Parliamentarians for Global Action (PGA)

<!DOCTYPE html>    <html dir="ltr" lang="en">  <head> <title>Parliamentarians for Global Action (PGA)</title> <meta http-equiv="Content-Type" content="text/html; charset=utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta name="description" content="Parliamentarians for Global Action (PGA) Email Forms"> <meta name="keywords" content="Parliamentarians for Global Action (PGA)"> <script src="//ajax.googleapis.com/ajax/libs/dojo/1.8/dojo/dojo.js"></script> <script type="text/javascript"> require([ "dojo/query", "dojo/dom", "dojo/dom-geometry", "dojo/dom-class", "dojo/dom-style", "dojo/dom-construct", "dijit/focus", "dojo/parser", "dijit/form/DateTextBox", "dojo/NodeList-traverse", "dojo/domReady!" ], function(query, dom, domGeom, domClass, domStyle, domConstruct, focusUtil, parser){ // Move the focused-field class to the field-group that contains the focused input. var handle = focusUtil.watch("curNode", function(name, oldValue, newValue){ var parent = query(newValue).closest('.field-group'); if(!domClass.contains(parent, "focused-field")) { query('.focused-field').removeClass('focused-field'); parent.addClass('focused-field'); } }); // Add error class to parent wrapper and only show error borders on empty fields in addresses query('.feedback.error').closest('.field-group').addClass('error'); query('.addressfield input:text[value=""]').addClass('empty'); // Focus first input of birthdayfield or phonefield-us when parent wrapper is clicked query('div.subfields').on("click", function(e){ var firstInput = query('input', e.target)[0]; focusUtil.focus(firstInput); }); // Use native checkboxes and radio buttons outside the app dojo.query(".radio input, .checkbox input").removeAttr("data-dojo-type"); // Render DateTextBoxes parser.parse(); query('form').on("submit",function(e){ var invalidDate = dojo.query('.dijitTextBoxError'); if(invalidDate.length){ query('.dijitDateTextBox ~ .feedback.error').forEach(domConstruct.destroy); invalidDate.forEach(function(node) { domConstruct.place('<div class="feedback error"><div class="errorText">Please enter a valid date</div></div>', node, 'after'); }); e.preventDefault(); } else if (window.bmak) { // Bot manager telemetry data window.bmak.form_submit(); } }); }); </script> <script src='https://www.google.com/recaptcha/api.js' async defer></script> <style type="text/css">/* Forms */ label { display:block; width:auto; margin-top:8px; font-weight:bold; } .mergeRow { padding:0 0 6px 0 !important; clear:both; } .field-group { position:relative; margin:3px 0 12px 0; overflow:hidden; background:transparent !important; } .mergeRow-radio .field-group, .mergeRow-interests-checkboxes .field-group {margin-bottom:6px;} input, textarea, select { display:block; margin:0; padding:10px; background:#fff; width:100%; border:2px solid #d0d0d0 !important; border-radius:3px; -webkit-appearance: none; } .field-group input, select, textarea, .dijitInputField { font-size: 14px; } 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flex-direction:row; justify-content:center; } .unsubscribe-sms-only .row{ display:flex; flex-direction:row; justify-content:center; margin-top:42px; } .unsubscribe-sms-only .col{ display:flex; flex-direction:column; justify-content:flex-start; margin-left:5px; } .unsubscribe-sms-only .header{ font-family:'Graphik'; font-size:20px; font-weight:500; line-height:28px; text-align:left; margin-bottom:4px; } .unsubscribe-sms-only .subheader{ margin-bottom:16px; display:flex; flex-direction:column; } .unsubscribe-sms-only .subheader .subtitle{ font-family:'Graphik'; font-size:16px; font-weight:400; line-height:24px; text-align:left; } .text-center{ text-align:center; } .line{ border:1px solid #D3D3D3; width:100%; } .unsubscribe-sms-only .button{ width:136px; height:36px; padding:6px 16px; border:1px solid transparent !important; border-radius:38px; background:#007c89; color:#ffffff; text-align:center; font-family:'Graphik'; font-size:13px; font-style:normal; font-weight:500; line-height:20px; cursor:pointer; -ms-transition:background-color 0.2s ease-in-out 0s, opacity 0.2s ease-in-out 0s; transition:background-color 0.2s ease-in-out 0s, opacity 0.2s ease-in-out 0s; } .unsubscribe-sms-only .button:hover{ background-color:#006570; } .unsubscribe-sms-only .disabled{ cursor:not-allowed; } #templateHeader{ padding:0px; background-color:#000000; } </style></head> <body> <div class="wrapper rounded6" id="templateContainer"> <h1 class="masthead"><a href="http://www.pgaction.org/"><img src="https://gallery.mailchimp.com/0e8d92efac28c9c27f6a24a56/images/f124ab05-3b57-446e-b24d-2ad86aa78db5.png" alt="" border="0" style="border:0px ; border-color:; border-style:; border-width: 0px; height: 120px; width: 600px; margin: 0; padding: 0;" width="600" height="120"></a></h1> <div id="templateBody" class="bodyContent rounded6"> <div id="subscribeFormWelcome"> </div> <div class="indicates-required"><span class="asterisk">*</span> indicates required</div> <form action="https://pgaction.us4.list-manage.com/subscribe/post" method="POST"> <input type="hidden" name="u" value="0e8d92efac28c9c27f6a24a56"> <input type="hidden" name="id" value="4f3629764c">  <div class="field-shift" aria-label="Please leave the following three fields empty" aria-hidden="true"> <label for="b_name">Name: </label> <input type="text" name="b_name" tabindex="-1" value="" placeholder="Freddie" id="b_name"> <label for="b_email">Email: </label> <input type="email" name="b_email" tabindex="-1" value="" placeholder="youremail@gmail.com" id="b_email"> <label for="b_comment">Comment: </label> <textarea name="b_comment" tabindex="-1" placeholder="Please comment" id="b_comment"></textarea> </div> <div id="mergeTable" class="mergeTable"> <div class="mergeRow dojoDndItem mergeRow-dropdown" id="mergeRow-11"> <label for="MERGE11">Title <span class="req asterisk">*</span></label> <div class="field-group"> <select class="select-small" id="MERGE11" name="MERGE11"><option value="Baroness">Baroness</option><option value="Dep.">Dep.</option><option value="Dip.">Dip.</option><option value="Dr.">Dr.</option><option value="Hon.">Hon.</option><option value="Lord">Lord</option><option value="Mme.">Mme.</option><option value="Mr.">Mr.</option><option value="Mrs.">Mrs.</option><option value="Ms.">Ms.</option><option value="Prof.">Prof.</option><option value="Rep.">Rep.</option><option value="Rt. Hon.">Rt. Hon.</option><option value="Sen.">Sen.</option><option value="Shri.">Shri.</option><option value="Sir">Sir</option><option value="Speaker">Speaker</option></select> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-1"> <label for="MERGE1">First Name <span class="req asterisk">*</span></label> <div class="field-group"> <input type="text" name="MERGE1" id="MERGE1" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-2"> <label for="MERGE2">Last Name <span class="req asterisk">*</span></label> <div class="field-group"> <input type="text" name="MERGE2" id="MERGE2" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-radio" id="mergeRow-8"> <label for="MERGE8">Gender</label> <div class="field-group"> <ul class="interestgroup_field radio-group" id="MERGE8"> <li> <label class="radio" for="MERGE8-0"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE8" id="MERGE8-0" value="Male" class="av-radio"> <span>Male</span> </label> </li><li> <label class="radio" for="MERGE8-1"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE8" id="MERGE8-1" value="Female" class="av-radio"> <span>Female</span> </label> </li><li> <label class="radio" for="MERGE8-2"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE8" id="MERGE8-2" value="Non-binary" class="av-radio"> <span>Non-binary</span> </label> </li><li> <label class="radio" for="MERGE8-3"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE8" id="MERGE8-3" value="Prefer not to say" class="av-radio"> <span>Prefer not to say</span> </label> </li> </ul> </div> </div> <div class="mergeRow dojoDndItem mergeRow-email" id="mergeRow-0"> <label for="MERGE0">Email Address <span class="req asterisk">*</span></label> <div class="field-group"> <input type="email" autocapitalize="off" autocorrect="off" name="MERGE0" id="MERGE0" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-15"> <label for="MERGE15">Name of Parliament <span class="req asterisk">*</span></label> <div class="field-group"> <input type="text" name="MERGE15" id="MERGE15" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-phone" id="mergeRow-17"> <label for="MERGE17">Mobile Phone</label> <div class="field-group"> <input type="text" name="MERGE17" id="MERGE17" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-phone" id="mergeRow-9"> <label for="MERGE9">Office Phone</label> <div class="field-group"> <input type="text" name="MERGE9" id="MERGE9" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-20"> <label for="MERGE20">City</label> <div class="field-group"> <input type="text" name="MERGE20" id="MERGE20" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-22"> <label for="MERGE22">Country <span class="req asterisk">*</span></label> <div class="field-group"> <input type="text" name="MERGE22" id="MERGE22" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-radio" id="mergeRow-24"> <label for="MERGE24">Preferred Method of Contact</label> <div class="field-group"> <ul class="interestgroup_field radio-group" id="MERGE24"> <li> <label class="radio" for="MERGE24-0"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE24" id="MERGE24-0" value="Email Above" class="av-radio"> <span>Email Above</span> </label> </li><li> <label class="radio" for="MERGE24-1"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE24" id="MERGE24-1" value="Other Email" class="av-radio"> <span>Other Email</span> </label> </li><li> <label class="radio" for="MERGE24-2"> <input type="radio" data-dojo-type="dijit/form/RadioButton" name="MERGE24" id="MERGE24-2" value="Whatsapp" class="av-radio"> <span>Whatsapp</span> </label> </li> </ul> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-12"> <label for="MERGE12">Other Email Address</label> <div class="field-group"> <input type="text" name="MERGE12" id="MERGE12" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-16"> <label for="MERGE16">Parliamentary Assistant Name</label> <div class="field-group"> <input type="text" name="MERGE16" id="MERGE16" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-18"> <label for="MERGE18">Parliamentary Assistant Email</label> <div class="field-group"> <input type="text" name="MERGE18" id="MERGE18" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-7"> <label for="MERGE7">Parliamentary Assistant Phone</label> <div class="field-group"> <input type="text" name="MERGE7" id="MERGE7" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-6"> <label for="MERGE6">Political Party <span class="req asterisk">*</span></label> <div class="field-group"> <input type="text" name="MERGE6" id="MERGE6" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-3"> <label for="MERGE3">Year Electoral Term Commenced</label> <div class="field-group"> <input type="text" name="MERGE3" id="MERGE3" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-4"> <label for="MERGE4">Year Current Electoral Term Ends</label> <div class="field-group"> <input type="text" name="MERGE4" id="MERGE4" size="25" value=""> </div> </div> <div id="interestTable"> <div id="mergeRow-100-8149" class="mergeRow dojoDndItem mergeRow-interests-checkboxes"> <label>Programme Interests</label> <div class="field-group groups"> <ul class="interestgroup_field checkbox-group"> <li class="!margin-bottom--lv2"> <label class="checkbox" for="group_256"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_256" name="group[8149][256]" value="1" class="av-checkbox"><span>Democracy and Human Rights</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_512"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_512" name="group[8149][512]" value="1" class="av-checkbox"><span>Non-discrimination/Inclusion based on Sexual Orientation and Gender Identity</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_1024"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_1024" name="group[8149][1024]" value="1" class="av-checkbox"><span>Rule of Law/International Criminal Court</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_2048"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_2048" name="group[8149][2048]" value="1" class="av-checkbox"><span>Arms Control</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_4096"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_4096" name="group[8149][4096]" value="1" class="av-checkbox"><span>Ending Child Marriage</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_2147483648"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_2147483648" name="group[8149][2147483648]" value="1" class="av-checkbox"><span>Abolition of the Death Penalty</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_4294967296"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_4294967296" name="group[8149][4294967296]" value="1" class="av-checkbox"><span>Protection of the Oceans</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_128"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_128" name="group[8149][128]" value="1" class="av-checkbox"><span>Climate Action</span> </label> </li> </ul> </div> </div> <div id="mergeRow-100-8145" class="mergeRow dojoDndItem mergeRow-interests-checkboxes"> <label>Committee Responsibilities</label> <div class="field-group groups"> <ul class="interestgroup_field checkbox-group"> <li class="!margin-bottom--lv2"> <label class="checkbox" for="group_1"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_1" name="group[8145][1]" value="1" class="av-checkbox"><span>Foreign Affairs</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_2"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_2" name="group[8145][2]" value="1" class="av-checkbox"><span>Women鈥檚 Affairs / Gender Equality</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_4"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_4" name="group[8145][4]" value="1" class="av-checkbox"><span>Human Rights</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_8"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_8" name="group[8145][8]" value="1" class="av-checkbox"><span>Legal Affairs</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_16"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_16" name="group[8145][16]" value="1" class="av-checkbox"><span>Labor and Social Affairs</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_32"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_32" name="group[8145][32]" value="1" class="av-checkbox"><span>Justice</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_64"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_64" name="group[8145][64]" value="1" class="av-checkbox"><span>Defence</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_8589934592"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_8589934592" name="group[8145][8589934592]" value="1" class="av-checkbox"><span>Arms Export Controls</span> </label> </li> </ul> </div> </div> <div id="mergeRow-100-8237" class="mergeRow dojoDndItem mergeRow-interests-checkboxes"> <label>Subscribe to periodic e-updates from PGA?</label> <div class="field-group groups"> <ul class="interestgroup_field checkbox-group"> <li class="!margin-bottom--lv2"> <label class="checkbox" for="group_8192"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_8192" name="group[8237][8192]" value="1" class="av-checkbox"><span>Yes</span> </label> </li> </ul> </div> </div> <div id="mergeRow-100-11769" class="mergeRow dojoDndItem mergeRowHidden mergeRow-interests-hidden" style="display:none;"> <label>Law List</label> <div class="field-group groups"> <ul class="interestgroup_field checkbox-group"> <li class="!margin-bottom--lv2"> <label class="checkbox" for="group_16384"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_16384" name="group[11769][16384]" value="1" class="av-checkbox"><span>French only mailings</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_32768"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_32768" name="group[11769][32768]" value="1" class="av-checkbox"><span>Spanish only mailings</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_65536"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_65536" name="group[11769][65536]" value="1" class="av-checkbox"><span>For English mailings that have other translations sent separately</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_131072"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_131072" name="group[11769][131072]" value="1" class="av-checkbox"><span>ICC States Parties</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_262144"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_262144" name="group[11769][262144]" value="1" class="av-checkbox"><span>ICC States not Parties</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_1048576"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_1048576" name="group[11769][1048576]" value="1" class="av-checkbox"><span>Region: Africa</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_2097152"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_2097152" name="group[11769][2097152]" value="1" class="av-checkbox"><span>Region: Latin America</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_4194304"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_4194304" name="group[11769][4194304]" value="1" class="av-checkbox"><span>Region: Memed</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_8388608"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_8388608" name="group[11769][8388608]" value="1" class="av-checkbox"><span>Region: CIS</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_16777216"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_16777216" name="group[11769][16777216]" value="1" class="av-checkbox"><span>Region: Europe (larger)</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_33554432"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="group_33554432" name="group[11769][33554432]" value="1" class="av-checkbox"><span>Region: European Union</span> </label> </li><li class="!margin-bottom--lv2"> <label class="checkbox" for="group_67108864"><input 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