CINXE.COM
YAS DBA Perl / Raku Foundation
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$('#sfp-paypal').attr('title', null); $('#sfp-daf-pay').attr('title', null); $('#sfp-alternative').children().attr('disabled', false); $('#sfp-paypal').children().attr('disabled', false); $('#sfp-daf-pay').children().attr('disabled', false); } } </script> <link href="/np/css/neonFrontV2/neoncrm-forms-2015.css" type="text/css" rel="stylesheet" /> <style type="text/css" > .neoncrm-browser-deprecation-notice { background-color:#FEEFB3; color:#9F6000; text-decoration:none; font-size:16px; border:1px solid #9F6000; } .neoncrm-browser-deprecation-notice a{ text-decoration:none; color:#163C59; } .neoncrm-browser-deprecation-notice p{ margin-left:20px; /* margin:0 auto; */ } </style> <h1 class="neoncrm-page-title">Donation</h1> <div class="neoncrm-org-toggle"> <input type="button" value="Donate as a Company" onclick="javascript:window.location.href='https://perlfoundation.app.neoncrm.com/np/clients/perlfoundation/donation.jsp?&constTypeFlag=org'" /> </div> <form name="pShoppingCartFormBean" method="POST" action="/np/publicaccess/donationSave.do" onsubmit="if(!validateDonationAmount()){return false;};return validateFields(this);" style="margin:0" id="donationForm"> <input type="hidden" name="ChangeType" value="false"/> <script language=javascript> var defaultType = 'credit-card'; function showEndDate(){ switchSuggestedAmounts ('recurring') getElement("recurringEndDate").style.display="block"; if(getElement('sfp-alternative')!=null){ $('#sfp-credit-card input[type="radio"]').attr('checked','checked'); $('#echeckhidden').attr('value', 'credit-card'); $('#sfp-credit-card-payment').show(); $('.sfp-submit-button').removeClass('sfp-disabled'); $('.sfp-submit-button').attr("onclick", "formSubmit();"); // $('#e-check-payment').hide(); $('#alternativePaymentCheckBox').attr('disabled','disabled'); } switchRecurringPayment(true); recurringOpened(defaultType); } function hiddenEndDate(){ switchSuggestedAmounts ('donation') getElement("recurringEndDate").style.display="none"; if(getElement("recurringDonation.endDate") != null){ getElement("recurringDonation.endDate").value=""; } if(getElement('sfp-alternative')!=null){ $('#sfp-credit-card input[type="radio"]').attr('checked','checked'); $('#echeckhidden').attr('value', 'credit-card'); $('#sfp-credit-card-payment').show(); // $('#e-check-payment').hide(); $('.sfp-submit-button').removeClass('sfp-disabled'); $('.sfp-submit-button').attr("onclick", "formSubmit();"); } if(getElement('sfp-daf-pay')!=null){ $('#sfp-daf-pay input[type="radio"]').removeAttr('disabled'); } switchRecurringPayment(false); recurringClosed(defaultType); } function switchSuggestedAmounts (type) { if (type == 'donation' && typeof donationSuggested != 'undefined') { jQuery('#neoncrm-suggested-donation-amounts').html(donationSuggested); } else if (type == 'recurring' && typeof recurringSuggested != 'undefined') { jQuery('#neoncrm-suggested-donation-amounts').html(recurringSuggested); } donationLevelInit(); } window.onload=function(){ } </script> <input type="hidden" name="orgId" value="perlfoundation"> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/common.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/popup.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/objects.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/calendar.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/PopupWindow.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/AnchorPosition.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/date.js"></SCRIPT> <SCRIPT LANGUAGE="JavaScript" SRC="/np/js/dataTypeValidate.js"></SCRIPT> <SCRIPT language=JavaScript> //for DEV-4240 var dev4240func = function(){ var donationAmount = document.querySelector('input[name="donation.amount"]'); if (donationAmount){ donationAmount.onfocus = function(){ var lvl0 = document.querySelector('input[name="donationLevel"][value="0"]'); if (lvl0) lvl0.checked = true; } //DEV-4716 start var levels = document.querySelectorAll('input[name="donationLevel"]'); if (levels && levels.length > 0) { for (var i = 0; i < levels.length; i++) { if(levels[i].value != '0'){ levels[i].onclick = function(){ donationAmount.value = ''; } } } }//DEV-4716 end } } var dev4240_ = window.onload; if (typeof window.onload != 'function') { window.onload = dev4240func; } else { window.onload = function() { dev4240_(); dev4240func(); } } // for DEV-4240 end function validateFields(form) { if(!validateItem("donation.amount", "Donation Amount (USD)", false)) return false; if(!validateItem("person.firstName", "First Name", false)) return false; if(!validateItem("person.lastName", "Last Name", false)) return false; if(!validateItem("person.email1", "Email", false)) return false; if(!validateItem("address.phone1", "Phone", false)) return false; if(!validateItem("address.street1", "Address", false)) return false; if(!validateItem("address.city", "City", false)) return false; if(!validatePwd("account.loginPassword")){ return false; } //dev-4947 if (getElement("account.smsPhoneNumber") && getElement("account.consentProfile.smsStatusBool") && getElement("account.consentProfile.smsStatusBool").checked) { if (isItemEmpty('account.smsPhoneNumber', false)) { alert("The SMS/MMS Number is required."); return false; } else { let usPhoneReg = /^(\+?1)?[2-9]\d{2}[2-9](?!11)\d{6}$/ if (!usPhoneReg.test(getElement("account.smsPhoneNumber").value.replaceAll(' ', '').replaceAll('-', '').replaceAll('\(', '').replaceAll('\)', ''))) { alert("The SMS/MMS Number is invalid."); return false; } } } getElement("submitButton").disabled=true; return true; } function validateDateItem(property){ var item = document.getElementById(property); var date=trim(item.value); if(date==""){ return true; } var reg="MM/dd/yyyy"; reg=reg.replace(/MM/,"((0[1-9])|1[0-2])"); reg=reg.replace(/dd/,"((0[1-9])|([1-2][0-9])|30|31)"); reg=reg.replace(/yyyy/,"[0-9]{4}"); reg=new RegExp("^"+reg+"$"); if(reg.test(date)==false){ alert("Date must be in MM/DD/YYYY format"); item.focus(); return false; } return true; } function validateDob(){ let month, day, year month = getElement('person.dobMM').value day = getElement('person.dobDD').value year = getElement('person.dobYYYY').value if ((year && isNaN(year)) || (month && isNaN(month)) || (day && isNaN(day))){ return false }else{ if(parseInt(year) < 0){ return false } if (parseInt(month) > 12 || parseInt(month) <= 0){ return false } if (parseInt(day) > 31 || parseInt(day) <= 0){ return false } if (parseInt(month) === 2 && parseInt(day) > 29){ return false } let date if (!year){ date = new Date(2000, month, 0) }else { date = new Date(year, month, 0) } if (parseInt(day) > date.getDate()){ return false } } return true } function validatePwd(property){ var item = getElement(property); if(item != null && "account.loginPassword" === property){ var loginName = getElement('account.loginName'); if(loginName != null && trim(loginName.value) != ""){ let regexpLoginName = /^[\da-zA-Z_@.+-]*$/g; if(!regexpLoginName.test(loginName.value)){ alert("Login name may consist of a-z, A-Z, 0-9, '.', '@', '_', '-'and '+' only"); return false; } if(loginName.value.length<4 || loginName.value.length>80){ alert('Login name must be at least 4 characters and at most 80 characters'); return false; } var regexp = /(?=\S*\d)\S{8,}$/; var blankRegexp = /\s/; if(!regexp.test(item.value) || blankRegexp.test(item.value)){ alert('Your password requires at least 8 characters, including at least one number. Spaces are not allowed.'); return false; } var retypePwd = getElement("loginPasswordRetype").value; if(item.value != retypePwd){ alert('The re-typed password doesn\'t match your original password'); return false; } } } return true; } function validateItem(property, name, isMulti) { var item; var isEmpty; if(isMulti){ var items = getAllChecked(property); isEmpty = items==null || items.length==0; item = getElement(property); } else { item = getElement(property); isEmpty = item!=null && item.value == ""; } if(isEmpty) { alert(name+" is a required field"); if(item!=null) item.focus(); return false; } if(item != null && "recurringDonation.nextPaymentDate" === property){ var date=trim(item.value); var reg="MM/dd/yyyy"; reg=reg.replace(/MM/,"((0[1-9])|1[0-2])"); reg=reg.replace(/dd/,"((0[1-9])|([1-2][0-9])|30|31)"); reg=reg.replace(/yyyy/,"[0-9]{4}"); reg=new RegExp("^"+reg+"$"); if(reg.test(date)==false){ alert("Date must be in MM/DD/YYYY format"); item.focus(); return false; } }else if(item != null && "recurringDonation.amount" === property){ var date=trim(item.value); var reg="([1-9])(([,\\d]*)|([,\\d]*\.\\d{1,2}))"; reg=new RegExp("^"+reg+"$"); if(reg.test(date)==false){ alert(name + " is invalid"); item.focus(); return false; } }else if(item != null && ("recurringDonation.creditCard.cvvNumber" === property || "recurringDonation.creditCard.address.zip" === property )){ var date=trim(item.value); var reg="\\d+"; reg=new RegExp("^"+reg+"$"); if(reg.test(date)==false){ alert(name + " is invalid"); item.focus(); return false; } // for DEV-3942 start }else if(item != null && ("payment.creditCard.cardNumberSecure" === property || "recurringDonation.creditCard.cardNumberSecure" === property)){ var cardNumber = item.value.replace(/\s/g,""); var reg="\\d+"; reg=new RegExp("^"+reg+"$"); if (!reg.test(cardNumber) || cardNumber.length < 12 || cardNumber.length > 19){ alert('Your credit card number must consist of numbers and be between 12 and 19 digits.'); return false; } } // for DEV-3942 end return true; } function isItemEmpty(property, isMulti) { if(isMulti){ var items = getAllChecked(property); return items==null || items.length==0; } else { var item = getElement(property); return item==null || item.value == ""; } } </SCRIPT> <input type=password autocomplete='off' style='display:none'> <input type=hidden name="skipDuplicateRequestCheck" value="1"> <div style="width:99%"> <div> <label class="neoncrm-field-label neoncrm-required"> Donation Amount (USD): </label> <input type="text" name="donation.amount" maxlength="100" size="10" value="" id="donation.amount" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <div class="neoncrm-radio-group"> <div class="neoncrm-radio-button neoncrm-recurring-donation"> <input type="radio" name="recurringFlag" value="0" checked="checked" onclick="hiddenEndDate();" id="oneTimeDonationRadio"> <label class="neoncrm-radio-label" for="oneTimeDonationRadio"> This is a one time donation </label> </div> <div class="neoncrm-radio-button"> <input type="radio" name="recurringFlag" value="1" onclick="showEndDate();" id="recurringDonationRadio"> <label class="neoncrm-radio-label" for="recurringDonationRadio">Make this a recurring donation deducted</label> <select name="recurringDonation.recurringInterval" class="neoncrm-select"><option value="1w">Weekly</option> <option value="2w">Every 2 Weeks</option> <option value="1m">Monthly</option> <option value="2m">Every 2 Months</option> <option value="3m">Quarterly</option> <option value="6m">Every 6 Months</option> <option value="12m">Annually</option></select> </div> </div> <div id="recurringEndDate" style="display:none"> <label class="neoncrm-field-label" for="recurringDonation.endDate">End Date:</label> <input type="text" name="recurringDonation.endDate" value="" id="recurringDonation.endDate" class="inputMedium"> <span> <SCRIPT LANGUAGE="JavaScript" ID="jscal3xx"> var cal3xx = new CalendarPopup(); cal3xx.showNavigationDropdowns(); </SCRIPT> <A HREF="#" onClick="cal3xx.select(getElement('recurringDonation.endDate'),'anchor3','MM/dd/yyyy'); return false;" NAME="anchor3" ID="anchor3"> <img src="/np/images/cal.gif" border="0"></A> </span></div> <label class="neoncrm-field-label neoncrm-required"> First Name: </label> <input type="text" name="person.firstName" maxlength="100" size="25" value="" id="person.firstName" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label neoncrm-required"> Last Name: </label> <input type="text" name="person.lastName" maxlength="200" size="25" value="" id="person.lastName" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label neoncrm-required"> Email: </label> <input type="text" name="person.email1" maxlength="100" size="25" value="" id="person.email1" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label neoncrm-required"> Phone: </label> <input type="text" name="address.phone1" maxlength="100" size="25" value="" id="address.phone1" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label neoncrm-required"> Address: </label> <input type="text" name="address.street1" maxlength="100" size="25" value="" id="address.street1" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label neoncrm-required"> City: </label> <input type="text" name="address.city" maxlength="100" size="25" value="" id="address.city" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label "> State (US & Candada): </label> <input type="hidden" name="multi_options_controls" value="address.state" disabled="false"/> <select name="address.state" id="address.state" class="neoncrm-select"><option value=""></option> <option value="AL">Alabama</option> <option value="AK">Alaska</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="FL">Florida</option> <option value="GA">Georgia</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="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</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="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> <option value="AS">American Samoa</option> <option value="FM">Federated States of Micronesia</option> <option value="GU">Guam</option> <option value="MH">Marshall Islands</option> <option value="MP">Northern Mariana Islands</option> <option value="PW">Palau</option> <option value="PR">Puerto Rico</option> <option value="UM">U.S. Minor Outlying Islands</option> <option value="VI">Virgin Islands</option> <option value="AA">Armed Forces Americas</option> <option value="AE">Armed Forces Europe, the Middle East, an</option> <option value="AP">Armed Forces Pacific</option> <option value="AB">Alberta</option> <option value="BC">British Columbia</option> <option value="MB">Manitoba</option> <option value="NB">New Brunswick</option> <option value="NL">Newfoundland and Labrador</option> <option value="NS">Nova Scotia</option> <option value="NT">Northwest Territories</option> <option value="NU">Nunavut Territory</option> <option value="ON">Ontario</option> <option value="PE">Prince Edward Island</option> <option value="QC">Quebec</option> <option value="SK">Saskatchewan</option> <option value="YT">Yukon Territory</option></select> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label "> State/Province (Outside US & Canada): </label> <input type="text" name="address.province" maxlength="100" size="25" value="" id="address.province" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label "> Zip: </label> <input type="text" name="address.zip" maxlength="100" size="12" value="" id="address.zip" class="neon2Field"> <span class='neonFieldText' > -</span> <label style="display: none;" for="address.zipSuffix">Zip Suffix</label> <input type="text" name="address.zipSuffix" maxlength="100" size="6" value="" id="address.zipSuffix" class="neon2Field" autocomplete="new-password" /> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label "> Country: </label> <input type="hidden" name="multi_options_controls" value="address.country" disabled="false"/> <select name="address.country" id="address.country" class="neoncrm-select"><option value=""></option> <option value="1">United States of America</option> <option value="2">Canada</option> <option value="3">Afghanistan</option> <option value="247">脜land Islands</option> <option value="4">Albania</option> <option value="5">Algeria</option> <option value="6">American Samoa</option> <option value="7">Andorra</option> <option value="8">Angola</option> <option value="242">Anguilla</option> <option value="9">Antarctica</option> <option value="10">Antigua and Barbuda</option> <option value="11">Argentina</option> <option value="12">Armenia</option> <option value="13">Aruba</option> <option value="14">Australia</option> <option value="15">Austria</option> <option value="16">Azerbaijan</option> <option value="17">Bahamas</option> <option value="18">Bahrain</option> <option value="19">Bangladesh</option> <option value="20">Barbados</option> <option value="21">Belarus</option> <option value="22">Belgium</option> <option value="23">Belize</option> <option value="24">Benin</option> <option value="25">Bermuda</option> <option value="26">Bhutan</option> <option value="27">Bolivia (Plurinational State of)</option> <option value="248">Bonaire, Sint Eustatius and Saba</option> <option value="28">Bosnia and Herzegovina</option> <option value="29">Botswana</option> <option value="30">Bouvet Island</option> <option value="31">Brazil</option> <option value="32">British Indian Ocean Territory</option> <option value="33">Brunei Darussalam</option> <option value="34">Bulgaria</option> <option value="35">Burkina Faso</option> <option value="36">Burundi</option> <option value="39">Cabo Verde</option> <option value="37">Cambodia</option> <option value="38">Cameroon</option> <option value="40">Cayman Islands</option> <option value="41">Central African Republic</option> <option value="42">Chad</option> <option value="43">Chile</option> <option value="44">China</option> <option value="45">Christmas Island</option> <option value="46">Cocos (Keeling) Islands</option> <option value="47">Colombia</option> <option value="48">Comoros</option> <option value="49">Congo</option> <option value="238">Congo (the Democratic Republic of the)</option> <option value="50">Cook Islands</option> <option value="51">Costa Rica</option> <option value="106">C么te d'Ivoire</option> <option value="52">Croatia</option> <option value="53">Cuba</option> <option value="249">Cura莽ao</option> <option value="54">Cyprus</option> <option value="55">Czechia</option> <option value="56">Denmark</option> <option value="57">Djibouti</option> <option value="58">Dominica</option> <option value="59">Dominican Republic</option> <option value="61">Ecuador</option> <option value="62">Egypt</option> <option value="63">El Salvador</option> <option value="64">Equatorial Guinea</option> <option value="65">Eritrea</option> <option value="66">Estonia</option> <option value="67">Ethiopia</option> <option value="68">Falkland Islands [Malvinas]</option> <option value="69">Faroe Islands</option> <option value="70">Fiji</option> <option value="71">Finland</option> <option value="73">France</option> <option value="75">French Guiana</option> <option value="171">French Polynesia</option> <option value="76">French Southern Territories</option> <option value="77">Gabon</option> <option value="78">Gambia</option> <option value="79">Georgia</option> <option value="80">Germany</option> <option value="81">Ghana</option> <option value="82">Gibraltar</option> <option value="84">Greece</option> <option value="85">Greenland</option> <option value="86">Grenada</option> <option value="87">Guadeloupe</option> <option value="88">Guam</option> <option value="89">Guatemala</option> <option value="250">Guernsey</option> <option value="90">Guinea</option> <option value="91">Guinea-Bissau</option> <option value="92">Guyana</option> <option value="93">Haiti</option> <option value="94">Heard Island and McDonald Islands</option> <option value="229">Holy See</option> <option value="95">Honduras</option> <option value="96">Hong Kong</option> <option value="97">Hungary</option> <option value="98">Iceland</option> <option value="99">India</option> <option value="100">Indonesia</option> <option value="101">Iran (Islamic Republic of)</option> <option value="102">Iraq</option> <option value="103">Ireland</option> <option value="251">Isle of Man</option> <option value="104">Israel</option> <option value="105">Italy</option> <option value="107">Jamaica</option> <option value="108">Japan</option> <option value="252">Jersey</option> <option value="109">Jordan</option> <option value="110">Kazakhstan</option> <option value="111">Kenya</option> <option value="112">Kiribati</option> <option value="158">Korea (the Democratic People's Republic of)</option> <option value="198">Korea (the Republic of)</option> <option value="113">Kuwait</option> <option value="114">Kyrgyzstan</option> <option value="115">Lao People's Democratic Republic</option> <option value="116">Latvia</option> <option value="117">Lebanon</option> <option value="118">Lesotho</option> <option value="119">Liberia</option> <option value="120">Libya</option> <option value="121">Liechtenstein</option> <option value="122">Lithuania</option> <option value="123">Luxembourg</option> <option value="124">Macao</option> <option value="125">Macedonia (the former Yugoslav Republic of)</option> <option value="126">Madagascar</option> <option value="127">Malawi</option> <option value="128">Malaysia</option> <option value="129">Maldives</option> <option value="130">Mali</option> <option value="131">Malta</option> <option value="132">Marshall Islands</option> <option value="133">Martinique</option> <option value="134">Mauritania</option> <option value="135">Mauritius</option> <option value="136">Mayotte</option> <option value="137">Mexico</option> <option value="138">Micronesia (Federated States of)</option> <option value="139">Moldova (the Republic of)</option> <option value="140">Monaco</option> <option value="141">Mongolia</option> <option value="253">Montenegro</option> <option value="142">Montserrat</option> <option value="143">Morocco</option> <option value="144">Mozambique</option> <option value="145">Myanmar</option> <option value="146">Namibia</option> <option value="147">Nauru</option> <option value="148">Nepal</option> <option value="149">Netherlands</option> <option value="151">New Caledonia</option> <option value="152">New Zealand</option> <option value="153">Nicaragua</option> <option value="154">Niger</option> <option value="155">Nigeria</option> <option value="156">Niue</option> <option value="157">Norfolk Island</option> <option value="159">Northern Mariana Islands</option> <option value="160">Norway</option> <option value="161">Oman</option> <option value="162">Pakistan</option> <option value="163">Palau</option> <option value="246">Palestine, State of</option> <option value="164">Panama</option> <option value="165">Papua New Guinea</option> <option value="166">Paraguay</option> <option value="167">Peru</option> <option value="168">Philippines</option> <option value="169">Pitcairn</option> <option value="170">Poland</option> <option value="172">Portugal</option> <option value="173">Puerto Rico</option> <option value="174">Qatar</option> <option value="175">R茅union</option> <option value="176">Romania</option> <option value="177">Russian Federation</option> <option value="178">Rwanda</option> <option value="254">Saint Barth茅lemy</option> <option value="180">Saint Helena, Ascension and Tristan da Cunha</option> <option value="181">Saint Kitts and Nevis</option> <option value="182">Saint Lucia</option> <option value="255">Saint Martin (French part)</option> <option value="183">Saint Pierre and Miquelon</option> <option value="185">Saint Vincent and the Grenadines</option> <option value="186">Samoa</option> <option value="187">San Marino</option> <option value="184">Sao Tome and Principe</option> <option value="188">Saudi Arabia</option> <option value="189">Senegal</option> <option value="256">Serbia</option> <option value="190">Seychelles</option> <option value="191">Sierra Leone</option> <option value="192">Singapore</option> <option value="245">Sint Maarten (Dutch part)</option> <option value="193">Slovakia</option> <option value="194">Slovenia</option> <option value="195">Solomon Islands</option> <option value="196">Somalia</option> <option value="197">South Africa</option> <option value="179">South Georgia and the South Sandwich Islands</option> <option value="243">South Sudan</option> <option value="199">Spain</option> <option value="200">Sri Lanka</option> <option value="201">Sudan</option> <option value="202">Suriname</option> <option value="203">Svalbard and Jan Mayen</option> <option value="204">Swaziland</option> <option value="205">Sweden</option> <option value="206">Switzerland</option> <option value="207">Syrian Arab Republic</option> <option value="209">Taiwan (Province of China)</option> <option value="208">Tajikistan</option> <option value="210">Tanzania, United Republic of</option> <option value="211">Thailand</option> <option value="60">Timor-Leste</option> <option value="212">Togo</option> <option value="213">Tokelau</option> <option value="214">Tonga</option> <option value="215">Trinidad and Tobago</option> <option value="216">Tunisia</option> <option value="217">Turkey</option> <option value="218">Turkmenistan</option> <option value="219">Turks and Caicos Islands</option> <option value="220">Tuvalu</option> <option value="221">Uganda</option> <option value="222">Ukraine</option> <option value="223">United Arab Emirates</option> <option value="83">United Kingdom of Great Britain and Northern Ireland</option> <option value="226">United States Minor Outlying Islands</option> <option value="225">Uruguay</option> <option value="227">Uzbekistan</option> <option value="228">Vanuatu</option> <option value="230">Venezuela (Bolivarian Republic of)</option> <option value="231">Viet Nam</option> <option value="232">Virgin Islands (British)</option> <option value="233">Virgin Islands (U.S.)</option> <option value="234">Wallis and Futuna</option> <option value="235">Western Sahara*</option> <option value="236">Yemen</option> <option value="239">Zambia</option> <option value="240">Zimbabwe</option></select> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <div class="neoncrm-section-title">If you would like to manage your Neon CRM account (i.e., view and print donation history, update profile, etc.), please create a login name and password below. Your password must be at least eight characters long, and contain at least one number.</div> <label class="neoncrm-field-label "> Create a Login Name: </label> <input type="text" name="account.loginName" maxlength="100" size="25" value="" id="account.loginName" class="neon2Field"> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label "> Password: </label> <input type="password" name="account.loginPassword" maxlength="25" size="25" value="" id="account.loginPassword" class="neon2Field" autocomplete="off" /> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <label class="neoncrm-field-label "> Retype Password: </label> <input type="password" name="loginPasswordRetype" maxlength="25" size="25" value="" id="loginPasswordRetype" class="neon2Field" autocomplete="off" /> <script> if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </script> <input type="hidden" name="address.faxType" value=""> <input type="hidden" name="donation.acknowledgeInfo.address.faxType" value=""> <input type="hidden" name="donation.matchCompanyInfo.address.faxType" value=""> <input type="hidden" name="account.isCompanyAccount" value="false"> </div> <SCRIPT language="javascript"> function validateDonationAmount(){ var donationAmount = 5; var recurringAmount = 5 if(false){ if(isChecked('donationLevel', '0')){ var amount = new CurrencyFormat().parse(getElement('donation.amount').value); if(isChecked('recurringFlag', '1')){ if(recurringAmount > 0 && recurringAmount > amount){ alert("You have not entered the minimum recurring donation amount of $"+Number(recurringAmount).toFixed(2)+'.'); return false; } }else{ if(donationAmount > 0 && donationAmount > amount){ alert("You have not entered the minimum donation amount of $"+Number(donationAmount).toFixed(2)+'.'); return false; } } } }else { var amount = new CurrencyFormat().parse(getElement('donation.amount').value); if(isChecked('recurringFlag', '1')){ if(recurringAmount > 0 && recurringAmount > amount){ alert("You have not entered the minimum recurring donation amount of $"+Number(recurringAmount).toFixed(2)+'.'); return false; } }else{ if(donationAmount > 0 && donationAmount > amount){ alert("You have not entered the minimum donation amount of $"+Number(donationAmount).toFixed(2)+'.'); return false; } } } if(isChecked('recurringFlag', '1')){ var nowYMD = '20250329'; var item = getElement("recurringDonation.endDate"); if(item != null){ var endDate = item.value; if(endDate != null && trim(endDate).length > 0){ var date=trim(endDate); var reg="MM/dd/yyyy"; reg=reg.replace(/MM/,"((0[1-9])|1[0-2])"); reg=reg.replace(/dd/,"((0[1-9])|([1-2][0-9])|30|31)"); reg=reg.replace(/yyyy/,"[0-9]{4}"); reg=new RegExp("^"+reg+"$"); if(reg.test(date)==false){ alert("End Date must be in MM/DD/YYYY format"); item.focus(); return false; } var dateArr = date.split("/"); var dateStr = dateArr[2]+dateArr[0]+dateArr[1]; if(dateStr < nowYMD){ alert("The End Date must be a future date."); item.focus(); return false; } } } } return true; } //Hot fix for DEV-5861 function validateDonationAmountNoAlert(){ var donationAmount = 5; var recurringAmount = 5 if(false){ if(isChecked('donationLevel', '0')){ var amount = getElement('donation.amount').value; if(isChecked('recurringFlag', '1')){ if(recurringAmount > 0 && recurringAmount > amount){ return false; } }else{ if(donationAmount > 0 && donationAmount > amount){ return false; } } } }else { var amount = getElement('donation.amount').value; if(isChecked('recurringFlag', '1')){ if(recurringAmount > 0 && recurringAmount > amount){ return false; } }else{ if(donationAmount > 0 && donationAmount > amount){ return false; } } } if(isChecked('recurringFlag', '1')){ var nowYMD = '20250329'; var item = getElement("recurringDonation.endDate"); if(item != null){ var endDate = item.value; if(endDate != null && trim(endDate).length > 0){ var date=trim(endDate); var reg="MM/dd/yyyy"; reg=reg.replace(/MM/,"((0[1-9])|1[0-2])"); reg=reg.replace(/dd/,"((0[1-9])|([1-2][0-9])|30|31)"); reg=reg.replace(/yyyy/,"[0-9]{4}"); reg=new RegExp("^"+reg+"$"); if(reg.test(date)==false){ item.focus(); return false; } var dateArr = date.split("/"); var dateStr = dateArr[2]+dateArr[0]+dateArr[1]; if(dateStr < nowYMD){ item.focus(); return false; } } } } return true; } //Because of a Chrome auto-fill bug, just disable auto-fill for zipSuffix for now. if(document.getElementById("address.zipSuffix")) document.getElementById("address.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("address2.zipSuffix")) document.getElementById("address2.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("donation.acknowledgeInfo.address.zipSuffix")) document.getElementById("donation.acknowledgeInfo.address.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("donation.matchCompanyInfo.address.zipSuffix")) document.getElementById("donation.matchCompanyInfo.address.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("payment.creditCard.address.zipSuffix")) document.getElementById("payment.creditCard.address.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("recurringDonation.creditCard.address.zipSuffix")) document.getElementById("recurringDonation.creditCard.address.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("shipping.address.zipSuffix")) document.getElementById("shipping.address.zipSuffix").setAttribute("autocomplete","new-password"); if(document.getElementById("membershipSpec.creditCard.address.zipSuffix")) document.getElementById("membershipSpec.creditCard.address.zipSuffix").setAttribute("autocomplete","new-password"); //if(document.getElementById("donation.amount")) document.getElementById("donation.amount").setAttribute("autocomplete","amount"); //Also disable auto-fill for Suffix if(document.getElementById("person.suffix")) document.getElementById("person.suffix").setAttribute("autocomplete","off"); if (jQuery19) { jQuery19('input[type="password"]').attr('autocomplete', 'new-password') } </SCRIPT> </div> <div class="neoncrm-form-buttons"> <INPUT name="submitButton" class="neoncrm-button neoncrm-submit" type=submit value="Submit"> </div> </form> <!-- <div style="margin-left:auto;margin-right:auto"> <a href="http://www.z2systems.com/neoncrm/thawte-site-seal" target="_blank">Security</a> </div> --> <!-- AddThis Button BEGIN --> <!-- AddThis Button END --> <!-- for DEV-4240 start --> <script type="text/javascript"> function donationLevelInit(){ var donationAmount = document.querySelector('input[name="donation.amount"]'); if (donationAmount) { donationAmount.onfocus = function () { var lvl0 = document.querySelector('#donationLevel_0'); if (lvl0) { lvl0.checked = true; } }; if(null!=donationAmount.value && donationAmount.value != ''){ var lvl0 = document.querySelector('#donationLevel_0'); if (lvl0){ lvl0.checked = true; } } } var levels = document.querySelectorAll('input[name="donationLevel"]'); if (levels && levels.length > 0) { for (var i = 0; i < levels.length; i++) { if(donationAmount && levels[i].id != 'donationLevel_0'){ levels[i].onclick = function(){ donationAmount.value = ''; } } if(levels[i].getAttribute("attr") == "defaultSelectLevel") { if(!donationAmount || null==donationAmount.value || donationAmount.value == '') { levels[i].checked = true } } } } } donationLevelInit() var defaultLevel = 'donation'; if(defaultLevel != null) { if (defaultLevel == 'donation') { var oneTime = document.querySelector('[id="oneTimeDonationRadio"]') if (oneTime) { oneTime.checked = true getElement("recurringEndDate").style.display="none"; } } else if (defaultLevel == 'recurring') { var recurring = document.querySelector('[id="recurringDonationRadio"]') if (recurring) { recurring.checked = true getElement("recurringEndDate").style.display="block"; } } } </script> <!-- for DEV-4240 end --> </div></div> </div><!--.container--> <!-- jQuery (necessary for Bootstrap's JavaScript plugins) --> </body> </html>