon-white"></i></a></div> <div class="title"><img src="/give/give2/assets/img/make_a-gift.png"></div> </div> </div> </div> </div>  <div id="main" class="container"> <div class="row"> <form id="give" class="form-vertical" action="/give/give2" method="post"> <input type="hidden" name="txnId" id="txnId" value="14826408" /> <input type="hidden" name="btk" id="btk" value="1732376579500" /> <input type="hidden" name="txnType" id="txnType" value="regular" disabled="disabled"/> <input type="hidden" name="pgnTPC" id="pgnTPC" value="399" disabled="disabled"/> <input type="hidden" name="checkAllFields" id="checkAllFields" value="1" /> <input type="hidden" name="isLoggedIn" id="is_logged_in" value="0" /> <input type="hidden" name="isUnsubscribed" id="is_unsubscribed" value="0" /> <div class="span10 offset1"> </div> <div id="steps"> <div id="step_1" class=""> <div id="gifts" class="span10 offset1 gifts" > <div id="gift_0" class="gift block" data-id="0"> <div class="block-header intro"> <div class="controls pull-right"> <a class="block-help-link meta">Help <i class="icon-chevron-down icon-white"></i></a> </div> <h3>Gift Details</h3> </div> <div class="block-help" style="display:none;"> <a class="block-help-close close" href="#"><i class="icon-remove"></i></a> <p><a href="http://giving.stanford.edu/how-to-give/phone-check"><em>Prefer to call us or mail a check?</em></a></p> <p>To direct your gift to funds or groups not listed in the <b>I Want to Support...</b> drop-down menu, type instructions in the <b>Special Instructions/Other Designation</b> field.</p> <p>Selecting <b>Joint Gift with My Spouse/Partner</b> will allow you to enter the name of your partner/spouse in the subsequent <b>About Me</b> section.</p> <p>For additional help, please see our <a href="http://giving.stanford.edu/questions-comments/frequently-asked-questions" target="_blank">Frequently Asked Questions</a>.</p> </div> <div class="block-content"> <div class="block-error-list hide"><ul></ul></div> <div id="support_row_0" class="support-row" data-pg-dependent="gift_type_select_0" data-pg-hide="" > <div class="block-row"> <div id="support_primary_row_0" class="row-fluid support-primary-row"> <div id="support_primary_0" class="support-primary span6 control-group"> <label class="control-label">I Want to Support...</label> <div class="controls"> <select id="support_primary_select_0" name="gifts[0].supportPrimary" class="menu utility support-primary-select calc-totals" data-pg-trigger="true" data-pg-ereceipt-trigger="true"> <option value="5" selected >Stanford Encyclopedia of Philosophy</option> <option value="10" >Other Stanford Designation</option> </select> </div> </div> <div id="show_giving_levels_container_0" class="show-giving-levels-container span6" data-pg-dependent="support_primary_select_0" data-pg-hide="false" > <a id="show_giving_levels_0" class="meta show-giving-levels" style="display:none"><span class="show-giving-levels-title">Show Giving Levels</span> <i class="icon-chevron-right"></i></a> </div> <div id="show_athletics_giving_levels_container_0" class="span6 show-athletics-giving-levels-container" data-pg-dependent="support_primary_select_0" data-pg-show="false" style="display:none" > <div class="show-athletics-giving-levels-title" style="display:none"> <a id="show_athletics_giving_levels_0" class="meta show-athletic-giving-levels-mobile"><span class="show-athletic-giving-levels-title-mobile">Show Giving Levels</span> <i class="icon-chevron-right"></i></a> <span id="show_athletics_giving_levels_0" class="show-athletic-giving-levels-desktop"><a class="meta show-athletic-giving-levels-title-desktop" href="/give/give2/assets/img/athletics_g2s2_givinglevels.jpg" target="_blank">Show Giving Levels</a> <i class="icon-chevron-right"></i></span> </div> </div> </div> <div id="support_secondary_row_0" class="row-fluid support-secondary-row" style="display:none;" > <div id="support_secondary_0" class="support-secondary span6 control-group"> <div class="controls"> <select id="support_secondary_select_0" name="gifts[0].supportSecondary" class="menu utility support-secondary-select calc-totals" data-pg-trigger="true" data-pg-ereceipt-trigger="true"> <option value="5" data-pg-inst-reqd="N" selected >Stanford Encyclopedia of Philosophy</option> </select> </div> </div> </div> <div id="support_other_row_0" class="row-fluid support-other-row"> <div id="support_other_0" class="span6 support-other control-group"> <input class="input-block-level field utility input calc-totals support-other-input" id="support_other_input_0" type="text" name="gifts[0].supportOther" value="" maxlength="255" placeholder="Special Instructions/Other Designation"> </div> <div id="support_other_characters_remaining_0" class="span3 characters-remaining"> <span class="meta">(<span>255</span> characters remaining)</span> </div> </div> </div> <hr class="divider"> </div> <div id="gift_type_and_amount_row_0" class="gift-type-and-amount-row" > <div class="block-row"> <div class="row-fluid"> <div id="gift_type_0" class="span3 gift-type control-group"> <label class="control-label">Gift Type</label> <div class="controls"> <select id="gift_type_select_0" name="gifts[0].giftType" class="gift-type-select menu utility calc-totals" data-id="0" data-pg-trigger="true" data-pg-ereceipt-trigger="true"> <option value="G1" selected >One-Time Gift</option> <option value="R2" data-pg-disqualify="true" >Recurring Gift</option> </select> </div> </div> <div id="gift_amount_0" class="span3 gift-amount control-group"> <label class="control-label">Amount</label> <div class="controls"> <div class="input-prepend input-prepend-amount control-group"> <span class="add-on">$</span> <input type="text" id="gift_amount_input_0" class="gift-amount-input input-block-level field utility calc-totals" name="gifts[0].amount" value="" maxlength="11"> <input type="hidden" id="gift_level_code_0" class="gift-level-code" name="gifts[0].giftLevelCode" value=""> </div> </div> </div> </div> </div> </div> <div id="gift_cantor_levels_0" class="gift-cantor-levels-row" style="display:none" > <div class="block-row"> <div class="row-fluid"> <div id="gift_levels_0" class="gift-levels control-group"> <label class="control-label">Membership Categories</label> <div class="controls"> <table class="table table-bordered"> <thead> <tr class="meta"> <th> </th> <th>Category</th> <th>Rate</th> </tr> </thead> </table> <div>* (Amount that is not tax-deductible)</div> </div> </div> </div> </div> <hr class="divider" /> <div class="block-row"> <div class="controls"> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="cantor_comments_0" class="span6 cantor-comments control-group"> <input class="input-block-level field utility input calc-totals cantor-comments-input" id="cantor_comments_input_0" type="text" name="gifts[0].cantorData.comments" value="" maxlength="255" placeholder="Special Instructions"> </div> <div id="cantor_coments_characters_remaining_0" class="span3 characters-remaining"> <span class="meta">(<span>255</span> characters remaining)</span> </div> </div> </div> </div> </div> </div> </div> <div id="gift_types_0" class="gift-types"> <div class="one_time_gift" id="one_time_gift_0"></div>     </div> <div id="options_0" class="options"> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <label class="control-label">Options</label> <div class="controls"> <div id="option_first_payment_0" class="option-first-payment gift-option-container" style="display:none;"> <label class="checkbox"> <input id="option_first_payment_checkbox_0" class="option-first-payment-checkbox calc-totals" type="checkbox" name="gifts[0].multiYearPledgeData.makeInitialPayment" value="Y" data-pg-trigger-check="true"> <span class="option-first-payment-label-text">Make First Payment Today</span> <span id="first_payment_today_total_0" class="meta first-payment-today-total" style="display:none;" data-pg-dependent="option_first_payment_checkbox_0" data-pg-show="checked"> (Your credit card will be charged $<span class="first-payment-amount">0.00</span> today) </span> </label> </div> <div id="option_joint_0" class="option-joint gift-option-container" style="display:none"> <label class="checkbox"> <input id="option_joint_checkbox_0" class="option-joint-checkbox" type="checkbox" name="gifts[0].jointGift" value="Y" /> <span class="option-joint-label-text"></span> </label>  </div> <div id="option_dedication_0" class="option-dedication gift-option-container" style="display:none"> <input type="hidden" class="gift-honorees-allowed" name="gifts[0].honorees-allowed" value="N" id="gift_honorees_allowed_0"> <label class="checkbox"> <input id="option_dedication_checkbox_0" class="option-dedication-checkbox" type="checkbox" name="gifts[0].dedication" value="Y"> In Honor/Memory of...</label>  </div> <div id="option_remain_anonymous_0" class="option-remain-anonymous gift-option-container" > <label class="checkbox"> <input type="checkbox" id="option_remain_anonymous_checkbox_0" class="option-remain-anonymous-checkbox" name="gifts[0].anonymous" value="Y" > I Wish to Remain Anonymous </label> </div> <div id="option_priority_seating_0" class="option-priority-seating gift-option-container" data-pg-dependent="support_primary_select_0" data-pg-show="" style="display:none" > <label class="checkbox"> <input type="checkbox" id="option_priority_seating_checkbox_0" class="option-priority-seating-checkbox" name="gifts[0].prioritySeating" value="Y" > Contribution toward Buck/Cardinal Club Priority Seats </label> <p class="meta span6">Buck/Cardinal Club Priority Seats are available for Stanford football and men's basketball. If you are not a current Buck/Cardinal Club priority seat holder and would like more information, please call 650.736.6907. <span style="color:#a31919"> For Priority Seating, please choose one-time or recurring gift from the gift type menu above.</span></p> </div> </div> </div> </div> </div>  </div> <div class="block-footer"> <div id="gifts_controls" class="controls" > <span class="gift-add-loading meta" style="display:none;">Loading...</span> <a class="add-gift meta" data-id="0" href="#">Add Another Gift <i class="icon-chevron-down"></i></a> <a class="remove-gift meta" data-id="0" href="#">Remove this Gift <i class="icon-remove"></i></a> </div> </div>  </div> </div> <div class="span10 offset1 "> <div id="sign_in" class="block sign-in"> <div class="block-header intro"> <h3>Sign In</h3> </div> <div class="block-content"> <div class="block-error-list hide"><ul></ul></div> <div class="block-row"> <div class="row-fluid"> <p>Signing in with your Stanford account will automatically fill in your name and address information in the next step of making your gift.</p> <p class="continue-as-guest-instructions">Selecting <b>Continue as Guest</b> will allow you to make a gift without signing in with an existing Stanford account.</p> <div id="sign_in_button" class="span4"> <a id="sign_in_link" href="#" class="btn btn-custom btn-custom-large open1 sign_in_link" style="display:block;">Stanford Account</a> <p class="muted hide">Signing in with your Stanford account or a linked social media account like Facebook, Twitter, or Google, will pre-fill your name and address information in the next step of making your gift.</p> </div> <div id="sign_in_or" class="span1">OR</div> <div id="guest_button" class="span4"> <a class="btn btn-custom btn-custom-large open1">Continue as Guest</a> <p class="muted hide">Continue as a guest to manually fill out your address information.</p> </div> </div> </div> </div> <div class="block-footer"> <div class="controls pull-right"> <a id="register_button" class="meta" href="#">Create a new Stanford Account <i class="icon-chevron-right"></i></a> </div> </div>  </div> </div> </div> <div id="step_2" class="hide"> <div id="about" class="span10 offset1 about"> <div class="block"> <div class="block-header intro"> <div class="controls pull-right"> <a class="block-help-link meta">Help <i class="icon-chevron-down icon-white"></i></a> </div> <h3>About Me</h3> <span class="additional-info">If you want to sign in using your Stanford Account, click <a href="#" class="sign_in_link meta">here</a>.</span> </div> <div class="block-help" style="display:none;"> <a class="block-help-close close" href="#"><i class="icon-remove"></i></a> <p>Signing in with your Stanford account will automatically fill in your name and address information below.</p> <p>If you are making a gift without signing in with a Stanford account, your <b>Name, Preferred Address, Spouse/Partner</b> (if indicated in the <b>Gift Details</b> section above), and <b>Email Address</b> must be entered to complete your gift transaction. Indicate whether the address you are providing is a home or business address and whether the email is a personal or business account.</p> </div> <div class="block-content"> <div class="block-error-list hide"><ul></ul></div> <div class="block-row"> <div class="control-group"> <label class="control-label">Name</label> <div class="controls"> <div class="row-fluid"> <div id="about_name_title" class="span4 about-name-title control-group"> <select id="about_name_title_select" class="about-name-title-select title-select menu utility" data-pg-trigger="true" name="aboutMe.name.title"> <option value="" selected="selected">Title</option> <option value="01">Mr.</option> <option value="03">Mrs.</option> <option value="02">Ms.</option> <option value="05">Dr.</option> <option value="06">Admiral</option> <option value="16">Captain</option> <option value="20">Colonel</option> <option value="22">Commander</option> <option value="05">Dr.</option> <option value="33">General</option> <option value="46">Lieutenant</option> <option value="47">Lieutenant Colonel</option> <option value="53">Major</option> <option value="54">Major General</option> <option value="04">Miss</option> <option value="01">Mr.</option> <option value="03">Mrs.</option> <option value="02">Ms.</option> <option value="97">Mx.</option> <option value="66">Professor</option> <option value="67">Rabbi</option> <option value="40">The Honorable</option> <option value="70">The Reverend</option>  </select> </div> </div> <div class="row-fluid"> <div id="about_name_first" class="span4 about-name-first control-group"> <input class="input-block-level about-name-first-input field utility" id="about_name_first_input" type="text" maxlength="25" placeholder="First" name="aboutMe.name.firstName" value=""> </div> <div id="about_name_middle" class="span4 about-name-middle control-group"> <input class="input-block-level about-name-middle-input field utility" id="about_name_middle_input" type="text" maxlength="25" placeholder="Middle (Optional)" name="aboutMe.name.middleName" value=""> </div> <div id="about_name_last" class="span4 about-name-last control-group"> <input class="input-block-level about-name-last-input field utility" id="about_name_last_input" type="text" maxlength="25" placeholder="Last" name="aboutMe.name.lastName" value=""> </div> </div> <div class="row-fluid"> <div id="about_name_personal_suffix" class="span4 about-name-personal-suffix control-group"> <select id="about_name_personal_suffix_select" class="about-name-personal-suffix-select personal-suffix-select menu utility" name="aboutMe.name.personalSuffix" data-pg-trigger="true"> <option value="" selected="selected">Personal Suffix</option> <option value="01">Jr.</option> <option value="02">Sr.</option> <option value="03">II</option> <option value="04">III</option> <option value="05">IV</option> </select> </div> <div id="about_name_professional_suffix" class="span4 about-name-professional-suffix control-group"> <select id="about_name_professional_suffix_select" class="about-name-professional-suffix-select professional-suffix-select menu utility" name="aboutMe.name.professionalSuffix" data-pg-trigger="true"> <option value="" selected="selected">Professional Suffix</option> <option value="10">AIA</option> <option value="41">CFA</option> <option value="01">CPA</option> <option value="11">DC</option> <option value="02">DD</option> <option value="03">DDS</option> <option value="12">DMD</option> <option value="39">DMin</option> <option value="04">DO</option> <option value="26">DVM</option> <option value="13">EdD</option> <option value="59">Emerita</option> <option value="58">Emeritus</option> <option value="05">Esq.</option> <option value="14">JD</option> <option value="29">LCSW</option> <option value="42">LICSW</option> <option value="15">LLB</option> <option value="06">LLD</option> <option value="43">M ARCH</option> <option value="16">MA</option> <option value="17">MBA</option> <option value="07">MD</option> <option value="46">MFA</option> <option value="28">MFT</option> <option value="35">MLA</option> <option value="19">MPH</option> <option value="45">MS</option> <option value="40">MSM</option> <option value="20">MSW</option> <option value="08">OD</option> <option value="60">OLY</option> <option value="27">PE</option> <option value="09">PhD</option> <option value="34">Pharm D</option> <option value="23">RN</option> <option value="22">Ret.</option> <option value="24">SJ</option> <option value="37">USA</option> <option value="47">USA, Ret.</option> <option value="30">USAF</option> <option value="48">USAF, Ret.</option> <option value="36">USAFR</option> <option value="49">USAFR, Ret.</option> <option value="38">USAR</option> <option value="50">USAR, Ret.</option> <option value="44">USCG</option> <option value="51">USCG, Ret.</option> <option value="52">USCGR</option> <option value="53">USCGR, Ret.</option> <option value="31">USMC</option> <option value="54">USMC, Ret.</option> <option value="32">USMCR</option> <option value="55">USMCR, Ret.</option> <option value="25">USN</option> <option value="56">USN, Ret.</option> <option value="33">USNR</option> <option value="57">USNR, Ret.</option> </select> </div> </div> </div> </div> </div> <div id="about_joint" class="about_joint hide"> <hr class="divider" /> <div class="block-row"> <input type="hidden" id="newspouse" value="Y"/> <div class="control-group"> <label class="control-label">Spouse/Partner </label> <div class="control-group"> <div class="controls"> <label class="radio inline"> <input type="radio" name="aboutMe.spouse.type" id="joint_radios_spouse" class="joint-radios-spouse" value="spouse" checked>Spouse </label> <label class="radio inline"> <input type="radio" name="aboutMe.spouse.type" id="joint_radios_partner" class="joint-radios-partner" value="partner" >Partner </label> </div> </div> <div class="controls"> <div class="row-fluid"> <div id="joint_title" class="span4 joint-title control-group"> <select id="joint_title_select" class="joint-title-select title-select" name="aboutMe.spouse.name.title" data-pg-trigger="true"> <option value="">Title</option> <option value="01">Mr.</option> <option value="03">Mrs.</option> <option value="02">Ms.</option> <option value="05">Dr.</option> <option value="06">Admiral</option> <option value="16">Captain</option> <option value="20">Colonel</option> <option value="22">Commander</option> <option value="05">Dr.</option> <option value="33">General</option> <option value="46">Lieutenant</option> <option value="47">Lieutenant Colonel</option> <option value="53">Major</option> <option value="54">Major General</option> <option value="04">Miss</option> <option value="01">Mr.</option> <option value="03">Mrs.</option> <option value="02">Ms.</option> <option value="97">Mx.</option> <option value="66">Professor</option> <option value="67">Rabbi</option> <option value="40">The Honorable</option> <option value="70">The Reverend</option> </select> </div> </div> <div class="row-fluid"> <div id="joint_first_name" class="span4 joint-first-name control-group"> <input id="joint_first_name_input" class="joint-first-name-input input-block-level field utlity input" type="text" maxlength="25" placeholder="First" name="aboutMe.spouse.name.firstName" value=""> </div> <div id="joint_middle_name" class="span4 joint-middle-name control-group"> <input id="joint_middle_name_input" class="joint-middle-name-input input-block-level field utlity input" type="text" maxlength="25" placeholder="Middle (Optional)" name="aboutMe.spouse.name.middleName" value=""> </div> <div id="joint_last_name" class="span4 joint-last-name control-group"> <input id="joint_last_name_input" class="joint-last-name-input input-block-level field utlity input" type="text" maxlength="25" placeholder="Last" name="aboutMe.spouse.name.lastName" value=""> </div> </div> <div class="row-fluid"> <div id="joint_personal_suffix" class="span4 joint-personal-suffix control-group"> <select id="joint_personal_suffix_select" class="joint-personal-suffix-select personal-suffix-select menu utility" name="aboutMe.spouse.name.personalSuffix" data-pg-trigger="true"> <option value="">Personal Suffix</option> <option value="01">Jr.</option> <option value="02">Sr.</option> <option value="03">II</option> <option value="04">III</option> <option value="05">IV</option> </select> </div> <div id="joint_professional_suffix" class="span4 joint-professional-suffix control-group"> <select id="joint_professional_suffix_select" class="joint-professional-suffix-select professional-suffix-select menu utility" name="aboutMe.spouse.name.professionalSuffix" data-pg-trigger="true"> <option value="">Professional Suffix</option> <option value="10">AIA</option> <option value="41">CFA</option> <option value="01">CPA</option> <option value="11">DC</option> <option value="02">DD</option> <option value="03">DDS</option> <option value="12">DMD</option> <option value="39">DMin</option> <option value="04">DO</option> <option value="26">DVM</option> <option value="13">EdD</option> <option value="59">Emerita</option> <option value="58">Emeritus</option> <option value="05">Esq.</option> <option value="14">JD</option> <option value="29">LCSW</option> <option value="42">LICSW</option> <option value="15">LLB</option> <option value="06">LLD</option> <option value="43">M ARCH</option> <option value="16">MA</option> <option value="17">MBA</option> <option value="07">MD</option> <option value="46">MFA</option> <option value="28">MFT</option> <option value="35">MLA</option> <option value="19">MPH</option> <option value="45">MS</option> <option value="40">MSM</option> <option value="20">MSW</option> <option value="08">OD</option> <option value="60">OLY</option> <option value="27">PE</option> <option value="09">PhD</option> <option value="34">Pharm D</option> <option value="23">RN</option> <option value="22">Ret.</option> <option value="24">SJ</option> <option value="37">USA</option> <option value="47">USA, Ret.</option> <option value="30">USAF</option> <option value="48">USAF, Ret.</option> <option value="36">USAFR</option> <option value="49">USAFR, Ret.</option> <option value="38">USAR</option> <option value="50">USAR, Ret.</option> <option value="44">USCG</option> <option value="51">USCG, Ret.</option> <option value="52">USCGR</option> <option value="53">USCGR, Ret.</option> <option value="31">USMC</option> <option value="54">USMC, Ret.</option> <option value="32">USMCR</option> <option value="55">USMCR, Ret.</option> <option value="25">USN</option> <option value="56">USN, Ret.</option> <option value="33">USNR</option> <option value="57">USNR, Ret.</option> </select> </div> </div> </div> </div> </div> <div class="block-row"> <div class="control-group"> <label class="control-label">Is this person an alumnus/a?</label> <div id="joint_alum_radios" class="controls"> <div class="control-group radio-container"> <label class="radio inline"> <input type="radio" id="joint_alum_radios_yes" class="joint-alum-radios-yes" value="Y" data-pg-trigger-radio="joint_alum_radios" name="aboutMe.spouse.alum" >Yes </label> <label class="radio inline"> <input type="radio" id="joint_alum_radios_no" class="joint-alum-radios-no" value="N" data-pg-trigger-radio="joint_alum_radios" name="aboutMe.spouse.alum" >No </label> </div> </div> </div> <div id="joint_alum_on" class="joint-alum-yes" data-pg-dependent="joint_alum_radios" data-pg-show="Y" style="display:none;"> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="joint_alum_degree" class="span4 joint-alum-degree control-group"> <select id="joint_alum_degree_input" class="joint-alum-degree-input utility menu" name="aboutMe.spouse.alumData.degree"> <option value="">Please enter degree</option><option value="AB">AB</option> <option value="AM">AM</option> <option value="B">B</option> <option value="BA">BA</option> <option value="BAR">BAR</option> <option value="BAS">BAS</option> <option value="BS">BS</option> <option value="BSN">BSN</option> <option value="CRT">Certificate</option> <option value="DDS">DDS</option> <option value="DDSc">DDSc</option> <option value="DMA">DMA</option> <option value="DMD">DMD</option> <option value="DNP">DNP</option> <option value="DO">DO</option> <option value="DPM">DPM</option> <option value="DVM">DVM</option> <option value="EDD">EDD</option> <option value="EDM">EDM</option> <option value="EDS">EDS</option> <option value="ENG">ENG</option> <option value="IA">IA</option> <option value="RES">Intern/Resident</option> <option value="JD">JD</option> <option value="JM">JM</option> <option value="JSD">JSD</option> <option value="JSM">JSM</option> <option value="LLB">LLB</option> <option value="LLM">LLM</option> <option value="MA">MA</option> <option value="MAR">MAR</option> <option value="MAT">MAT</option> <option value="MBA">MBA</option> <option value="MCRP">MCRP</option> <option value="MD">MD</option> <option value="MDIV">MDIV</option> <option value="MEA">MEA</option> <option value="MFA">MFA</option> <option value="MLA">MLA</option> <option value="MLIS">MLIS</option> <option value="MLS">MLS</option> <option value="MPA">MPA</option> <option value="MPH">MPH</option> <option value="MPP">MPP</option> <option value="MRP">MRP</option> <option value="MS">MS</option> <option value="MSD">MSD</option> <option value="MSM">MSM</option> <option value="MSN">MSN</option> <option value="MSW">MSW</option> <option value="MF">Med Fellow</option> <option value="03">Other non-Stanford Doctoral Degree</option> <option value="02">Other non-Stanford Masters Degree</option> <option value="01">Other non-Stanford Undergrad Degree</option> <option value="PHD">PHD</option> <option value="PD">PostDoc</option> <option value="RN">RN</option> </select> </div> <div id="joint_alum_year" class="span4 joint-alum-year control-group"> <input id="joint_alum_year_input" class="joint-alum-year-input input-block-level field utility input" type="text" maxlength="4" placeholder="Year" name="aboutMe.spouse.alumData.year" value=""> </div> </div> </div> </div> </div>  </div> <div class="block-row" id="joint_reason_change_container" style="display:none;"> <label>If you have changed your spouse/partner information, please tell us the reason for the change:</label> <div id="joint_reason_change" class="joint-reason-change control-group"> <input class="input-block-level joint-reason-change-input field utility" id="joint_reason_change_input" type="text" maxlength="255" placeholder="Reason for change" name="aboutMe.spouse.comments" value=""> </div> </div> </div> <hr class="divider" /> <div class="block-row"> <div id="about_address" class="about-address"> <div class="control-group"> <label class="control-label">Preferred Address</label> <div class="controls"> <div id="about_address_radios" class="about-address-radios control-group radio-container"> <label class="radio inline"> <input type="radio" name="aboutMe.chosenAddress" id="about_address_radios_home" class="about-address-radios-home" data-pg-trigger-radio="about_address_radios" value="home" checked>Home </label> <label class="radio inline"> <input type="radio" name="aboutMe.chosenAddress" id="about_address_radios_business" class="about-address-radios-business" data-pg-trigger-radio="about_address_radios" value="business" >Business </label> </div> <div id="wrapper_about_address_home" class="about-address-home" data-pg-dependent="about_address_radios" data-pg-show="home" > <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="about_address_home_street_address1" class="span8 about-address-home-street-address1 control-group"> <input id="about_address_home_street_address1_input" class="about-address-home-street-address1-input input-block-level field utility" type="text" maxlength="40" placeholder="Street Address 1" name="aboutMe.homeAddr.street1" value=""> </div> </div> <div class="row-fluid"> <div id="about_address_home_street_address2" class="span8 about-address-home-street-address2 control-group"> <input id="about_address_home_street_address2_input" class="about-address-home-street-address2-input input-block-level field utility" type="text" maxlength="40" placeholder="Street Address 2" name="aboutMe.homeAddr.street2" value="" > </div> </div> <div class="row-fluid"> <div id="about_address_home_city" class="span4 about-address-home-city control-group"> <input id="about_address_home_city_input" class="about-address-home-city-input input-block-level field utility" type="text" maxlength="30" placeholder="City" name="aboutMe.homeAddr.city" value=""> </div> <div id="about_address_home_province" class="span4 about-address-home-province control-group" data-pg-dependent="about_address_home_country_select" data-pg-hide=" | " style="display:none;"> <input id="about_address_home_province_input" class="about-address-home-province-input input-block-level field utility" type="text" maxlength="40" placeholder="Province" name="aboutMe.homeAddr.province" value=""> </div> <div id="about_address_home_state" class="span4 about-address-home-state control-group" data-pg-dependent="about_address_home_country_select" data-pg-show=" | " > <select id="about_address_home_state_select" class="utility menu about-address-home-state-select" name="aboutMe.homeAddr.state"> <option value="" selected="selected">State</option> <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="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">Fed. 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="AA">Military/Americas</option> <option value="AE">Military/Europe</option> <option value="AP">Military/Pacific</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="MP">No. Mariana Islands</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 Islands</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 class="row-fluid"> <div id="about_address_home_postal_code" class="span4 about-address-home-postal-code control-group"> <input id="about_address_home_postal_code_input" class="about-address-home-postal-code-input input-block-level field utility" type="text" placeholder="ZIP/Postal Code" maxlength="10" name="aboutMe.homeAddr.postalCode" value=""> </div> <div id="about_address_home_country" class="span4 about-address-home-country control-group"> <select id="about_address_home_country_select" name="aboutMe.homeAddr.country" class="utility menu about-address-home-country-select country-select" data-pg-trigger="true" data-pg-ereceipt-trigger="true"> <option value="">Country</option> <option value="115">Afghanistan</option> <option value="118">Aland Islands</option> <option value="120">Albania</option> <option value="125">Algeria</option> <option value="130">Andorra</option> <option value="135">Angola</option> <option value="136">Anguilla</option> <option value="134">Antarctica</option> <option value="137">Antigua and Barbuda</option> <option value="140">Argentina</option> <option value="143">Armenia</option> <option value="000">Aruba</option> <option value="145">Australia</option> <option value="150">Austria</option> <option value="153">Azerbaijan</option> <option value="155">Bahamas</option> <option value="158">Bahrain</option> <option value="157">Bangladesh</option> <option value="160">Barbados</option> <option value="163">Belarus</option> <option value="165">Belgium</option> <option value="195">Belize</option> <option value="330">Benin</option> <option value="170">Bermuda</option> <option value="175">Bhutan</option> <option value="180">Bolivia</option> <option value="211">Bonaire, Sint Eustatius and Saba</option> <option value="182">Bosnia and Herzegovina</option> <option value="183">Botswana</option> <option value="185">Brazil</option> <option value="187">British Indian Ocean Terr</option> <option value="189">British Virgin Islands</option> <option value="212">Brunei Darussalam</option> <option value="205">Bulgaria</option> <option value="940">Burkina Faso</option> <option value="215">Burundi</option> <option value="218">Cambodia</option> <option value="225">Cameroon</option> <option value="230">Canada</option> <option value="315">Cape Verde</option> <option value="222">Cayman Islands</option> <option value="245">Central African Republic</option> <option value="255">Chad</option> <option value="260">Chile</option> <option value="265">China</option> <option value="266">Christmas Island</option> <option value="223">Cocos Islands</option> <option value="280">Colombia</option> <option value="226">Comoros</option> <option value="290">Congo, Democratic Republic of the</option> <option value="247">Congo, Republic of the</option> <option value="316">Cook Islands</option> <option value="300">Costa Rica</option> <option value="525">Cote d'Ivoire</option> <option value="318">Croatia</option> <option value="310">Cuba</option> <option value="248">Curacao</option> <option value="320">Cyprus</option> <option value="327">Czech Republic</option> <option value="555">Democratic People's Republic of Korea</option> <option value="335">Denmark</option> <option value="337">Djibouti</option> <option value="336">Dominica</option> <option value="345">Dominican Republic</option> <option value="355">Ecuador</option> <option value="930">Egypt</option> <option value="365">El Salvador</option> <option value="452">Equatorial Guinea</option> <option value="291">Eritrea</option> <option value="369">Estonia</option> <option value="380">Ethiopia</option> <option value="382">Falkland Islands</option> <option value="391">Faroe Islands</option> <option value="392">Fiji</option> <option value="390">Finland</option> <option value="395">France</option> <option value="383">French Guiana</option> <option value="393">French Polynesia</option> <option value="405">Gabon</option> <option value="410">Gambia</option> <option value="451">Georgia</option> <option value="421">Germany</option> <option value="425">Ghana</option> <option value="430">Gibraltar</option> <option value="440">Greece</option> <option value="432">Greenland</option> <option value="441">Grenada</option> <option value="442">Guadeloupe</option> <option value="450">Guatemala</option> <option value="254">Guernsey</option> <option value="455">Guinea</option> <option value="453">Guinea-Bissau</option> <option value="457">Guyana</option> <option value="460">Haiti</option> <option value="462">Heard Island and McDonald Islands</option> <option value="470">Honduras</option> <option value="475">Hong Kong</option> <option value="480">Hungary</option> <option value="485">Iceland</option> <option value="490">India</option> <option value="495">Indonesia</option> <option value="500">Iran</option> <option value="505">Iraq</option> <option value="510">Ireland</option> <option value="513">Isle of Man</option> <option value="515">Israel</option> <option value="520">Italy</option> <option value="530">Jamaica</option> <option value="535">Japan</option> <option value="537">Jersey</option> <option value="540">Jordan</option> <option value="543">Kazakhstan</option> <option value="550">Kenya</option> <option value="431">Kiribati</option> <option value="565">Kuwait</option> <option value="563">Kyrgyzstan</option> <option value="570">Laos</option> <option value="573">Latvia</option> <option value="580">Lebanon</option> <option value="582">Lesotho</option> <option value="585">Liberia</option> <option value="590">Libya</option> <option value="595">Liechtenstein</option> <option value="600">Lithuania</option> <option value="610">Luxembourg</option> <option value="613">Macao</option> <option value="612">Macedonia</option> <option value="615">Madagascar</option> <option value="620">Malawi</option> <option value="625">Malaysia</option> <option value="627">Maldives</option> <option value="630">Mali</option> <option value="635">Malta</option> <option value="637">Martinique</option> <option value="640">Mauritania</option> <option value="643">Mauritius</option> <option value="644">Mayotte</option> <option value="645">Mexico</option> <option value="650">Moldova</option> <option value="655">Monaco</option> <option value="660">Mongolia</option> <option value="661">Montenegro</option> <option value="662">Montserrat</option> <option value="665">Morocco</option> <option value="670">Mozambique</option> <option value="210">Myanmar</option> <option value="673">Namibia</option> <option value="672">Nauru</option> <option value="675">Nepal</option> <option value="680">Netherlands</option> <option value="695">New Caledonia</option> <option value="700">New Zealand</option> <option value="705">Nicaragua</option> <option value="710">Niger</option> <option value="715">Nigeria</option> <option value="720">Niue</option> <option value="723">Norfolk Island</option> <option value="730">Norway</option> <option value="735">Oman</option> <option value="740">Pakistan</option> <option value="743">Palestinian Territories</option> <option value="745">Panama</option> <option value="747">Papua New Guinea</option> <option value="750">Paraguay</option> <option value="755">Peru</option> <option value="760">Philippines</option> <option value="762">Pitcairn</option> <option value="765">Poland</option> <option value="770">Portugal</option> <option value="777">Qatar</option> <option value="560">Republic of Korea</option> <option value="775">Reunion</option> <option value="785">Romania</option> <option value="800">Russian Federation</option> <option value="795">Rwanda</option> <option value="811">Saint Barthelemy</option> <option value="819">Saint Helena</option> <option value="690">Saint Kitts and Nevis</option> <option value="818">Saint Lucia</option> <option value="813">Saint Martin</option> <option value="817">Saint Pierre and Miquelon</option> <option value="946">Saint Vincent and the Grenadines</option> <option value="975">Samoa</option> <option value="805">San Marino</option> <option value="807">Sao Tome & Principe</option> <option value="810">Saudi Arabia</option> <option value="820">Senegal</option> <option value="812">Serbia</option> <option value="816">Seychelles</option> <option value="825">Sierra Leone</option> <option value="830">Singapore</option> <option value="831">Sint Maarten</option> <option value="832">Slovak Republic</option> <option value="833">Slovenia</option> <option value="197">Solomon Islands</option> <option value="835">Somalia</option> <option value="840">South Africa</option> <option value="850">South Georgia and South Sandwich</option> <option value="842">South Sudan</option> <option value="855">Spain</option> <option value="250">Sri Lanka</option> <option value="860">Sudan</option> <option value="865">Suriname</option> <option value="867">Svalbard and Jan Mayen</option> <option value="868">Swaziland</option> <option value="870">Sweden</option> <option value="875">Switzerland</option> <option value="880">Syrian Arab Republic</option> <option value="270">Taiwan</option> <option value="883">Tajikistan</option> <option value="885">Tanzania</option> <option value="890">Thailand</option> <option value="771">Timor-Leste</option> <option value="895">Togo</option> <option value="897">Tonga</option> <option value="900">Trinidad and Tobago</option> <option value="905">Tunisia</option> <option value="910">Turkey</option> <option value="914">Turkmenistan</option> <option value="912">Turks and Caicos Islands</option> <option value="915">Tuvalu</option> <option value="919">US Minor Outlying Islands</option> <option value="920">Uganda</option> <option value="918">Ukraine</option> <option value="138">United Arab Emirates</option> <option value="370">United Kingdom</option> <option value=" " selected>United States</option> <option value="945">Uruguay</option> <option value="943">Uzbekistan</option> <option value="947">Vanuatu</option> <option value="950">Vatican City</option> <option value="955">Venezuela</option> <option value="960">Viet Nam</option> <option value="971">Wallis and Futuna Islands</option> <option value="973">Western Sahara</option> <option value="980">Yemen</option> <option value="990">Zambia</option> <option value="780">Zimbabwe</option> </select> </div> </div> </div> </div> </div> <div id="wrapper_about_address_business" class="about-address-business" data-pg-dependent="about_address_radios" data-pg-show="business" style="display:none;"> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="about_address_business_company" class="span4 about-address-business-company control-group"> <input id="about_address_business_company_input" class="about-address-business-company-input input-block-level field utility" type="text" maxlength="60" placeholder="Company" name="aboutMe.busiAddr.company" value="" > </div> <div id="about_address_business_company_additional" class="span4 about-address-business-company-additional control-group"> <input id="about_address_business_company_additional_input" class="about-address-business-company-additional-input input-block-level field utility" type="text" maxlength="60" placeholder="Company Additional" name="aboutMe.busiAddr.companyAdditional" value="" > </div> </div> <div class="row-fluid"> <div id="about_address_business_street_address1" class="span8 about-address-business-street-address1 control-group"> <input id="about_address_business_street_address1_input" class="about-address-business-street-address1-input input-block-level field utility" type="text" maxlength="40" placeholder="Street Address 1" name="aboutMe.busiAddr.street1" value=""> </div> </div> <div class="row-fluid"> <div id="about_address_business_street_address2" class="span8 about-address-business-street-address2 control-group"> <input id="about_address_business_street_address2_input" class="about-address-business-street-address2-input input-block-level field utility" type="text" maxlength="40" placeholder="Street Address 2" name="aboutMe.busiAddr.street2" value="" > </div> </div> <div class="row-fluid"> <div id="about_address_business_city" class="span4 about-address-business-city control-group"> <input id="about_address_business_city_input" class="about-address-business-city-input input-block-level field utility" type="text" maxlength="30" placeholder="City" name="aboutMe.busiAddr.city" value=""> </div> <div id="about_address_business_province" class="span4 about-address-business-province control-group" data-pg-dependent="about_address_business_country_select" data-pg-hide=" | " style="display:none;"> <input id="about_address_business_province_input" class="about-address-business-province-input input-block-level field utility" type="text" maxlength="40" placeholder="Province" name="aboutMe.busiAddr.province" value=""> </div> <div id="about_address_business_state" class="span4 about-address-business-state control-group" data-pg-dependent="about_address_business_country_select" data-pg-show=" | " > <select id="about_address_business_state_select" name="aboutMe.busiAddr.state" class="utility menu about-address-business-state-select"> <option value="" selected="selected">State</option> <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="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">Fed. 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="AA">Military/Americas</option> <option value="AE">Military/Europe</option> <option value="AP">Military/Pacific</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="MP">No. Mariana Islands</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 Islands</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 class="row-fluid"> <div id="about_address_business_postal_code" class="span4 about-address-business-postal-code control-group"> <input id="about_address_business_postal_code_input" class="about-address-business-postal-code-input input-block-level field utility" type="text" placeholder="ZIP/Postal Code" name="aboutMe.busiAddr.postalCode" value=""> </div> <div id="about_address_business_country" class="span4 about-address-business-country control-group"> <select id="about_address_business_country_select" name="aboutMe.busiAddr.country" class="utility menu about-address-business-country-select country-select" data-pg-trigger="true" data-pg-ereceipt-trigger="true"> <option value="">Country</option> <option value="115">Afghanistan</option> <option value="118">Aland Islands</option> <option value="120">Albania</option> <option value="125">Algeria</option> <option value="130">Andorra</option> <option value="135">Angola</option> <option value="136">Anguilla</option> <option value="134">Antarctica</option> <option value="137">Antigua and Barbuda</option> <option value="140">Argentina</option> <option value="143">Armenia</option> <option value="000">Aruba</option> <option value="145">Australia</option> <option value="150">Austria</option> <option value="153">Azerbaijan</option> <option value="155">Bahamas</option> <option value="158">Bahrain</option> <option value="157">Bangladesh</option> <option value="160">Barbados</option> <option value="163">Belarus</option> <option value="165">Belgium</option> <option value="195">Belize</option> <option value="330">Benin</option> <option value="170">Bermuda</option> <option value="175">Bhutan</option> <option value="180">Bolivia</option> <option value="211">Bonaire, Sint Eustatius and Saba</option> <option value="182">Bosnia and Herzegovina</option> <option value="183">Botswana</option> <option value="185">Brazil</option> <option value="187">British Indian Ocean Terr</option> <option value="189">British Virgin Islands</option> <option value="212">Brunei Darussalam</option> <option value="205">Bulgaria</option> <option value="940">Burkina Faso</option> <option value="215">Burundi</option> <option value="218">Cambodia</option> <option value="225">Cameroon</option> <option value="230">Canada</option> <option value="315">Cape Verde</option> <option value="222">Cayman Islands</option> <option value="245">Central African Republic</option> <option value="255">Chad</option> <option value="260">Chile</option> <option value="265">China</option> <option value="266">Christmas Island</option> <option value="223">Cocos Islands</option> <option value="280">Colombia</option> <option value="226">Comoros</option> <option value="290">Congo, Democratic Republic of the</option> <option value="247">Congo, Republic of the</option> <option value="316">Cook Islands</option> <option value="300">Costa Rica</option> <option value="525">Cote d'Ivoire</option> <option value="318">Croatia</option> <option value="310">Cuba</option> <option value="248">Curacao</option> <option value="320">Cyprus</option> <option value="327">Czech Republic</option> <option value="555">Democratic People's Republic of Korea</option> <option value="335">Denmark</option> <option value="337">Djibouti</option> <option value="336">Dominica</option> <option value="345">Dominican Republic</option> <option value="355">Ecuador</option> <option value="930">Egypt</option> <option value="365">El Salvador</option> <option value="452">Equatorial Guinea</option> <option value="291">Eritrea</option> <option value="369">Estonia</option> <option value="380">Ethiopia</option> <option value="382">Falkland Islands</option> <option value="391">Faroe Islands</option> <option value="392">Fiji</option> <option value="390">Finland</option> <option value="395">France</option> <option value="383">French Guiana</option> <option value="393">French Polynesia</option> <option value="405">Gabon</option> <option value="410">Gambia</option> <option value="451">Georgia</option> <option value="421">Germany</option> <option value="425">Ghana</option> <option value="430">Gibraltar</option> <option value="440">Greece</option> <option value="432">Greenland</option> <option value="441">Grenada</option> <option value="442">Guadeloupe</option> <option value="450">Guatemala</option> <option value="254">Guernsey</option> <option value="455">Guinea</option> <option value="453">Guinea-Bissau</option> <option value="457">Guyana</option> <option value="460">Haiti</option> <option value="462">Heard Island and McDonald Islands</option> <option value="470">Honduras</option> <option value="475">Hong Kong</option> <option value="480">Hungary</option> <option value="485">Iceland</option> <option value="490">India</option> <option value="495">Indonesia</option> <option value="500">Iran</option> <option value="505">Iraq</option> <option value="510">Ireland</option> <option value="513">Isle of Man</option> <option value="515">Israel</option> <option value="520">Italy</option> <option value="530">Jamaica</option> <option value="535">Japan</option> <option value="537">Jersey</option> <option value="540">Jordan</option> <option value="543">Kazakhstan</option> <option value="550">Kenya</option> <option value="431">Kiribati</option> <option value="565">Kuwait</option> <option value="563">Kyrgyzstan</option> <option value="570">Laos</option> <option value="573">Latvia</option> <option value="580">Lebanon</option> <option value="582">Lesotho</option> <option value="585">Liberia</option> <option value="590">Libya</option> <option value="595">Liechtenstein</option> <option value="600">Lithuania</option> <option value="610">Luxembourg</option> <option value="613">Macao</option> <option value="612">Macedonia</option> <option value="615">Madagascar</option> <option value="620">Malawi</option> <option value="625">Malaysia</option> <option value="627">Maldives</option> <option value="630">Mali</option> <option value="635">Malta</option> <option value="637">Martinique</option> <option value="640">Mauritania</option> <option value="643">Mauritius</option> <option value="644">Mayotte</option> <option value="645">Mexico</option> <option value="650">Moldova</option> <option value="655">Monaco</option> <option value="660">Mongolia</option> <option value="661">Montenegro</option> <option value="662">Montserrat</option> <option value="665">Morocco</option> <option value="670">Mozambique</option> <option value="210">Myanmar</option> <option value="673">Namibia</option> <option value="672">Nauru</option> <option value="675">Nepal</option> <option value="680">Netherlands</option> <option value="695">New Caledonia</option> <option value="700">New Zealand</option> <option value="705">Nicaragua</option> <option value="710">Niger</option> <option value="715">Nigeria</option> <option value="720">Niue</option> <option value="723">Norfolk Island</option> <option value="730">Norway</option> <option value="735">Oman</option> <option value="740">Pakistan</option> <option value="743">Palestinian Territories</option> <option value="745">Panama</option> <option value="747">Papua New Guinea</option> <option value="750">Paraguay</option> <option value="755">Peru</option> <option value="760">Philippines</option> <option value="762">Pitcairn</option> <option value="765">Poland</option> <option value="770">Portugal</option> <option value="777">Qatar</option> <option value="560">Republic of Korea</option> <option value="775">Reunion</option> <option value="785">Romania</option> <option value="800">Russian Federation</option> <option value="795">Rwanda</option> <option value="811">Saint Barthelemy</option> <option value="819">Saint Helena</option> <option value="690">Saint Kitts and Nevis</option> <option value="818">Saint Lucia</option> <option value="813">Saint Martin</option> <option value="817">Saint Pierre and Miquelon</option> <option value="946">Saint Vincent and the Grenadines</option> <option value="975">Samoa</option> <option value="805">San Marino</option> <option value="807">Sao Tome & Principe</option> <option value="810">Saudi Arabia</option> <option value="820">Senegal</option> <option value="812">Serbia</option> <option value="816">Seychelles</option> <option value="825">Sierra Leone</option> <option value="830">Singapore</option> <option value="831">Sint Maarten</option> <option value="832">Slovak Republic</option> <option value="833">Slovenia</option> <option value="197">Solomon Islands</option> <option value="835">Somalia</option> <option value="840">South Africa</option> <option value="850">South Georgia and South Sandwich</option> <option value="842">South Sudan</option> <option value="855">Spain</option> <option value="250">Sri Lanka</option> <option value="860">Sudan</option> <option value="865">Suriname</option> <option value="867">Svalbard and Jan Mayen</option> <option value="868">Swaziland</option> <option value="870">Sweden</option> <option value="875">Switzerland</option> <option value="880">Syrian Arab Republic</option> <option value="270">Taiwan</option> <option value="883">Tajikistan</option> <option value="885">Tanzania</option> <option value="890">Thailand</option> <option value="771">Timor-Leste</option> <option value="895">Togo</option> <option value="897">Tonga</option> <option value="900">Trinidad and Tobago</option> <option value="905">Tunisia</option> <option value="910">Turkey</option> <option value="914">Turkmenistan</option> <option value="912">Turks and Caicos Islands</option> <option value="915">Tuvalu</option> <option value="919">US Minor Outlying Islands</option> <option value="920">Uganda</option> <option value="918">Ukraine</option> <option value="138">United Arab Emirates</option> <option value="370">United Kingdom</option> <option value=" " selected>United States</option> <option value="945">Uruguay</option> <option value="943">Uzbekistan</option> <option value="947">Vanuatu</option> <option value="950">Vatican City</option> <option value="955">Venezuela</option> <option value="960">Viet Nam</option> <option value="971">Wallis and Futuna Islands</option> <option value="973">Western Sahara</option> <option value="980">Yemen</option> <option value="990">Zambia</option> <option value="780">Zimbabwe</option> </select> </div> </div> </div> </div> </div> </div> </div> </div> </div> <hr class="divider" /> <div class="block-row"> <div id="about_email" class="about-email"> <div class="control-group"> <label class="control-label">Preferred Email</label> <div class="controls"> <div id="about_email_radios" class="about-email-radios control-group radio-container"> <label class="radio inline"> <input type="radio" name="aboutMe.chosenEmail" id="about_email_radios_personal" class="about-email-radios-personal" data-pg-trigger-radio="about_email_radios" value="personal" checked ><span class="radio-text">Personal</span> </label> <label class="radio inline"> <input type="radio" name="aboutMe.chosenEmail" id="about_email_radios_business" class="about-email-radios-business" data-pg-trigger-radio="about_email_radios" value="business" ><span class="radio-text">Business</span> </label> </div> <div id="wrapper_about_email_personal" class="about-email-personal" data-pg-dependent="about_email_radios" data-pg-show="personal" > <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="about_email_personal" class="span4 about-email-personal control-group"> <input id="about_email_personal_input" class="about-email-personal-input input-block-level field utility" type="text" maxlength="60" placeholder="Personal Email" spellcheck="false" name="aboutMe.homeEmail" value=""> </div> </div> </div> </div> </div> <div id="wrapper_about_email_business" class="about-email-business" data-pg-dependent="about_email_radios" data-pg-show="business" style="display:none;"> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="about_email_business" class="span4 about-email-business control-group"> <input id="about_email_business_input" class="about-email-business-input input-block-level field utility" type="text" maxlength="60" placeholder="Business Email" spellcheck="false" name="aboutMe.busiEmail" value=""> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="block-footer"> </div> </div> </div> <div id="payment" class="span10 offset1 payment"> <div class="block"> <div class="block-header intro"> <div class="controls pull-right"> <a class="block-help-link meta">Help <i class="icon-chevron-down icon-white"></i></a> </div> <h3>Payment Details</h3> </div> <div class="block-help" style="display:none;"> <a class="block-help-close close" href="#"><i class="icon-remove"></i></a> <p>If you want to make your gift via wire transfer, you will need to enter your <b>Account Name</b>, <b>Account Number</b>, and the <b>Phone Number</b> on your account.</p> <p>For each type of stock in a securities gift, you will need to enter the <b>Stock Name</b>, <b>Number of Shares</b>, and <b>Market Price per Share</b>. Your gift total will be calculated in the box below, and your total securities gift must equal the value entered in the <b>Gift Details</b> section above. Add additional stocks with the <b>Add Another Stock</b> link.</p> <p>After clicking the <b>Confirm Details</b> button for either a wire transfer or securities transaction, you will be taken to a page where you can print a Letter of Authorization. To complete your transaction, sign and date this letter and send it to your financial institution or broker.</p> </div> <div class="block-content payment-not-needed"> <div class="block-error-list hide"><ul></ul></div> <div class="block-row"> No payment needed. </div> </div> <div class="block-content payment-needed"> <div class="block-error-list hide"><ul></ul></div> <div class="block-row"> <div class="control-group"> <label class="control-label">Payment Type</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type" class="payment-type span4 control-group"> <select id="payment_type_select" class="payment-type-select utility menu" name="payment.typeDropdown" data-pg-trigger="true" data-pg-ereceipt-trigger="true"> <option value="CC" >Credit Card</option> </select> <input type="hidden" value="" name="payment.type" id="payment_type_input" class="payment-type-input"> </div> </div> </div> </div> </div> <div id="payment_type_credit_card_container"> <div id="payment_type_credit_card" class="payment-type-credit-card" data-pg-dependent="payment_type_select" data-pg-show="CC"> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="payment_type_credit_card_radios" class="payment-type-credit-card-radios span6 control-group radio-container"> <label class="radio inline"> <input type="radio" id="payment_type_credit_card_radios_amex" class="payment-type-credit-card-radios-amex required" name="payment.creditcardData.type" value="AE">AmEx </label> <label class="radio inline"> <input type="radio" id="payment_type_credit_card_radios_discover" class="payment-type-credit-card-radios-discover" name="payment.creditcardData.type" value="DC">Discover </label> <label class="radio inline"> <input type="radio" id="payment_type_credit_card_radios_mastercard" class="payment-type-credit-card-radios-mastercard" name="payment.creditcardData.type" value="MC">MasterCard </label> <label class="radio inline"> <input type="radio" id="payment_type_credit_card_radios_visa" class="payment-type-credit-card-radios-visa" name="payment.creditcardData.type" value="BA">Visa </label> </div> </div> </div> </div> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="payment_type_credit_card_name" class="span6 payment-type-credit-card-name control-group"> <input class="payment-type-credit-card-name-input input-block-level utility field" id="payment_type_credit_card_name_input" type="text" maxlength="255" placeholder="Name on Card" value="" name="payment.creditcardData.name"> </div> </div> <div class="row-fluid"> <div id="payment_type_credit_card_number" class="span4 payment-type-credit-card-number control-group"> <input class="payment-type-credit-card-number-input input-block-level utility field" id="payment_type_credit_card_number_input" type="text" maxlength="19" placeholder="Card Number" value="" name="payment.creditcardData.cardNumber">  </div> <div id="payment_type_credit_card_ccv" class="span2 payment-type-credit-card-ccv control-group"> <input class="payment-type-credit-card-ccv-input input-block-level utility field" id="payment_type_credit_card_ccv_input" type="text" maxlength="4" placeholder="CCV" value="" name="payment.creditcardData.cvv"> </div> <div id="payment_type_credit_card_ccs_help" class="span6 payment-type-credit-card-ccv-help control-group"> <a id="show_ccv_help" class="meta show-ccv-help" data-toggle="modal" href="#ccv_help">What's this </a><i class="icon-question-sign"></i> </div> </div> </div> </div> <div class="control-group"> <label class="control-label option">Expiration Date</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_credit_card_month" class="span4 payment-type-credit-card-month control-group"> <select id="payment_type_credit_card_month_select" class="payment-type-credit-card-month-select utility menu" name="payment.creditcardData.expMonth"> <option value='01' selected>January</option><option value='02' >February</option><option value='03' >March</option><option value='04' >April</option><option value='05' >May</option><option value='06' >June</option><option value='07' >July</option><option value='08' >August</option><option value='09' >September</option><option value='10' >October</option><option value='11' >November</option><option value='12' >December</option> </select> </div> <div id="payment_type_credit_card_year" class="span2 payment-type-credit-card-year control-group"> <select id="payment_type_credit_card_year_select" class="payment-type-credit-card-year-select utility menu" name="payment.creditcardData.expYear"> <option value="2022" >2022</option> <option value="2023" >2023</option> <option value="2024" >2024</option> <option value="2025" >2025</option> <option value="2026" >2026</option> <option value="2027" >2027</option> <option value="2028" >2028</option> <option value="2029" >2029</option> <option value="2030" >2030</option> </select> </div> </div> </div> </div> </div> </div> </div>  <div id="ccv_help" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>CCV (Card Code Verification) Help</h3> </div> <div class="modal-body"> <p>To complete your transaction, you must enter your credit card's security code.</p> <p>MasterCard, Visa, and Discover card holders can find their 3-digit security code on the back of their card, just to the right of the signature strip.</p> <p>American Express card holders can find their 4-digit security code on the front of their card, just above and to the right of the card number.</p> </div> <div class="modal-footer"> </div> </div> <div id="payment_type_wire_transfer" class="payment-type-wire-transfer" data-pg-dependent="payment_type_select" data-pg-show="WT" style="display:none;"> <hr class="divider" /> <div class="block-row"> <div class="control-label">Important:</div> <div class="highlight-text">By filling out this online form, Stanford will be notified of your intent to make wire transfer and will be able to expedite the processing of your gift. To complete the transaction, you must fill out and print a Letter of Authorization form and submit it to your financial institution.</div> </div> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <label class="control-label">My Account</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_wire_transfer_name" class="span3 payment-type-wire-transfer-name control-group"> <input class="payment-type-wire-transfer-name-input input-block-level utility field" id="payment_type_wire_transfer_name_input" type="text" placeholder="Account Name" name="payment.wiretransferData.accountTitle" maxlength="40" value=""> </div> <div id="payment_type_wire_transfer_number" class="span3 payment-type-wire-transfer-number control-group"> <input class="payment-type-wire-transfer-number-input input-block-level utility field" id="payment_type_wire_transfer_number_input" type="text" placeholder="Account Number" name="payment.wiretransferData.accountNumber" maxlength="25" value="" > </div> <div id="payment_type_wire_transfer_phone_number" class="span3 payment-type-wire-transfer-phone-number control-group"> <input class="payment-type-wire-transfer-phone-number-input input-block-level utility field" id="payment_type_wire_transfer_phone_number_input" type="text" placeholder="Phone Number" name="payment.wiretransferData.contactPhoneNumber" maxlength="22" value="" > </div> </div> </div> </div> </div> <div class="block-row"> <div class="control-group"> <label class="control-label">Special Instructions</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_wire_transfer_special_instructions" class="span9 payment-type-wire-transfer-special-instructions control-group has-textarea-counter"> <textarea id="payment_type_wire_transfer_special_instructions_textarea" class="input-block-level utility textarea payment-type-wire-transfer-special-instructions-textarea" placeholder="Special instructions..." name="payment.wiretransferData.specialInstructions" rows="3"></textarea> <span id="payment_type_wire_transfer_special_instructions_counter" class="payment-type-wire-transfer-special-instructions-counter meta"><span class="counter">0</span> characters remaining</span> </div> </div> </div> </div> </div> </div>   <div id="authorization_letter" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>Wire Transfer Information</h3> </div> <div class="modal-body" id="authorization_letter_print"> <h4>International Wiring Instructions</h4> <h5>Individual Name:</h5> <p> Stanford University Gift Processing </p> <h5>Bank Name:</h5> <p> Wells Fargo Bank<br /> San Francisco Main Office<br /> 420 Montgomery Street<br /> San Francisco, CA 94104 USA </p> <h5>BIC or SWIFT #:</h5> <p> WFBIUS6WFFX </p> <h5>Account #:</h5> <p>4944-863570</p> <h5>Reference/OBI:</h5> <p>Gift Processing</p> <h4>Domestic Wiring Instructions</h4> <h5>Individual Name:</h5> <p>Stanford University Gift Processing</p> <h5>Bank Name:</h5> <p> Wells Fargo Bank<br /> San Francisco Main Office<br /> 420 Montgomery Street<br /> San Francisco, CA 94104 USA </p> <h5>ABA Routing number:</h5> <p>121-000248</p> <h5>Account number:</h5> <p>4944-863570<p> <h5>Reference:</h5> <p>Gift Processing</p> <p><strong>NOTE:</strong> To ensure accurate handling, please send a confirming email to:</p> <ul> <li>wire_transfers@lists.stanford.edu</li> <li>This will reach Cash Management (cashmanagement@lists.stanford.edu) as well as Stanford Gift Processing (gp-coordinator@lists.stanford.edu)</li> </ul> <p>This confirming email should indicate:</p> <ul> <li>Date Stanford should expect the wire</li> <li>Dollar amount</li> <li>Sending organization</li> <li>Intended department at Stanford (if known)</li> </ul> </div> <div class="modal-footer"> <a id="authorization_print_button" href="#" class="btn"><strong>Print This Letter</strong></a> <a id="authorization_email_button" href="#" class=""><strong>Email Me This Letter</strong></a> </div> </div> <div id="payment_type_securities" class="payment-type-securities" data-pg-dependent="payment_type_select" data-pg-show="ST" style="display:none;"> <hr class="divider" /> <div class="block-row"> <div class="alert"> If you would like to make a gift of mutual funds, bonds, foreign or restricted stock, please contact the Gift Securities Team at 650.721.1917, as these transactions require special handling. </div> <div class="control-label">Important:</div> <div class="highlight-text">By filling out this online form, Stanford will be notified of your intent to make a securities transfer and will be able to expedite the processing of your gift. To complete the transaction, you must fill out and print a Letter of Authorization form, sign it, and submit it to your broker. Some brokerage firms require this letter to be Notarized or Medallion Signature Guaranteed. Please check with your broker for additional requirements</div> </div> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <label class="control-label">Broker and Account Information</label> <div class="controls"> <div class="control-group"> <label class="control-label option">Broker Name</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_broker_name" class="span6 payment-type-securities-broker-name control-group"> <input id="payment_type_securities_broker_name_input" class="input-block-level utility field payment-type-securities-broker-name-input" type="text" placeholder="Name" name="payment.securities.brokerName" value="" maxlength="255"> </div> <div class="span5">If no broker, please enter "None."</div> </div> </div> </div> <div class="row-fluid"> <div class="span6"> <div class="control-group"> <label class="control-label option">Brokerage Firm</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_broker_firm" class="payment-type-securities-broker-firm control-group"> <select id="payment_type_securities_broker_firm_input" class="payment-type-securities-broker-firm-input utility menu" name="payment.securities.brokerageFirm" data-pg-trigger="true"><option value="AGE">AG Edwards</option> <option value="AMF">Ameriprise Financial</option> <option value="SCH">Charles Schwab & Co.</option> <option value="CSW">Credit Suisse</option> <option value="DBA">Deutsche Bank</option> <option value="ETR">E*Trade</option> <option value="EDW">Edward Jones</option> <option value="FID">Fidelity</option> <option value="GMS">Goldman Sachs</option> <option value="INT">Interactive Brokers</option> <option value="HRS">Harris Bank</option> <option value="JEF">Jefferies & Co., Inc.</option> <option value="JPM">JP Morgan Private Banking</option> <option value="LPL">LPL Financial Co.</option> <option value="MRL">Merrill Lynch</option> <option value="MOR">Morgan Stanley</option> <option value="NBR">Neuberger Berman</option> <option value="NOR">Northern Trust</option> <option value="OPP">Oppenheimer & Co.</option> <option value="RAY">Raymond James</option> <option value="DRS">RBC Dain Rauscher</option> <option value="BRD">Robert Baird & Co.</option> <option value="SCB">Sanford C. Bernstein & Co.</option> <option value="SCT">ScottTrade</option> <option value="SNC">Stifel, Nicolaus & Co., Inc.</option> <option value="SYB">Stone & Youngberg</option> <option value="TDW">TD Ameritrade</option> <option value="UBS">UBS Financial Services</option> <option value="UPJ">USBancorp</option> <option value="URS">US Bank</option> <option value="VNG">Vanguard</option> <option value="WAS">Wachovia</option> <option value="WDE">Wedbush Morgan</option> <option value="WLS">Wells Fargo Advisors</option> <option value="BLR">William Blair & Co</option> <option value="OTH">Other</option> </select> </div> </div> </div> </div> <div class="control-group" data-pg-dependent="payment_type_securities_broker_firm_input" data-pg-show="OTH" style="display:none;"> <label class="control-label option">Other Brokerage Firm</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_other_broker_firm" class="payment-type-securities-other-broker-firm control-group"> <input id="payment_type_securities_other_broker_firm_input" class="input-block-level utility field payment-type-securities-other-broker-firm-input" type="text" placeholder="Name" name="payment.securities.otherBrokerageFirm" maxlength="40" value=""> </div> </div> </div> </div> <div class="control-group"> <label class="control-label option">Phone Number</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_broker_phone" class="payment-type-securities-broker-phone control-group"> <input id="payment_type_securities_broker_phone_input" class="input-block-level utility field payment-type-securities-broker-phone-input" type="text" placeholder="Phone Number" name="payment.securities.brokerPhoneNumber" maxlength="22" value=""> </div> </div> </div> </div> <div class="control-group"> <label class="control-label option">Fax Number</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_broker_fax" class="payment-type-securities-broker-fax control-group"> <input id="payment_type_securities_broker_fax_input" class="input-block-level utility field payment-type-securities-broker-fax-input" type="text" placeholder="Fax Number" name="payment.securities.brokerFaxNumber" maxlength="22" value=""> </div> </div> </div> </div> <div class="control-group"> <label class="control-label option">From my Account</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_broker_account_number" class="payment-type-securities-broker-account-number control-group"> <input id="payment_type_securities_broker_account_number_input" class="input-block-level utility field payment-type-securities-broker-account-number-input" type="text" placeholder="Account Number" maxlength="25" name="payment.securities.accountNumber" value=""> </div> </div> </div> </div> <div class="control-group"> <label class="control-label option">Held in the Name of</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_broker_account_title" class="payment-type-securities-broker-account-title control-group"> <input id="payment_type_securities_broker_account_title_input" class="input-block-level utility field payment-type-securities-broker-account-title-input" type="text" placeholder="Account Title" maxlength="40" name="payment.securities.accountTitle" value=""> </div> </div> </div> </div> <div class="control-group"> <label class="control-label option">I can provide cost basis for this gift:</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_basis"> <select id="payment_type_securities_basis_input" name="payment.securities.basisKnown"> <option value="U">Not sure</option> <option value="Y">Yes</option> <option value="N">No</option> </select> </div> </div> </div> </div> </div> <div class="span6"> <p class="highlight-text">If you are filling out this form on behalf of the donor, please fill in the following information:</p> <div id="form_filled_out_by"> <div class="control-group"> <label class="control-label option">This form was filled out by</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_filled_out_by_name"><input id="payment_type_securities_filled_out_by_name_input" class="input-block-level utility field payment-type-securities-filled-out-by-name-input" type="text" placeholder="Name" maxlength="60" name="payment.securities.filledOutName" value=""></div> </div> <div class="row-fluid"> <div id="payment_type_securities_filled_out_by_relationship"><input id="payment_type_securities_filled_out_by_relationship_input" class="input-block-level utility field payment-type-securities-filled-out-by-relationship-input" type="text" placeholder="Relationship to Donor" maxlength="40" name="payment.securities.relationshipToDonor" value=""></div> </div> <div class="row-fluid"> <div id="payment_type_securities_filled_out_by_phone"><input id="payment_type_securities_filled_out_by_phone_input" class="input-block-level utility field payment-type-securities-filled-out-by-phone-input" type="text" placeholder="Phone Number" maxlength="22" name="payment.securities.filledOutPhone" value=""></div> </div> </div> </div> <div class="control-group"> <p>Please make sure that the About Me section above has the donor's information, not your information.</p> </div> </div> </div> </div> </div> </div> </div> <hr class="divider"> <div class="block-row"> <div id="payment_type_securities_stocks" class="payment-type-securities-stocks"> <p>Please accept this letter as my authorization to irrevocably transfer:</p> <div class="payment-type-securities-stocks-stock"> <div class="control-group"> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_stock_0_name" class="span4 payment-type-securities-stock-name control-group"> <input id="payment_type_securities_stock_0_name_input" class="input-block-level utility field payment-type-securities-stock-name-input" type="text" placeholder="Stock Name" name="payment.securities.stocks[0].stockName" value="" maxlength="120"> </div> <div id="payment_type_securities_stock_0_shares" class="span4 payment-type-securities-stock-shares control-group"> <input id="payment_type_securities_stock_0_shares_input" class="input-block-level utility field payment-type-securities-stock-shares-input calc-totals" type="text" placeholder="Shares" name="payment.securities.stocks[0].numberOfShares" value=""> </div> <div id="payment_type_securities_stock_0_amount" class="span4 payment-type-securities-stock-amount control-group"> <div class="input-prepend input-prepend-amount control-group"> <span class="add-on">$</span><input maxlength="9" type="text" id="payment_type_securities_stock_0_amount_input" class="payment-type-securities-stock-amount-input input-block-level field utility calc-totals" placeholder="Approximate Total Value" name="payment.securities.stocks[0].amount" value=""> </div> </div> </div> </div> </div> </div> <div id="payment_type_securities_stocks_controls" class="controls"> <a class="add-stock meta" href="#">Add Another Stock <i class="icon-chevron-down"></i></a> <a class="remove-stock meta" href="#">Remove Last Stock <i class="icon-remove"></i></a> </div> <div class="block-well"> <div class="block-well-row"> <table id="payment_type_securites_totals" class="payment-type-securities-totals"> <tr class="payment-type-securities-total-gift-amount"> <th class="task">Total Gift Amount</th> <td class="value">$<span>00.00</span></td> </tr> <tr class="payment-type-securities-total-security-transfer"> <th class="task">Total Security Transfer</th> <td class="value">$00.00</td> </tr> <tr class="payment-type-securities-net-required"> <th class="task">Net Required</th> <td class="value">$00.00</td> </tr> </table> </div> </div> </div> </div> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <label class="control-label">Your Contact Information</label> <div class="controls"> <div class="control-group"> <label class="control-label option">Your Phone Number</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_contact_phone" class="span6 payment-type-securities-contact-phone control-group"> <input id="payment_type_securities_contact_phone_input" class="input-block-level utility field payment-type-securities-contact-phone-input" type="text" placeholder="Phone Number" name="payment.securities.contactPhoneLocal" maxlength="22" value=""> </div> </div> </div> </div> </div> </div> </div> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <label class="control-label">Special Instructions</label> <div class="controls"> <div class="row-fluid"> <div id="payment_type_securities_special_instructions" class="span9 payment-type-securities-special-instructions control-group has-textarea-counter"> <textarea id="payment_type_securities_special_instructions_textarea" class="input-block-level utility textarea payment-type-securities-special-instructions-textarea" placeholder="Special instructions..." name="payment.securities.specialInstructions" rows="3"></textarea> <span id="payment_type_securities_special_instructions_counter" class="payment-type-securities-special-instructions-counter meta"><span class="counter">0</span> characters remaining</span> </div> </div> </div> </div> </div> </div> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <p class="help-block"><span class="task">Make your gift go even further!</span> Check to see if your employer will match your gift. <a href="http://www.matchinggifts.com/stanford/" target="stanfordgw">Find My Company »</a>.</p> <div class="controls"> <div class="row-fluid"> <div class="span12"> <label class="checkbox"> <input id="payment_match_employer" class="payment-match-employer" type="checkbox" value="Y" name="payment.matchEmployer" >I will submit a matching gift from my employer. </label> </div> </div> </div> </div> </div>  <div id="e_receipt_container"> <hr class="divider" /> <div class="block-row"> <div class="control-group"> <div class="logged-in not-unsubscribed"> <p class="help-block task">You will receive an email receipt for this gift for tax purposes.</p> <p class="help-block">If you would prefer to receive a paper receipt for tax purposes, please check one or both of the following boxes:</p> </div> <div class="logged-in unsubscribed hide"> <p class="help-block task">You have previously indicated that you prefer not to receive email gift receipts for tax purposes.</p> <p class="help-block">Uncheck the box below if you want to receive an email tax receipt for this gift instead of a paper receipt by mail:</p> </div> <div class="not-logged-in hide"> <p class="help-block task">You will receive an email receipt for this gift for tax purposes.</p> <p class="help-block">If you would prefer to receive a paper receipt for tax purposes, please check the following box:</p> </div> <div class="controls"> <div class="row-fluid" id="e_receipt_opt_out_single_container"> <div class="span12"> <label class="checkbox"> <input id="e_receipt_opt_out_single" class="e-receipt-opt-out-single" type="checkbox" value="Y" name="payment.eReceiptOptOutSingle" >I do not want to receive an email tax receipt for this gift. </label> </div> </div> <div class="row-fluid" id="e_receipt_opt_out_multiple_container"> <div class="span12"> <label class="checkbox"> <input id="e_receipt_opt_out_multiple" class="e-receipt-opt-out-multiple" type="checkbox" value="Y" name="payment.eReceiptOptOutMultiple" >I never want to receive an email tax receipt for any gift. </label> </div> </div> </div> </div> </div> </div> </div> <div class="block-footer"> <a id="confirm_button" class="btn btn-custom btn-custom-large span2 open2"> Confirm Details</a> <span id="gift-confirm" class="control-label option span4" style="display:none;margin-left:20px;">Processing....</span> </div> </div> </div> </div> <div id="step_3" class="hide">  </div> </div> </form> </div>  </div> <div id="modals"> <div id="session_reset_modal" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>Gift Not Processed</h3> </div> <div class="modal-body"> <p>Your gift was not processed. Please start a new gift.</p> <div class="clearfix"> <a class="btn btn-custom btn-custom-large modal-close">OK</a> </div> </div> <div class="modal-footer"> </div> </div>  <div id="cc_denied_modal" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>There has been a problem with your gift</h3> </div> <div class="modal-body"> <p></p> <div class="clearfix"> <a class="btn btn-custom btn-custom-large cc-modal-close">OK</a> </div> </div> <div class="modal-footer"> </div> </div>  <div id="invalid_session_modal" class="modal hide fade" data-keyboard="false" data-backdrop="static"> <div class="modal-header"> <h3>Important Note</h3> </div> <div class="modal-body"> <p>You have more than one gift transaction open. Please close this window/tab and use your other window/tab to complete your gift.</p> </div> <div class="modal-footer"> </div> </div>  <div id="session_timeout_modal" class="modal hide fade" data-keyboard="false" data-backdrop="static"> <div class="modal-header"> <h3>Timed Out</h3> </div> <div class="modal-body"> <p>Your gift transaction has been timed out for security reasons. Please start a new gift.</p> <p><a class="btn btn-custom btn-custom-large modal-reload" href="https://cardinalalumni.stanford.edu/get/page/makeagift?pgnTPC=399&stp=26&olc=06448&cturl=close">Reload Page</a></p> </div> <div class="modal-footer"> </div> </div>  <div id="dbe_modal" class="modal hide fade" data-keyboard="false" data-backdrop="static"> <div class="modal-header"> <h3>Contact Us</h3> </div> <div class="modal-body"> <p>Your gift cannot be processed at this time. Please contact our customer service department.</p> <p>Call us toll free at: 866.543.0243 (international visitors should call 650.724.0627). Our customer service representatives are available Monday through Friday, 8 a.m. to 5 p.m. Pacific Time.</p> </div> <div class="modal-footer"> </div> </div>  <div id="bak_modal" class="modal hide fade" data-keyboard="false" data-backdrop="static"> <div class="modal-header"> <h3>A browser error has occurred</h3> </div> <div class="modal-body"> <p>Please press this button to start over.</p> <p><a class="btn btn-custom btn-custom-large modal-reload" href="https://cardinalalumni.stanford.edu/get/page/makeagift?pgnTPC=399&stp=26&olc=06448&cturl=close">Make a Gift</a></p> </div> <div class="modal-footer"> </div> </div>  <div id="giving_levels" class="modal hide fade"></div>  <div id="phone_modal" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>Give by phone or mail</h3> </div> <div class="modal-body"> <strong>By Phone:</strong> <p> Toll-Free: (866) 543-0243<br /> International: (650) 724-0627<br /> Our customer service representatives are available Monday-Friday from 8am-5pm Pacific Time<br /> </p> <strong>By Mail:</strong> <p> Gift Processing<br /> P.O. Box 20466<br /> Stanford, CA 94309<br /> </p> </div> <div class="modal-footer"> </div> </div>  <div id="error_modal" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>There has been an error in this form</h3> </div> <div class="modal-body" id="error_modal_body"> <p class="generic-mesage">Please check all of the fields.</p> <p class="explanation"></p> <div class="clearfix"> <a class="btn btn-custom btn-custom-large modal-close">Review Errors</a> </div> </div> <div class="modal-footer"> </div> </div>  <div id="backend_error_modal" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>There has been an error submitting this form</h3> </div> <div class="modal-body" id="backend_error_modal_body"> <p class="explanation"></p> <div class="clearfix"> <a class="btn btn-custom btn-custom-large modal-close">Review Errors</a> </div> </div> <div class="modal-footer"> </div> </div>  <div id="processing_modal" class="modal hide fade" data-keyboard="false" data-backdrop="static"> <div class="modal-header"> <h3>Processing...</h3> </div> <div class="modal-body" id="processing_modal_body"> <div class="in_progress"> <p>One moment please while we process your payment.</p> <p>At this time:</p> <ul> <li>Do not hit the back button</li> <li>Do not refresh the page</li> <li>Do not close your browser</li> </ul> <p>If you haven't received an email confirmation within 5 minutes, please contact Online Customer Service at (866)543-0243 or (650)724-0627 to see if your transaction completed successfully.</p> <div><img class="arrow" src="/give/give2/assets/img/spinner.gif" alt="Processing"></div> </div> <div class="timed_out"> <p class="alert-text">There might have been a problem processing your transaction.</p> <p>If you haven't received an email confirmation within 5 minutes, please contact Online Customer Service at (866)543-0243 or (650)724-0627 to see if your transaction completed successfully.</p> <p><a href="http://giving.stanford.edu/">Return to the Giving to Stanford homepage</a></p> </div> </div> <div class="modal-footer"> </div> </div>  <div id="sign_in_modal" class="modal hide fade"> <div class="modal-header"> <a class="close" data-dismiss="modal" >×</a> <h3>Sign In</h3> </div> <div class="modal-body"> <div class="messages" style="display:none;"> </div> <form id="sign_in_form" name="sign_in_form" action="/cas/service/doLogin?pg=yes&am=cas" method="post"> <div class="controls"> <div class="row-fluid"> <div class="input-prepend"> <span class="add-on"><i class="icon-user"></i></span> <input id="username" name="username" class="input" type="text" placeholder="Username" value=""> </div> <div class="input-prepend"> <span class="add-on"><i class="icon-lock"></i></span> <input id="password" name="password" class="input" type="password" placeholder="Password"> </div> </div> <div class="row-fluid"><button id="sign_in_submit" type="submit" class="give-submit-button btn btn-custom btn-custom-large" value="Log In">Sign in</button></div> <div class="row-fluid"> <label class="checkbox"> <input id="remember_me" type="checkbox" name="rememberMe" checked="checked" value="y"> <span class="remember-me-label-text">Remember my username</span> </label> </div> </div> </form> </div> <div class="modal-footer"> <a href="#" class="forgot-password-link">Forgot your password?</a> <a href="#" class="forgot-username-link pull-left">Forgot your username?</a> </div> </div>  </div>  <div id="csContainer" style="display: none;"> <iframe id="csIFrame" name="csIFrame" src=""></iframe>  <form id="csForm" action="https://secureacceptance.cybersource.com/silent/embedded/pay" method="POST" target="csIFrame"> <input type="hidden" name="cvv2" id="cvv2" value=""/> <input type="hidden" name="card_number" id="card_number" value=""/> </form> </div> <script> // This is to trigger all the ajax calls related to the gift type - loading gift type DELAY.add(function() { $('.gift-type-select').trigger('change'); $('.payment-type-select').trigger('change'); }) ; var nonSecureServer = "cardinalalumni.stanford.edu" ; </script>  <div class="global"> <div class="container"> <div class="footer"> <a href="/feedback/Service/getForm?url=/give/home" target="_blank" class="printVersion">Customer Service</a> - <a href="/give/give2/privacy.html" target="_blank" class="printVersion">Privacy Policy</a> - <a href="http://www.stanford.edu" target="_new" class="printVersion">Stanford.edu</a> <div class="pull-right"><span>漏 Stanford University. 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