<!DOCTYPE html>
<html>

<head>
<base href="https://secure3.convio.net/hfb/site/" />
<title>

Harvey Relief - Houston Food Bank
</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<meta http-equiv="Content-Script-Type" content="text/javascript" />
<meta name="Keywords" content=" " />
<meta name="Description" content="" />
<meta name="Robots" content="index, follow" />









<script type="text/javascript" src="../yui3/yui/yui-min.js"></script><noscript>&nbsp;</noscript>
<script type="text/javascript" src="../js/convio/modules.js?version=2.9"></script><noscript>&nbsp;</noscript>
<script type="text/javascript">
var Y = YUI({base: '../yui3/',
insertBefore: 'yui_marker_loader_css', // insert all YUI module css before customstyle so it can be overridden
debug: false, 
modules: getModules('../', 'convio', true)});
</script><noscript>&nbsp;</noscript>


<script type="text/javascript" src="../js/utils.js"></script><noscript>&nbsp;</noscript>

<script type="text/javascript" src="../js/obs_comp_rollup.js"></script><noscript>&nbsp;</noscript>


<link href="../css/themes/default.css" rel="stylesheet" type="text/css" />
<link href="../css/themes/alphacube.css" rel="stylesheet" type="text/css"/>





<link href="../css/UserGlobalStyle.css" rel="stylesheet" type="text/css" />


<link href="../css/responsive/ResponsiveBase.css" rel="stylesheet" type="text/css" />


<link href="../css/responsive/DonFormResponsive.css" rel="stylesheet" type="text/css" />



<link href="../css/FormComponentsBehavior.css" rel="stylesheet" type="text/css" />
<script type="text/javascript" src="../js/FormComponentsBehavior.js"></script><noscript>&nbsp;</noscript>
<script type="text/javascript" src="../js/don_level_elements.js"></script><noscript>&nbsp;</noscript>
<script type="text/javascript" src="../js/don_premium_elements.js"></script><noscript>&nbsp;</noscript>
<script type="text/javascript" src="../js/donations2.js"></script><noscript>&nbsp;</noscript>


<link rel="stylesheet" type="text/css" id="yui_marker_loader_css" />
<link href="../css/CustomStyle.css" rel="stylesheet" type="text/css" />
<link href="../css/CustomWysiwygStyle.css" rel="stylesheet" type="text/css" />






<meta name="CnvHeaderVersion" content="v5.0" />


<meta charset="utf-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Wrapper</title>

    <meta name="viewport" id="view" content="width=device-width minimum-scale=1, maximum-scale=1" />

    <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css">

    <!-- Google Fonts -->
    <link href='https://fonts.googleapis.com/css?family=Open+Sans:400,300,300italic,400italic,600,600italic,700,700italic,800,800italic&subset=latin,latin-ext' rel='stylesheet' type='text/css'>

    <script src="../js/jquery.js"></script>
<!-- GOOGLE TRACKING ECOMMERCE -->
<script type="text/javascript">
    var _gaq = _gaq || [];
    var formDefinition ={
      transactionId:  {fieldName:"Confirmation Number" ,value:"0"} // Transaction ID
      ,affiliation:   {fieldName:"Affiliation"         ,value:"FY18 Disaster Relief"}
      ,total:         {fieldName:"Donation Amount"     ,value:"($0.01)", valueType:"number"}
      ,tax:           {fieldName:"Tax"                 ,value:"$0.00"}
      ,shipping:      {fieldName:"Shipping"            ,value:"1"}
      ,city:          {fieldName:"City"                ,value:""}
      ,state:         {fieldName:"State"               ,value:""}
      ,country:       {fieldName:"Country"             ,value:""}
      ,skuCode:       {fieldName:"SKU Code (form ID)"  ,value:"9314"}
      ,name:          {fieldName:"Product Name"        ,value:"FY18 Disaster Relief - Harvey"}
      ,category:      {fieldName:"Category"            ,value:"Donation"}
     
    };

jQuery(document).ready (function ($){
    
    var transactionId = '0';
    if(transactionId !== '0')
    {

      _gaq.push(['_setAccount', 'UA-12866137-1']);
      _gaq.push(['_trackPageview']);
      _gaq.push(['_addTrans',
      formDefinition.transactionId.value,   //transaction ID - required
      formDefinition.affiliation.value,     // affiliation or store name
      formDefinition.total.value,           //total - required
      formDefinition.tax.value,             // tax
      formDefinition.shipping.value,        // shipping
      "'"+formDefinition.city.value+"'",    // city
      "'"+formDefinition.state.value+"'",   // state or province
      "'"+formDefinition.country.value+"'"    // Country
      ]);

      _gaq.push(['_addItem',
          formDefinition.transactionId.value, // transaction ID - required
          formDefinition.skuCode.value,       // SKU/code - required
          formDefinition.name.value,          // product name
          formDefinition.category.value,      // category or variation
          formDefinition.total.value,         //  unit price - required
          '1'                                 // quantity - required
        ]);

      _gaq.push(['_trackTrans']); //submits transaction to the Analytics servers

      (function() {
        var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true;
        ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js';
        var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s);
      })();
    }  
});
</script>

<!-- /GOOGLE TRACKING ECOMMERCE -->
<!-- Google Tag Manager -->
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
})(window,document,'script','dataLayer','GTM-W8S67V');</script>
<!-- End Google Tag Manager -->




<script type="text/javascript">
var _gaq = _gaq || [];
_gaq.push(['_setAccount', 'UA-12866137-1']);
_gaq.push(['_setDomainName', 'none']);
_gaq.push(['_setAllowLinker', true]);


_gaq.push(['_trackPageview', '/funnel/Donation2/FY18 Disaster Relief - Harvey/form1']);


(function() {
var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true;
ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js';
var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s);
})();
addOnLoadHandler(function() {
// track items and transactions 
if (typeof trackItemsAndTransactions != "undefined" && typeof trackItemsAndTransactions != null){
trackItemsAndTransactions();
}
});
</script><noscript>&nbsp;</noscript>
 
 
 
 

		
</head>
<body













>	
    <!-- Google Tag Manager (noscript) -->
<noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-W8S67V"
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<!-- End Google Tag Manager (noscript) -->
<div class="main-wrapper">
        <!-- Region 1 Wrap -->
        <div class="container parent-container">
            <div class="row">
                <div class="col-sm-3 main-area">
                    <a id="logo" href="http://www.houstonfoodbank.org"><img src="../images/hfb_logo-new.png" alt="Houston Food Bank" /></a>
                </div>
            </div>

            <hr class="divider-green">

            <div class="row">
                <div class="col-sm-12 main-area">
                    








<form name="process" id="ProcessForm" action="https://secure3.convio.net/hfb/site/Donation2" method="post"  >

<div class="donation-form-container responsive">
<script type="text/javascript">
<!--
function reloadPage() {
window.location.reload(true);
}
function testAjax() {

var xmlHttp = null;
// Opera 8.0+, Firefox, Chrome, Safari
try {
xmlHttp = new XMLHttpRequest();
}catch (e){
// Internet Explorer Browsers
try{
xmlHttp = new ActiveXObject("Msxml2.XMLHTTP");
}catch (e) {
try{
xmlHttp = new ActiveXObject("Microsoft.XMLHTTP");
}catch (e){
return false;
}
}
}

xmlHttp.open('POST','AjaxHelper;jsessionid=00000000.app315b?NONCE_TOKEN=D45880DA5198FC99C7FE849CD378738B', true);
xmlHttp.send();

}
addOnLoadHandler(testAjax);
// -->
</script>


<div class="donation-form-content">






<input type="hidden" name="user_donation_amt" id="user_donation_amt" value="" />
<input type="hidden" name="company_min_matching_amt" id="company_min_matching_amt" value="" />
<input type="hidden" name="currency_locale" id="currency_locale" value="en_US" />





<div class="form-row">
<div class="html-caption-container">
<p><style type="text/css">

* {
    box-sizing: border-box;
}

body {
    background: url(https://secure3.convio.net/hfb/images/bkgrd_veg.jpg) no-repeat top center;
    font-family: 'Open Sans', 'Lucida Sans Unicode', 'Lucida Grande', sans-serif !important;
    line-height: 1;
    position: relative;
    -webkit-font-smoothing: antialiased;
}

.main-wrapper {
    margin: 0 auto;
    max-width: 1020px;
    -webkit-box-shadow: 0 0 10px rgba(0, 0, 0, 0.5);
    -moz-box-shadow: 0 0 10px rgba(0, 0, 0, 0.5);
    box-shadow: 0 0 10px rgba(0, 0, 0, 0.5);
    background-color: #fff;
    min-height: 600px;
    padding-top: 20px;
}

.parent-container {
    font-family: 'Open Sans', 'Lucida Sans Unicode', 'Lucida Grande', sans-serif !important;
}

.container {
    max-width: 100%;
}

.main-area {
    padding: 0px 40px;
}

.don-standard-levels,
#payment_typecc_type_row,
#donor_email_opt_in_Row {
    display: none;
}

h3 {
    color: #ff6633;
    font-size: 24px;
    font-weight: 700;
    line-height: 24px;
    text-align: left;
    margin-top: 20px;
    margin-bottom: 20px;
}


/* Form Stylins */

label {
    font-weight: 700;
    white-space: inherit;
}

#tribute_show_honor_fields_row label,
.donation-level-container-generic-repeat label {
    display: inline-block;
}

input[type="text"],
textarea,
select {
    border-radius: 2px;
    border-style: solid;
    border-width: 1px;
    border-color: #cccccc;
    background-color: #ffffff;
    height: 40px;
    width: 288px;
    display: block;
    margin: 10px 0px;
}

select {
    height: 40px !important;
}

#payment_typecc_exp_date_MONTH,
#payment_typecc_exp_date_YEAR {
    width: 133px;
    float: left;
}

#payment_typecc_exp_date_MONTH {
    margin-right: 20px;
}

textarea {
    height: 144px;
}

#tribute_show_honor_fields_row {
    margin: 12px 0px;
}

#payment_cc_container h3 {
    color: #ff6633;
    font-size: 24px;
    font-weight: 700;
    line-height: 24px;
    text-align: left;
    margin-bottom: 18px;
}

#pstep_finish {
    background-color: #ff6633;
    width: 288px;
    height: 54px;
    color: #fff;
    line-height: 54px;
    font-size: 22px;
    font-weight: 700;
    text-align: center;
    margin: 25px 0px;
}


/* Style Dividers */

.divider-green {
    border-top: 15px solid #7abc00;
    margin-right: -15px;
    margin-left: -15px;
}

.dashed-divider {
    border-top: 2px dashed #bfbfbf;
    margin: 25px 0px;
}

.footer-divider{
    border-top:1px solid #cccccc;
    margin-left: -15px;
    margin-right: -15px;
}


/* Style Header Content */

.donation-header {
    font-family: 'Open Sans', 'Lucida Sans Unicode', 'Lucida Grande', sans-serif !important;
    color: #000;
    text-align: left;
}

.donation-header img {
    width: 100%;
}

.donation-header h1 {
    color: #ff6633;
    font-size: 30px;
    font-weight: 700;
    line-height: 34px;
    margin-top: 0px;
}

.donation-header h2 {
    font-size: 22px;
    font-weight: 700;
    line-height: 28px;
}

.donation-header p {
    font-size: 16px;
    font-weight: 400;
    line-height: 24px;
    margin: 20px 0px;
}


/*Honor Fields */

.honor-container {
    background-color: #fcfcfc;
    border-radius: 2px;
    border: 1px solid #e1e1e1;
    padding: 12px;
    max-width: 300px;
}

.honor-container h3 {
    font-size: 18px !important;
    text-align: center;
}

.honor-container input[type=text],
.honor-container select,
.honor-container textarea {
    width: 100%;
}


/* Donation Buttons */

#buttons-holder label{
    width: 100%;
}

.donation-buttons {
    margin-top: 20px;
    margin-bottom: 20px;
}

.button-instance {
    text-align: center;
    margin-bottom: 10px;
    padding: 0 10px;
}

.button-amount {
    height: 56px;
    font-size: 22px;
    font-weight: 700;
    line-height: 52px;
    color: #ff6633;
    border: 3px solid #ff6633;
}

.button-amount-selected {
    background-color: #ff6633;
    color: #fff !important;
}

.button-instance span {
    color: #000000;
    font-size: 14px;
    font-weight: 400;
    line-height: 20px;
    display: inline-block;
    padding-top: 10px;
}

.button-instance .recurring {padding-top: 0;}


/* Custom Donation Amount */

.custom-donation {
    color: #ff6633;
    font-size: 16px;
    font-weight: 700;
    line-height: 20px;
    text-align: left;
    margin-top: 20px;
}

.custom-donation input {
    border-radius: 2px;
    border-style: solid;
    border-width: 1px;
    border-color: #cccccc;
    background-color: #ffffff;
    width: 93%;
    height: 48px;
    display: inline-block !important;
    margin: 0;
    padding:6px;
}

.custom-dollar {
    width: 5%;
    display: inline-block;
    color: #000;
    font-size: 24px;
    font-weight: 600;
    line-height: 20px;
}


/* Footer */

footer {
    margin-top: 30px !important;
    color: #000;
    font-size: 14px;
    font-weight: 400;
    line-height: 22px;
    text-align: left;
}

footer a {
    color: #26699c !important;
    text-decoration: none;
}

@media(max-width:768px) {
    LABEL {
        white-space: inherit;
    }
    label {
        width: 90%;
    }
}

@media(max-width:480px) {
    .main-area {
        padding: 0px 15px;
    }
    .gift-message {
        margin-bottom: 20px;
    }
    input[type="text"],
    textarea,
    select,
    #pstep_finish {
        width: 100%;
    }
    #payment_typecc_exp_date_MONTH,
    #payment_typecc_exp_date_YEAR {
        width: 46%;
    }
    .featured-image {
        display: none;
    }
    .custom-donation input {
        width: 93%;
    }
}

</style>

<script>
    //Disable old stylesheet
    jQuery(document).ready(function() {


        jQuery('link[href="../css/responsive/DonFormResponsive.css"]').prop('disabled', true);
        jQuery('link[href="../css/responsive/ResponsiveBase.css"]').prop('disabled', true);
        jQuery('link[href="../css/FormComponentsBehavior.css"]').prop('disabled', true);

        /*Change Credit Text */
        jQuery('#payment_cc_container h3').text('Payment Information');

        var honor = jQuery('.honor-container');

        jQuery('#tribute_type_row, #tribute_honoree_first_name_row, #tribute_notify_recip_name_row, #tribute_notify_recip_street1_row, #tribute_notify_recip_city_row, #tribute_notify_recip_state_row, #tribute_notify_recip_zip_row, #tribute_message_body_row').appendTo(honor);

        honor.hide();

        var honorSelect = jQuery('#tribute_show_honor_fieldsname');

        honorSelect.change(function(){
            if(honorSelect.attr('checked')){
               honor.slideDown('slow');
            } else {
               honor.slideUp('slow');
            }
        });

    });
</script>

<script type="text/javascript">
    jQuery(document).ready(function(){

        /* Array from Polyfill */

        if (!Array.from) {
  Array.from = (function () {
    var toStr = Object.prototype.toString;
    var isCallable = function (fn) {
      return typeof fn === 'function' || toStr.call(fn) === '[object Function]';
    };
    var toInteger = function (value) {
      var number = Number(value);
      if (isNaN(number)) { return 0; }
      if (number === 0 || !isFinite(number)) { return number; }
      return (number > 0 ? 1 : -1) * Math.floor(Math.abs(number));
    };
    var maxSafeInteger = Math.pow(2, 53) - 1;
    var toLength = function (value) {
      var len = toInteger(value);
      return Math.min(Math.max(len, 0), maxSafeInteger);
    };

    // The length property of the from method is 1.
    return function from(arrayLike/*, mapFn, thisArg */) {
      // 1. Let C be the this value.
      var C = this;

      // 2. Let items be ToObject(arrayLike).
      var items = Object(arrayLike);

      // 3. ReturnIfAbrupt(items).
      if (arrayLike == null) {
        throw new TypeError("Array.from requires an array-like object - not null or undefined");
      }

      // 4. If mapfn is undefined, then let mapping be false.
      var mapFn = arguments.length > 1 ? arguments[1] : void undefined;
      var T;
      if (typeof mapFn !== 'undefined') {
        // 5. else
        // 5. a If IsCallable(mapfn) is false, throw a TypeError exception.
        if (!isCallable(mapFn)) {
          throw new TypeError('Array.from: when provided, the second argument must be a function');
        }

        // 5. b. If thisArg was supplied, let T be thisArg; else let T be undefined.
        if (arguments.length > 2) {
          T = arguments[2];
        }
      }

      // 10. Let lenValue be Get(items, "length").
      // 11. Let len be ToLength(lenValue).
      var len = toLength(items.length);

      // 13. If IsConstructor(C) is true, then
      // 13. a. Let A be the result of calling the  internal method of C with an argument list containing the single item len.
      // 14. a. Else, Let A be ArrayCreate(len).
      var A = isCallable(C) ? Object(new C(len)) : new Array(len);

      // 16. Let k be 0.
      var k = 0;
      // 17. Repeat, while k < len&#8230; (also steps a - h)
      var kValue;
      while (k < len) {
        kValue = items[k];
        if (mapFn) {
          A[k] = typeof T === 'undefined' ? mapFn(kValue, k) : mapFn.call(T, kValue, k);
        } else {
          A[k] = kValue;
        }
        k += 1;
      }
      // 18. Let putStatus be Put(A, "length", len, true).
      A.length = len;
      // 20. Return A.
      return A;
    };
  }());
}




        /* Url Parameters */

        var urlParam = function(name) {
            var results = new RegExp('[\?&]' + name + '=([^&#]*)').exec(window.location.href);
            if (results == null) {
                return null;
            } else {
                return results[1] || 0;
            }
        };

        var multiply;

        if(urlParam('multiply')){
           multiply = parseInt(urlParam('multiply'));
        } else {
           multiply = 3;
        }

        /* Find Donation Amounts */
        var donations = jQuery('.donation-level-amount-container').text();
        donations = donations.replace(/(\r\n|\n|\r)/gm,"");
        donations = donations.split('$');
        donations.shift();

        var newButtonCreated = '';

        var systemCustomInput = jQuery('.donation-level-user-entered input[type=text]');
        var customHolder = jQuery('.custom-holder');

        systemCustomInput.appendTo(customHolder);

        var radioAmounts = jQuery('input[name="level_standardexpanded"]');

        var idRadio = radioAmounts.map(function () {
                    return jQuery(this).attr("id");
         });

         idRadio = Array.from(idRadio);
         idRadio.pop();

        /* Activate Donations */

        var buttonAppend = function(amount, id){

            var amount_comma = amount;
            str = amount_comma.replace(/,/g, "");

            var amount = parseInt(str);

            var newButton = '<div class="col-xs-6 col-md-3 button-instance">';
            newButton += '<label for="' + id +'"><div class="button-amount">$' + amount + '</div></label>';
            newButton += ' <span>Will provide <strong class="meals-amount">' + (amount * multiply) + '</strong> nutritious meals</span> <span class="recurring"></span></div>';
            return newButton;
        }

        for(var i = 0; i < donations.length; i++){

                newButtonCreated += buttonAppend(donations[i], idRadio[i]);

        }

       jQuery('#buttons-holder').html(newButtonCreated);

       jQuery('.button-amount').click(function(){
           jQuery('.button-amount').removeClass('button-amount-selected');
           jQuery(this).addClass('button-amount-selected');
           systemCustomInput.val('');
       });

       systemCustomInput.click(function(){
           jQuery('.button-amount').removeClass('button-amount-selected');
       });

       /*RECURRING FUNVTIONALLITY */
       $("#level_standardauto_repeatname").change(function(event) {
         if ($("#level_standardauto_repeatname").is(":checked")) {
           $(".recurring").append('every month');
         }
         else{
          $(".recurring").html('');
         }
       });

        if(urlParam('set.DonationLevel')){
            var paramPassed = urlParam('set.DonationLevel');
            jQuery('label[for*=' +paramPassed+ ']').children().click().trigger('change');
        }

       if(urlParam('set.customLevel')){
            var customPassed = parseFloat(urlParam('set.customLevel'));
            console.log("customLevel");
            jQuery('.custom-dollar + input').click().trigger('change').val(customPassed);
        }

       if(urlParam('MONTHLY')){
          jQuery('label[for="level_standardauto_repeatname"]').click().trigger('change');
       }

      if(urlParam('set.OptionalRepeat')){
         $(".recurring").append('every month');
      }
    });
</script>

</p>
<div class="row donation-header">
<div class="col-md-7">
<h1>Help Feed Our Hungry Neighbors When They Need It Most</h1>
<h2>Every $1 Provides 3 Meals</h2>
<p>Your support helps provide meals for hungry neighbors in emergencies and throughout the year. Together, we can help people in their greatest time of need. Once all this year's disaster relief and recovery needs have been met, any remaining donations will be used to fund ongoing hunger-relief efforts.</p>
</div>
<div class="col-md-5 featured-image">
        <img class="img-responsive" src="../images/content/pagebuilder/help-everyone.jpg" alt="Help Feed" />
    </div>
</div>
</div>
</div>



<div class="form-row">
<div class="html-caption-container">
<div class="row donation-buttons">
<div class="col-sm-7">
<div id="buttons-holder" class="row">
            
    
        </div>
<div class="row custom-donation">
<div class="col-sm-3 gift-message">
                Your Gift of Any Amount:
            </div>
<div class="col-sm-9 custom-holder">
               <span class="custom-dollar">$</span>
            </div>
</div>
</div>
</div>
</div>
</div>




<div class="don-standard-levels form-row">
<div class="levels-label">

</div>

<div id="level_standard_row" class="form-row form-donation-level">

<div class="form-content">
<span class="field-required"></span> <span class="aural-only">Field Is Required</span>

<span class="FormLabelText">Select Gift Amount:</span> 


<div class="donation-level-general-ask">

</div>

<div class="donation-levels">

<div class="donation-level-container">
<div class="form-content">

<div class="donation-level-input-container form-input">

<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded11699"
value="11699"


onclick="evalMatchingGift('$75.00');"
/>
</div>

<label for="level_standardexpanded11699" onclick="">


<div class="donation-level-amount-container">
$75.00
</div>


<div class="donation-level-label-container">
50.00
</div>


</label>







</div>

<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_11699expandedsubmit" value="true" /> 
</div>
</div>
<div class="donation-level-container">
<div class="form-content">

<div class="donation-level-input-container form-input">

<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded11700"
value="11700"


onclick="evalMatchingGift('$100.00');"
/>
</div>

<label for="level_standardexpanded11700" onclick="">


<div class="donation-level-amount-container">
$100.00
</div>


<div class="donation-level-label-container">
100.00
</div>


</label>







</div>

<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_11700expandedsubmit" value="true" /> 
</div>
</div>
<div class="donation-level-container">
<div class="form-content">

<div class="donation-level-input-container form-input">

<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded11701"
value="11701"


onclick="evalMatchingGift('$250.00');"
/>
</div>

<label for="level_standardexpanded11701" onclick="">


<div class="donation-level-amount-container">
$250.00
</div>


<div class="donation-level-label-container">
250.00
</div>


</label>







</div>

<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_11701expandedsubmit" value="true" /> 
</div>
</div>
<div class="donation-level-container">
<div class="form-content">

<div class="donation-level-input-container form-input">

<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded11702"
value="11702"


onclick="evalMatchingGift('$500.00');"
/>
</div>

<label for="level_standardexpanded11702" onclick="">


<div class="donation-level-amount-container">
$500.00
</div>


<div class="donation-level-label-container">
500.00
</div>


</label>







</div>

<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_11702expandedsubmit" value="true" /> 
</div>
</div>
<div class="donation-level-container">
<div class="form-content">

<div class="donation-level-input-container form-input">

<div class="donation-level-label-input-container">
<input type="radio" name="level_standardexpanded" id="level_standardexpanded11703"
value="11703"


onclick="evalMatchingGift(document.getElementById('level_standardexpanded11703amount').value);"
/>
</div>

<label for="level_standardexpanded11703" onclick="">



<div class="donation-level-label-container">
Enter an Amount
</div>


</label>


<div class="donation-level-user-entered">
<label for="level_standardexpanded11703amount"><span class="aural-only">Enter amount</span></label>
<input type="text" name="level_standardexpanded11703amount" id="level_standardexpanded11703amount" value="" size="12"
onfocus="var el = document.getElementById ('level_standardexpanded11703');if (el) el.click(); fire_obs_comp_event('level_standardexpanded11703amount', this, event);evalMatchingGift(value); "
onchange="fire_obs_comp_event('level_standardexpanded11703amount', this, event);evalMatchingGift(value);"
onkeyup="fire_obs_comp_event('level_standardexpanded11703amount', this, event);evalMatchingGift(value);"/>
</div>





</div>

<input type="hidden" name="level_standardexpandedsubmit" id="level_standard_11703expandedsubmit" value="true" /> 
</div>
</div>
</div>
</div>
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function(){
// subscribe observables
jQuery('div.donation-level-element-container').find('input[type="radio"]').each(function() {
var syncAction = function(obj) {
if (obj.is(':checked')) {
obj.closest('div.donation-level-container').addClass('selected');
}
else {
obj.closest('div.donation-level-container').removeClass('selected');
};
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('div.donation-level-container').removeClass('selected');
syncAction(jQuery(this));
});
});
});
});
</script><noscript>&nbsp;</noscript>
</div>

<div class="levels-gift-aid">

</div>
<input type="hidden" name="level_standardsubmit" id="level_standardsubmit" value="true" />
<script type="text/javascript">
function evalMatchingGift(gift) {

}
</script><noscript>&nbsp;</noscript>
</div>
<div class="donation-level-container-generic-repeat form-input">

<div class="generic-repeat-label-checkbox-container">
<input type="checkbox" name="level_standardauto_repeatname" id="level_standardauto_repeatname"

onclick="fire_obs_comp_event('level_standardauto_repeat', this);"
onkeypress="fire_obs_comp_event('level_standardauto_repeat', this);"
/>

<label for="level_standardauto_repeatname">
Make this an automatic monthly gift to reduce my mailings and support families year-round.
</label>

</div>
<input type="hidden" name="level_standardauto_repeatsubmit" id="level_standardauto_repeatsubmit" value="true" />
</div>



<div id="tribute_show_honor_fields_row" class="form-row form-checkbox">

<div class="form-content">


<input type="checkbox" name="tribute_show_honor_fieldsname" id="tribute_show_honor_fieldsname"

onclick="fire_obs_comp_event('tribute_show_honor_fields', this);" />
<label for="tribute_show_honor_fieldsname">Make this gift in honor or in memory of someone.</label>
<input type="hidden" name="tribute_show_honor_fieldssubmit" id="tribute_show_honor_fieldssubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_show_honor_fields', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_show_honor_fields_row', _display);
this.disable_submit_flag (_hidden);
}
comp.set = function (_value)
{
if (document.getElementById('tribute_show_honor_fieldsname')) {
document.getElementById('tribute_show_honor_fieldsname').checked = _value;
this.fireEvent();
}
}
comp.get = function()
{
if (document.getElementById('tribute_show_honor_fieldsname')) {
return document.getElementById('tribute_show_honor_fieldsname').checked;
}
}
comp.clear = function()
{
this.set(false);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>



<div class="form-row">
<div class="html-caption-container">
<div class="honor-container">
<h3>Who are you giving this gift in honor or in memory of?</h3>
</div>
</div>
</div>




<div id="tribute_type_row" class="form-row form-selectlist">

<div class="form-content">

<label class="FormLabel" for="tribute_type">Honor Gift Type:</label>
<select name="tribute_type" id="tribute_type" size="1" 
 >
<option ></option>
<option value="tribute_type_value1" >In Memory of</option>
<option value="tribute_type_value2" >In Honor of</option>

</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_type', '');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_type_Row', _display);
this.disable_submit_flag (_hidden);
} 
//-->
</script>
<noscript><br/>Required</noscript>

<input type="hidden" name="tribute_typesubmit" id="tribute_typesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_type', '');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_type_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_type'));

function tribute_type_listChanged(_evt)
{
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_type', src);
}
}
var el = document.getElementById('tribute_type');
if (el) {
Utils.addEvent (el, 'change', tribute_type_listChanged);
}
</script><noscript>&nbsp;</noscript>
</div>
</div>





<div id="tribute_honoree_first_name_row" class="form-row form-text">

<div class="form-content">

<label for="tribute_honoree_first_namename">Honoree Full Name:</label>

<input type="text" name="tribute_honoree_first_namename" id="tribute_honoree_first_namename"
value=""
maxlength="50"
 />

<input type="hidden" name="tribute_honoree_first_namesubmit" id="tribute_honoree_first_namesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_honoree_first_name', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_honoree_first_name_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_honoree_first_name'));

</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="tribute_notify_recip_name_row" class="form-row form-text">

<div class="form-content">

<label for="tribute_notify_recip_namename">Name of Person to Notify:</label>

<input type="text" name="tribute_notify_recip_namename" id="tribute_notify_recip_namename"
value=""
maxlength="70"
 />

<input type="hidden" name="tribute_notify_recip_namesubmit" id="tribute_notify_recip_namesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_notify_recip_name', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_notify_recip_name_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_notify_recip_name'));

</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="tribute_notify_recip_street1_row" class="form-row form-text">

<div class="form-content">

<label for="tribute_notify_recip_street1name">Address of Person to Notify:</label>

<input type="text" name="tribute_notify_recip_street1name" id="tribute_notify_recip_street1name"
value=""
maxlength="50"
 />

<input type="hidden" name="tribute_notify_recip_street1submit" id="tribute_notify_recip_street1submit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_notify_recip_street1', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_notify_recip_street1_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_notify_recip_street1'));

</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="tribute_notify_recip_city_row" class="form-row form-text">

<div class="form-content">

<label for="tribute_notify_recip_cityname">City:</label>

<input type="text" name="tribute_notify_recip_cityname" id="tribute_notify_recip_cityname"
value=""
maxlength="50"
 />

<input type="hidden" name="tribute_notify_recip_citysubmit" id="tribute_notify_recip_citysubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_notify_recip_city', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_notify_recip_city_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_notify_recip_city'));

</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="tribute_notify_recip_state_row" class="form-row form-selectlist">

<div class="form-content">

<label class="FormLabel" for="tribute_notify_recip_state">State:</label>
<select name="tribute_notify_recip_state" id="tribute_notify_recip_state" size="1" 
 onchange="fire_obs_comp_event('tribute_notify_recip_state', this)">
<option ></option>
<option value="AK" >AK - Alaska</option>
<option value="AL" >AL - Alabama</option>
<option value="AR" >AR - Arkansas</option>
<option value="AZ" >AZ - Arizona</option>
<option value="CA" >CA - California</option>
<option value="CO" >CO - Colorado</option>
<option value="CT" >CT - Connecticut</option>
<option value="DC" >DC - District of Columbia</option>
<option value="DE" >DE - Delaware</option>
<option value="FL" >FL - Florida</option>
<option value="GA" >GA - Georgia</option>
<option value="HI" >HI - Hawaii</option>
<option value="IA" >IA - Iowa</option>
<option value="ID" >ID - Idaho</option>
<option value="IL" >IL - Illinois</option>
<option value="IN" >IN - Indiana</option>
<option value="KS" >KS - Kansas</option>
<option value="KY" >KY - Kentucky</option>
<option value="LA" >LA - Louisiana</option>
<option value="MA" >MA - Massachusetts</option>
<option value="MD" >MD - Maryland</option>
<option value="ME" >ME - Maine</option>
<option value="MI" >MI - Michigan</option>
<option value="MN" >MN - Minnesota</option>
<option value="MO" >MO - Missouri</option>
<option value="MS" >MS - Mississippi</option>
<option value="MT" >MT - Montana</option>
<option value="NC" >NC - North Carolina</option>
<option value="ND" >ND - North Dakota</option>
<option value="NE" >NE - Nebraska</option>
<option value="NH" >NH - New Hampshire</option>
<option value="NJ" >NJ - New Jersey</option>
<option value="NM" >NM - New Mexico</option>
<option value="NV" >NV - Nevada</option>
<option value="NY" >NY - New York</option>
<option value="OH" >OH - Ohio</option>
<option value="OK" >OK - Oklahoma</option>
<option value="OR" >OR - Oregon</option>
<option value="PA" >PA - Pennsylvania</option>
<option value="RI" >RI - Rhode Island</option>
<option value="SC" >SC - South Carolina</option>
<option value="SD" >SD - South Dakota</option>
<option value="TN" >TN - Tennessee</option>
<option value="TX" >TX - Texas</option>
<option value="UT" >UT - Utah</option>
<option value="VA" >VA - Virginia</option>
<option value="VT" >VT - Vermont</option>
<option value="WA" >WA - Washington</option>
<option value="WI" >WI - Wisconsin</option>
<option value="WV" >WV - West Virginia</option>
<option value="WY" >WY - Wyoming</option>
<option value="AS" >AS - American Samoa</option>
<option value="FM" >FM - Federated States of Micronesia</option>
<option value="GU" >GU - Guam</option>
<option value="MH" >MH - Marshall Islands</option>
<option value="MP" >MP - Northern Mariana Islands</option>
<option value="PR" >PR - Puerto Rico</option>
<option value="PW" >PW - Palau</option>
<option value="VI" >VI - Virgin Islands</option>
<option value="AA" >AA - Armed Forces Americas</option>
<option value="AE" >AE - Armed Forces</option>
<option value="AP" >AP - Armed Forces Pacific</option>
<option value="AB" >AB - Alberta</option>
<option value="BC" >BC - British Columbia</option>
<option value="MB" >MB - Manitoba</option>
<option value="NB" >NB - New Brunswick</option>
<option value="NL" >NL - Newfoundland and Labrador</option>
<option value="NS" >NS - Nova Scotia</option>
<option value="NT" >NT - Northwest Territories</option>
<option value="NU" >NU - Nunavut</option>
<option value="ON" >ON - Ontario</option>
<option value="PE" >PE - Prince Edward Island</option>
<option value="QC" >QC - Quebec</option>
<option value="SK" >SK - Saskatchewan</option>
<option value="YT" >YT - Yukon</option>
<option value="None" >None</option>

</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_notify_recip_state_Row', _display);
this.disable_submit_flag (_hidden);
} 
//-->
</script>
<noscript><br/>Required</noscript>

<input type="hidden" name="tribute_notify_recip_statesubmit" id="tribute_notify_recip_statesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_notify_recip_state', '');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_notify_recip_state_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_notify_recip_state'));

function tribute_notify_recip_state_listChanged(_evt)
{
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_notify_recip_state', src);
}
}
var el = document.getElementById('tribute_notify_recip_state');
if (el) {
Utils.addEvent (el, 'change', tribute_notify_recip_state_listChanged);
}
</script><noscript>&nbsp;</noscript>
</div>
</div>





<div id="tribute_notify_recip_zip_row" class="form-row form-text">

<div class="form-content">

<label for="tribute_notify_recip_zipname">Zip:</label>

<input type="text" name="tribute_notify_recip_zipname" id="tribute_notify_recip_zipname"
value=""
maxlength="50"
 />

<input type="hidden" name="tribute_notify_recip_zipsubmit" id="tribute_notify_recip_zipsubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_notify_recip_zip', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_notify_recip_zip_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_notify_recip_zip'));

</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="tribute_message_body_row" class="form-row form-text">

<div class="form-content">

<label for="tribute_message_bodyname">Your Message:</label>

<textarea cols="50" rows="4" name="tribute_message_bodyname" id="tribute_message_bodyname"  ></textarea>

<input type="hidden" name="tribute_message_bodysubmit" id="tribute_message_bodysubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('tribute_message_body', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('tribute_message_body_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('tribute_show_honor_fields.true', new ComponentDisplayer ('tribute_message_body'));

</script><noscript>&nbsp;</noscript>
</div>
</div>



<div class="form-row">
<div class="html-caption-container">
<hr class="dashed-divider" />
</div>
</div>



<div class="form-row">
<div class="html-caption-container">
<h3>Billing Information</h3>
</div>
</div>




<div id="billing_first_name_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name:</label>

<input type="text" name="billing_first_namename" id="billing_first_namename"
value=""
maxlength="50"
 />

<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('billing_first_name', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_first_name_row', _display);
this.disable_submit_flag (_hidden);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>



<div id="billing_last_name_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name:</label>

<input type="text" name="billing_last_namename" id="billing_last_namename"
value=""
maxlength="50"
 />

<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('billing_last_name', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_last_name_row', _display);
this.disable_submit_flag (_hidden);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>



<div id="organization-name-visible_row" class="form-row form-checkbox">

<div class="form-content">


<input type="checkbox" name="organization-name-visiblename" id="organization-name-visiblename"

onclick="fire_obs_comp_event('organization-name-visible', this);" />
<label for="organization-name-visiblename">Make this gift on behalf of an organization</label>
<input type="hidden" name="organization-name-visiblesubmit" id="organization-name-visiblesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('organization-name-visible', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('organization-name-visible_row', _display);
this.disable_submit_flag (_hidden);
}
comp.set = function (_value)
{
if (document.getElementById('organization-name-visiblename')) {
document.getElementById('organization-name-visiblename').checked = _value;
this.fireEvent();
}
}
comp.get = function()
{
if (document.getElementById('organization-name-visiblename')) {
return document.getElementById('organization-name-visiblename').checked;
}
}
comp.clear = function()
{
this.set(false);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>

<div id="donor-organization-name_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="donor-organization-namename">Organization Name:</label>

<input type="text" name="donor-organization-namename" id="donor-organization-namename"
value=""
maxlength="255"
 />

<input type="hidden" name="donor-organization-namesubmit" id="donor-organization-namesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('donor-organization-name', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('donor-organization-name_row', _display);
this.disable_submit_flag (_hidden);
}

observe_component ('organization-name-visible.true', new ComponentEnabler ('donor-organization-name'));


observe_component ('organization-name-visible.true', new ComponentDisplayer ('donor-organization-name'));

</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="billing_addr_street1_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street 1:</label>

<input type="text" name="billing_addr_street1name" id="billing_addr_street1name"
value=""
maxlength="50"
 />

<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('billing_addr_street1', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_addr_street1_row', _display);
this.disable_submit_flag (_hidden);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="billing_addr_city_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City:</label>

<input type="text" name="billing_addr_cityname" id="billing_addr_cityname"
value=""
maxlength="50"
 />

<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('billing_addr_city', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_addr_city_row', _display);
this.disable_submit_flag (_hidden);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="billing_addr_state_row" class="form-row form-selectlist">

<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_state">State/Province:</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" 
 onchange="fire_obs_comp_event('billing_addr_state', this)">
<option ></option>
<option value="AK" >AK - Alaska</option>
<option value="AL" >AL - Alabama</option>
<option value="AR" >AR - Arkansas</option>
<option value="AZ" >AZ - Arizona</option>
<option value="CA" >CA - California</option>
<option value="CO" >CO - Colorado</option>
<option value="CT" >CT - Connecticut</option>
<option value="DC" >DC - District of Columbia</option>
<option value="DE" >DE - Delaware</option>
<option value="FL" >FL - Florida</option>
<option value="GA" >GA - Georgia</option>
<option value="HI" >HI - Hawaii</option>
<option value="IA" >IA - Iowa</option>
<option value="ID" >ID - Idaho</option>
<option value="IL" >IL - Illinois</option>
<option value="IN" >IN - Indiana</option>
<option value="KS" >KS - Kansas</option>
<option value="KY" >KY - Kentucky</option>
<option value="LA" >LA - Louisiana</option>
<option value="MA" >MA - Massachusetts</option>
<option value="MD" >MD - Maryland</option>
<option value="ME" >ME - Maine</option>
<option value="MI" >MI - Michigan</option>
<option value="MN" >MN - Minnesota</option>
<option value="MO" >MO - Missouri</option>
<option value="MS" >MS - Mississippi</option>
<option value="MT" >MT - Montana</option>
<option value="NC" >NC - North Carolina</option>
<option value="ND" >ND - North Dakota</option>
<option value="NE" >NE - Nebraska</option>
<option value="NH" >NH - New Hampshire</option>
<option value="NJ" >NJ - New Jersey</option>
<option value="NM" >NM - New Mexico</option>
<option value="NV" >NV - Nevada</option>
<option value="NY" >NY - New York</option>
<option value="OH" >OH - Ohio</option>
<option value="OK" >OK - Oklahoma</option>
<option value="OR" >OR - Oregon</option>
<option value="PA" >PA - Pennsylvania</option>
<option value="RI" >RI - Rhode Island</option>
<option value="SC" >SC - South Carolina</option>
<option value="SD" >SD - South Dakota</option>
<option value="TN" >TN - Tennessee</option>
<option value="TX" >TX - Texas</option>
<option value="UT" >UT - Utah</option>
<option value="VA" >VA - Virginia</option>
<option value="VT" >VT - Vermont</option>
<option value="WA" >WA - Washington</option>
<option value="WI" >WI - Wisconsin</option>
<option value="WV" >WV - West Virginia</option>
<option value="WY" >WY - Wyoming</option>
<option value="AS" >AS - American Samoa</option>
<option value="FM" >FM - Federated States of Micronesia</option>
<option value="GU" >GU - Guam</option>
<option value="MH" >MH - Marshall Islands</option>
<option value="MP" >MP - Northern Mariana Islands</option>
<option value="PR" >PR - Puerto Rico</option>
<option value="PW" >PW - Palau</option>
<option value="VI" >VI - Virgin Islands</option>
<option value="AA" >AA - Armed Forces Americas</option>
<option value="AE" >AE - Armed Forces</option>
<option value="AP" >AP - Armed Forces Pacific</option>
<option value="AB" >AB - Alberta</option>
<option value="BC" >BC - British Columbia</option>
<option value="MB" >MB - Manitoba</option>
<option value="NB" >NB - New Brunswick</option>
<option value="NL" >NL - Newfoundland and Labrador</option>
<option value="NS" >NS - Nova Scotia</option>
<option value="NT" >NT - Northwest Territories</option>
<option value="NU" >NU - Nunavut</option>
<option value="ON" >ON - Ontario</option>
<option value="PE" >PE - Prince Edward Island</option>
<option value="QC" >QC - Quebec</option>
<option value="SK" >SK - Saskatchewan</option>
<option value="YT" >YT - Yukon</option>
<option value="None" >None</option>

</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_addr_state_Row', _display);
this.disable_submit_flag (_hidden);
} 
//-->
</script>
<noscript><br/>Required</noscript>

<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('billing_addr_state', '');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_addr_state_row', _display);
this.disable_submit_flag (_hidden);
}


function billing_addr_state_listChanged(_evt)
{
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_state', src);
}
}
var el = document.getElementById('billing_addr_state');
if (el) {
Utils.addEvent (el, 'change', billing_addr_state_listChanged);
}
</script><noscript>&nbsp;</noscript>
</div>
</div>





<div id="billing_addr_zip_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">ZIP/Postal Code:</label>

<input type="text" name="billing_addr_zipname" id="billing_addr_zipname"
value=""
maxlength="50"
 />

<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('billing_addr_zip', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('billing_addr_zip_row', _display);
this.disable_submit_flag (_hidden);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>




<div id="donor_email_address_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">E-mail Address:</label>

<input type="text" name="donor_email_addressname" id="donor_email_addressname"
value=""
maxlength="50"
 />

<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('donor_email_address', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('donor_email_address_row', _display);
this.disable_submit_flag (_hidden);
}


</script><noscript>&nbsp;</noscript>
</div>
</div>




<div class="form-row form-checkbox" id="donor_email_opt_in_Row">

<div class="form-content">

<span class="check-box-form-label-text"></span>


<input type="hidden" name="donor_email_opt_inname" id="donor_email_opt_inname" value="implicit" />
<span class="auto-opt-in-warning-message">If you donate and have not already registered, you will receive periodic updates and communications from Houston Food Bank.</span>


<script type="text/javascript">
var comp = new ObservableComponent ('donor_email_opt_in', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('donor_email_opt_in_Row', _display);
this.disable_submit_flag (_hidden);
}
comp.set = function (_value)
{
if (document.getElementById('donor_email_opt_inname')) {
document.getElementById('donor_email_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function()
{
if (document.getElementById('donor_email_opt_inname'))
return document.getElementById('donor_email_opt_inname').checked;
}
comp.clear = function()
{
this.set(false);
}

 
</script><noscript>&nbsp;</noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true" />
</div>
</div>




<div class="form-row">
<div class="html-caption-container">
<hr class="dashed-divider" />
</div>
</div>




<div class="payment-type-element-container">

<div class="payment-type-selection-container payment-field-container">
<h3>Payment Method:</h3>
<div id="payment_typepay_typeradio_row" class="form-row">

<div class="form-content">
<div class="payment-type-selections" id="payment_typepay_typeradio_payment_types">
<span class="internal-payment"><span class="payment-type-option selected"><input type="radio" name="payment_typepay_typeradio" id="payment_typepay_typeradiopaypal"
value="paypal"

checked="checked"
onclick="fire_obs_comp_event('payment_typepay_typeradio', this);"
onkeypress="fire_obs_comp_event('payment_typepay_typeradio', this);" /><label for="payment_typepay_typeradiopaypal"><a href="javascript:void(0);" class="payment-type-label"><img src="../images/payment/paypal-logo.png" alt="Pay with Paypal" /></a></label><script type="text/javascript">
var comp = new ObservableRadioComponent ('payment_typepay_typeradio', 'name');
</script><noscript>&nbsp;</noscript></span><span class="payment-type-option"><input type="radio" name="payment_typepay_typeradio" id="payment_typepay_typeradiocredit"
value="credit"


onclick="fire_obs_comp_event('payment_typepay_typeradio', this);"
onkeypress="fire_obs_comp_event('payment_typepay_typeradio', this);" /><label for="payment_typepay_typeradiocredit"><a href="javascript:void(0);" class="payment-type-label">Credit Card</a></label><script type="text/javascript">
var comp = new ObservableRadioComponent ('payment_typepay_typeradio', 'name');
</script><noscript>&nbsp;</noscript></span><span class="payment-type-option"><input type="radio" name="payment_typepay_typeradio" id="payment_typepay_typeradioach"
value="ach"


onclick="fire_obs_comp_event('payment_typepay_typeradio', this);"
onkeypress="fire_obs_comp_event('payment_typepay_typeradio', this);" /><label for="payment_typepay_typeradioach"><a href="javascript:void(0);" class="payment-type-label">Bank Account Withdrawal</a></label><script type="text/javascript">
var comp = new ObservableRadioComponent ('payment_typepay_typeradio', 'name');
</script><noscript>&nbsp;</noscript></span></span>
<span class="external-payment"></span>
</div>
<input type="hidden" name="payment_typepay_typeradiosubmit" id="payment_typepay_typeradiosubmit" value="true" />
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observable for payment type options
jQuery('.payment-type-option').each(function() {
var syncAction = function(obj) {
if (obj.hasClass('selected')) {
var radioGroupName = obj.find('input').attr('name');
obj.find('input').attr('checked', true);
fire_obs_comp_event(radioGroupName, obj.find('input').get());
}
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('.payment-type-option').removeClass('selected');
jQuery(this).addClass('selected');
syncAction(jQuery(this));
var selectedValue = jQuery(this).find('input').val();
if (selectedValue == 'paypal' || selectedValue == 'amazon') {
// open up a boxinator dialog
jQuery(document).trigger('redirect-external');
jQuery('#btn_next').click();
}
});
});
});
});
var comp = new ObservableRadioComponent ('payment_typepay_typeradio', 'name');
comp.hide = function(_hidden)
{ 
var _display = _hidden ? 'none' : '';
set_display ('payment_typepay_typeradio_row', _display);
this.disable_submit_flag (_hidden);
}
</script><noscript>&nbsp;</noscript>
</div>
</div>

</div>


<div id="payment_cc_container" class="payment-field-container">
<h3>Credit Card Information:</h3>
<div id="payment_typecc_type_row" class="form-row form-radio-array">

<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="payment_typecc_type_Visa" id="payment_typecc_type_Visa" />
</li><li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="payment_typecc_type_Discover" id="payment_typecc_type_Discover" />
</li><li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="payment_typecc_type_American_Express" id="payment_typecc_type_American_Express" />
</li><li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="payment_typecc_type_MasterCard" id="payment_typecc_type_MasterCard" />
</li>
</ul>
</fieldset>
<input type="hidden" name="payment_typecc_typesubmit" id="payment_typecc_typesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableRadioComponent ('payment_typecc_type', 'name');
comp.hide = function(_hidden)
{ 
var _display = _hidden ? 'none' : '';
set_display ('payment_typecc_type_row', _display);
this.disable_submit_flag (_hidden);
}
</script><noscript>&nbsp;</noscript>
</div>
</div>
<div id="payment_typecc_number_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="payment_typecc_numbername">Credit Card Number:</label>

<input type="text" name="payment_typecc_numbername" id="payment_typecc_numbername"
value=""
maxlength="22"
autocomplete="off" />

<input type="hidden" name="payment_typecc_numbersubmit" id="payment_typecc_numbersubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('payment_typecc_number', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('payment_typecc_number_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('null', new ComponentDisplayer ('payment_typecc_number'));

</script><noscript>&nbsp;</noscript>
</div>
</div>
<div id="payment_typecc_exp_date_row" class="form-row form-date">

<div class="form-content">
<span class="field-required"></span>
<label for="payment_typecc_exp_date_MONTH">
<span class="label-text">Expiration Date:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="payment_typecc_exp_date_YEAR" ><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">

<fieldset class="cardExpGroup">
<select name="payment_typecc_exp_date_MONTH" id="payment_typecc_exp_date_MONTH" onChange="fire_obs_comp_event('payment_typecc_exp_date_MONTH', this)">
<option value="1" >01</option>
<option value="2" selected="selected">02</option>
<option value="3" >03</option>
<option value="4" >04</option>
<option value="5" >05</option>
<option value="6" >06</option>
<option value="7" >07</option>
<option value="8" >08</option>
<option value="9" >09</option>
<option value="10" >10</option>
<option value="11" >11</option>
<option value="12" >12</option>
</select>
<select name="payment_typecc_exp_date_YEAR" id="payment_typecc_exp_date_YEAR" onChange="fire_obs_comp_event('payment_typecc_exp_date_YEAR', this)">
<option value="2018" selected="selected">2018</option>
<option value="2019" >2019</option>
<option value="2020" >2020</option>
<option value="2021" >2021</option>
<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>

</select>
</fieldset>
<input type="hidden" name="payment_typecc_exp_date_DAY" id="payment_typecc_exp_date_DAY" value="1" />
<script type="text/javascript">
<!--
var comp1 = new ObservableComponent ('payment_typecc_exp_date_MONTH', '');
comp1.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display ('payment_typecc_exp_date_Row', _display);
this.disable_submit_flag (_hidden);
}
var comp2 = new ObservableComponent ('payment_typecc_exp_date_YEAR', '');
comp2.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display ('payment_typecc_exp_date_Row', _display);
this.disable_submit_flag (_hidden); 
}
//--> 
</script><noscript>&nbsp;</noscript>
</div>
<input type="hidden" name="payment_typecc_exp_datesubmit" id="payment_typecc_exp_datesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('payment_typecc_exp_date', 'input');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('payment_typecc_exp_date_row', _display);
disable_submit_flag ('payment_typecc_exp_datesubmit', _hidden);
}
comp.disable = function(_disabled)
{
disable_element ('payment_typecc_exp_date_MONTH', _disabled);
disable_element ('payment_typecc_exp_date_DAY', _disabled);
disable_element ('payment_typecc_exp_date_YEAR', _disabled);
disable_element ('payment_typecc_exp_date_HOUR12',_disabled);
disable_element ('payment_typecc_exp_date_HOUR24',_disabled); //For UK, 24 hour clock used
disable_element ('payment_typecc_exp_date_MINUTE',_disabled);
disable_element ('payment_typecc_exp_date_AMPM', _disabled);
}

</script><noscript>&nbsp;</noscript>
</div>
</div>


</div>


<div id="payment_bank_container" class="payment-field-container">
<h3>Checking Account Information:</h3>
<div id="payment_typerouting_number_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="payment_typerouting_numbername">Bank Routing Number:</label>
<a href="http://help.convio.net/site/PageServer?s_site=hfb&amp;pagename=User_Donation_ACH" class="HelpLink"
title="What is this? Opens new window.">What is this?</a>
<input type="text" name="payment_typerouting_numbername" id="payment_typerouting_numbername"
value="" size="20"
maxlength="20"
onchange="fire_obs_comp_event('payment_typerouting_number', this);"

autocomplete="off" />
<input type="hidden" name="payment_typerouting_numbersubmit" id="payment_typerouting_numbersubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('payment_typerouting_number', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('payment_typerouting_number_row', _display);
this.disable_submit_flag (_hidden);
}

</script><noscript>&nbsp;</noscript>
</div>
</div>
<div id="payment_typebank_account_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="payment_typebank_accountname">Bank Account Number:</label>

<input type="text" name="payment_typebank_accountname" id="payment_typebank_accountname"
value=""
maxlength="20"
autocomplete="off" />

<input type="hidden" name="payment_typebank_accountsubmit" id="payment_typebank_accountsubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('payment_typebank_account', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('payment_typebank_account_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('null', new ComponentDisplayer ('payment_typebank_account'));

</script><noscript>&nbsp;</noscript>
</div>
</div>
<div id="payment_typeverify_bank_account_row" class="form-row form-text">

<div class="form-content">
<span class="field-required"></span>
<label for="payment_typeverify_bank_accountname">Verify Bank Account Number:</label>

<input type="text" name="payment_typeverify_bank_accountname" id="payment_typeverify_bank_accountname"
value=""
maxlength="20"
autocomplete="off" />

<input type="hidden" name="payment_typeverify_bank_accountsubmit" id="payment_typeverify_bank_accountsubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('payment_typeverify_bank_account', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('payment_typeverify_bank_account_row', _display);
this.disable_submit_flag (_hidden);
}


observe_component ('null', new ComponentDisplayer ('payment_typeverify_bank_account'));

</script><noscript>&nbsp;</noscript>
</div>
</div><div id="payment_type.account_type_row" class="form-row form-radio-array">

<div class="form-content">
<fieldset>
<legend><span class="field-required"></span>&nbsp;Account Type:</legend>
<ul class="radio-array-list">
<li>
<input type="radio" name="payment_type.account_type" id="payment_type.account_type_payment_typeaccount_type_checking" value="CHECKING"  
onclick="fire_obs_comp_event('payment_type.account_type', this);" />
<span class="radio-label"> 
<label for="payment_type.account_type_payment_typeaccount_type_checking" >Checking</label>
</span>
</li><li>
<input type="radio" name="payment_type.account_type" id="payment_type.account_type_payment_typeaccount_type_savings" value="SAVINGS"  
onclick="fire_obs_comp_event('payment_type.account_type', this);" />
<span class="radio-label"> 
<label for="payment_type.account_type_payment_typeaccount_type_savings" >Savings</label>
</span>
</li>
</ul>
</fieldset>
<input type="hidden" name="payment_type.account_typesubmit" id="payment_type.account_typesubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableRadioComponent ('payment_type.account_type', 'name');
comp.hide = function(_hidden)
{ 
var _display = _hidden ? 'none' : '';
set_display ('payment_type.account_type_row', _display);
this.disable_submit_flag (_hidden);
}
</script><noscript>&nbsp;</noscript>
</div>
</div>
<div id="payment_typeach_confirm_row" class="form-row form-checkbox">

<div class="form-content">
<span class="field-required"></span>

<input type="checkbox" name="payment_typeach_confirmname" id="payment_typeach_confirmname"

onclick="fire_obs_comp_event('payment_typeach_confirm', this);" />
<label for="payment_typeach_confirmname">By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.</label>
<input type="hidden" name="payment_typeach_confirmsubmit" id="payment_typeach_confirmsubmit" value="true" />
<script type="text/javascript">
var comp = new ObservableComponent ('payment_typeach_confirm', 'name');
comp.hide = function(_hidden)
{
var _display = _hidden ? 'none' : '';
set_display ('payment_typeach_confirm_row', _display);
this.disable_submit_flag (_hidden);
}
comp.set = function (_value)
{
if (document.getElementById('payment_typeach_confirmname')) {
document.getElementById('payment_typeach_confirmname').checked = _value;
this.fireEvent();
}
}
comp.get = function()
{
if (document.getElementById('payment_typeach_confirmname')) {
return document.getElementById('payment_typeach_confirmname').checked;
}
}
comp.clear = function()
{
this.set(false);
}

observe_component ('null', new ComponentEnabler ('payment_typeach_confirm'));


</script><noscript>&nbsp;</noscript>
</div>
</div>
</div>


<div id="payment_check_container" class="payment-field-container">
<h3>Check Information</h3>

</div>

<input type="hidden" name="payment_typesubmit" id="payment_typesubmit" value="true" />
<script type="text/javascript">
function PaymentObserver()
{
this.observe = function(_event)
{
var sVal = _event.component.get();
switch (sVal)
{
case 'check':
hide_element('payment_cc_container');
hide_element('payment_bank_container');
show_element('payment_check_container');
break;
case 'credit':
hide_element('payment_bank_container');
hide_element('payment_check_container');
show_element('payment_cc_container');
break;
case 'ach':
hide_element('payment_cc_container');
hide_element('payment_check_container');
show_element('payment_bank_container');
break;
case 'paypal':
case 'amazon':
default:
// hide all
hide_element('payment_bank_container');
hide_element('payment_cc_container');
hide_element('payment_check_container');
break;
}
}
}
// Set the observer to show/hide the relevant fields
observe_component ('payment_typepay_typeradio', new PaymentObserver());
</script><noscript>&nbsp;</noscript>
</div>




<div class="button-container clearfix">
<div class="button-sub-container">

<button class="step-button action-button finish-step" type="submit" id="pstep_finish" name="pstep_finish" value="Give Now">Give Now</button>




</div>
</div>
<input type="hidden" name="idb" id="idb" value="1438804321" />
<input type="hidden" name="df_id" id="df_id" value="9314" />
<input type="hidden" name="mfc_pref" id="mfc_pref" value="T" />



</div>
 
<input type="hidden" name="9314.donation" id="9314.donation" value="form1" />
 
</div>
<script type="text/javascript">
function deny_submit()
{
alert ('Form submission is not enabled when previewing an individual data element.');
return false;
}
</script><noscript>&nbsp;</noscript>

</form>




                </div>
            </div>
        </div>

        <footer class="container">
            <div class="row">
                <div class="col-sm-12 main-area">
                    <p>If you prefer to make your gift by mail, please send your check made out to "Houston Food Bank" to 535 Portwall, Houston, TX 77029. To&nbsp;make a gift by phone, please contact <a href="mailto:donorservices@houstonfoodbank.org">Donor Services</a> at 713-547-8623.</p>
                </div>
            </div>
            
            <hr class="footer-divider">
            
            <div class="row">
                <div class="col-sm-12 main-area">
                    <p>&copy; 2018 Houston Food Bank. All rights reserved.</p>
                </div>
            </div>

        </footer>
    </div>

</body>

</html>
