












<!DOCTYPE HTML>



<meta property="og:type" content="article"/>
<meta property="og:title" content="2017 Hurricane Flood Relief"/>
<meta property="og:description" content="2017 Hurricane Flood Relief"/>
<meta property="og:site_name" content="Civil Air Patrol"/>
<meta property="og:image" content="https://gocivilairpatrol.z2systems.com/np/clients/gocivilairpatrol/logo.gif"/>
<meta property="og:url" content="https://gocivilairpatrol.z2systems.com/np/clients/gocivilairpatrol/donation.jsp?campaign=10&"/>







<!DOCTYPE html><html lang="en"><head><meta charset="utf-8"><meta http-equiv="X-UA-Compatible" content="IE=edge"><meta name="viewport" content="width=device-width, initial-scale=1"><title>Civil Air Patrol</title><link href="/np/css/webTemplateV3/bootstre.css" rel="stylesheet"/><!--[if lt IE 9]><script src="https://oss.maxcdn.com/html5shiv/3.7.2/html5shiv.min.js"></script><script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script><![endif]--><link href="/np/css/webTemplateV3/style001.css" rel="stylesheet"/><link href='/np/css/webTemplateV3/css00000.css' rel='stylesheet' type='text/css'/><link href='/np/clients/gocivilairpatrol/customCss.css' rel='stylesheet' type='text/css'/><meta http-equiv="Content-Type" content="text/html;charset=utf-8"></head><body><div class="wrapper"><header id="header"><div class="container"><div class="row"><div id="logo_Image_div" class="header-image col-sm-12"><img id="logo_Image" src="/neon/resource/gocivilairpatrol/templateImage/logoImage_43.jpg?r=62471820953158262"></div></div></div></header><div id="content"><div class="container"><div class="row"><div class="col-md-6 col-md-offset-3"><div id="form-wrapper"> 

<div class="neoncrm-browser-deprecation-notice" style="display: none;" id="warningDiv" >
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_neoncrm_ga('create', 'UA-43014483-1', 'auto', {'name': 'neoncrmTracker'});


_neoncrm_ga('neoncrmTracker.send', 'pageview');

function switchRecurringPayment(isForRecurring) {
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}
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<link href="/np/css/neonFrontV2/neoncrm-forms-2015.css" type="text/css" rel="stylesheet" />

<style type="text/css" >
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</style>




































<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>
        function showEndDate(){
        	
            switchRecurringPayment(true);
        }
        function hiddenEndDate(){
        	
            switchRecurringPayment(false);
        }

        window.onload=function(){
        	 
        	  }
    </script>
    
    
    <input type="hidden" name="orgId" value="gocivilairpatrol">
    
    <input type=hidden name="campaignId" value="10">
    
    
    










<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>
    //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", "Gift Amount", false))
            return false;
        

        

        
        

        
        if(!validateItem("person.firstName", "First Name", false))
            return false;
        

        

        
        

        
        if(!validateItem("person.lastName", "Last Name", false))
            return false;
        

        

        
        

        
        if(!validateItem("address.street1", "Address", false))
            return false;
        

        

        
        

        
        if(!validateItem("address.city", "City", false))
            return false;
        

        

        
        

        
        if(!validateItem("address.state", "State", false))
            return false;
        

        

        
        

        
        if(!validateItem("address.zip", "Zip Code", false))
            return false;
        

        

        
        

        
        if(!validateItem("person.email1", "Email", false))
            return false;
        

        

        
        

        

        

        //dev-4947
        

        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+"$");
        if(reg.test(date)==false){
            alert("Date must be in MM/DD/YYYY format");
            item.focus();
            return false;
        }
        return true;
    }
    function validatePwd(property){
        var item = getElement(property);
        if(item != null && "account.loginPassword" === property){
            var loginName = getElement('account.loginName');
            if(loginName != null && trim(loginName.value) != ""){
                var regexp = /(?=\S*\d)\S{8,}$/;
                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>
        
        
        <div class="neoncrm-section-title"><h2><strong>Members Helping Members</strong></h2>
</div>
        
        
            <div class="neoncrm-section-header"><h3><strong>CAP’s Hurricane Relief Support For Our Members</strong></h3>
</div>
        
        
        

        <label class="neoncrm-field-label neoncrm-required">Gift Amount:</label>
        

















	

		<input type="text" name="donation.amount" maxlength="100" size="10" value="" id="donation.amount" class="neon2Field">

            

	




 


 
 




        



        

        


        

        
        
        
        
        <div class="neoncrm-section-title"><h4><strong>Donor Information</strong></h4>
</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">

            

	




 


 
 




        



        

        


        

        
        

        <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">

            

	




 


 
 




        



        

        


        

        
        

        <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">

            

	




 


 
 




        



        

        


        

        
        

        <label class="neoncrm-field-label "></label>
        

















	

		<input type="text" name="address.street2" maxlength="100" size="25" value="" id="address.street2" class="neon2Field">

            

	




 


 
 




        



        

        


        

        
        

        <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">

            

	




 


 
 




        



        

        


        

        
        

        <label class="neoncrm-field-label neoncrm-required">State:</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</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 TERR.</option>
<option value="NU">NUNAVUT</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</option></select>
		  
	  
 




        



        

        


        

        
        

        <label class="neoncrm-field-label neoncrm-required">Zip Code:</label>
        

















	

		<input type="text" name="address.zip" maxlength="100" size="12" value="" id="address.zip" class="neon2Field">

            

	




 


 
 
    <span class='neonFieldText' > -</span>
    

















	

		<input type="text" name="address.zipSuffix" maxlength="100" size="6" value="" id="address.zipSuffix" class="neon2Field">

            

	




 


 
 



 




        



        

        


        

        
        

        <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">

            

	




 


 
 




        



        

        


        

        
        
        <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 = 0;
            var recurringAmount = 0
            if(false){
                if(isChecked('donationLevel', '0')){
                    var amount = getElement('donation.amount').value;
                    if(isChecked('recurringFlag', '1')){
                        if(recurringAmount > 0 && recurringAmount > amount){
                            alert("The recurring donation amount must be bigger than the minimum value of $"+Number(recurringAmount).toFixed(2)+'.');
                            return false;
                        }
                    }else{
                        if(donationAmount > 0 && donationAmount > amount){
                            alert("The donation amount must be bigger than the minimum value of $"+Number(donationAmount).toFixed(2)+'.');
                            return false;
                        }
                    }
                }

            }else {
                var amount = getElement('donation.amount').value;
                if(isChecked('recurringFlag', '1')){
                    if(recurringAmount > 0 && recurringAmount > amount){
                        alert("The recurring donation amount must be bigger than the minimum value of $"+Number(recurringAmount).toFixed(2)+'.');
                        return false;
                    }
                }else{
                    if(donationAmount > 0 && donationAmount > amount){
                        alert("The donation amount must be bigger than the minimum value of $"+Number(donationAmount).toFixed(2)+'.');
                        return false;
                    }
                }
            }
            if(isChecked('recurringFlag', '1')){
                var nowYMD = '20180214';
                var item = getElement("recurringDonation.endDate");
                if(item != null){
                    var endDate = item.value;
                    if(endDate != null && trim(endDate).length > 0){
                        var date=trim(endDate);
                        var reg="MM/dd/yyyy";
                        reg=reg.replace(/MM/,"((0[1-9])|1[0-2])");
                        reg=reg.replace(/dd/,"((0[1-9])|([1-2][0-9])|30|31)");
                        reg=reg.replace(/yyyy/,"[0-9]{4}");
                        reg=new RegExp("^"+reg+"$");
                        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;
        }

        //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","off");
        if(document.getElementById("address2.zipSuffix")) document.getElementById("address2.zipSuffix").setAttribute("autocomplete","off");
        if(document.getElementById("donation.acknowledgeInfo.address.zipSuffix")) document.getElementById("donation.acknowledgeInfo.address.zipSuffix").setAttribute("autocomplete","off");
        if(document.getElementById("donation.matchCompanyInfo.address.zipSuffix")) document.getElementById("donation.matchCompanyInfo.address.zipSuffix").setAttribute("autocomplete","off");
        if(document.getElementById("payment.creditCard.address.zipSuffix")) document.getElementById("payment.creditCard.address.zipSuffix").setAttribute("autocomplete","off");
        if(document.getElementById("recurringDonation.creditCard.address.zipSuffix")) document.getElementById("recurringDonation.creditCard.address.zipSuffix").setAttribute("autocomplete","off");
        if(document.getElementById("shipping.address.zipSuffix")) document.getElementById("shipping.address.zipSuffix").setAttribute("autocomplete","off");
        //Also disable auto-fill for Suffix
        if(document.getElementById("person.suffix")) document.getElementById("person.suffix").setAttribute("autocomplete","off");
    </SCRIPT>
</div>


    
    <input type="hidden" name="recurringFlag" value="0">
    


    


    
    <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"><img src="/np/images/ssl_valid_z2systems.gif" width="199" height="39" border="0" /></a>
</div>



<!-- AddThis Button BEGIN -->



<!-- AddThis Button BEGIN -->
<div class="addthis_toolbox addthis_default_style addthis_32x32_style">
<a class="addthis_button_facebook"></a>
<a class="addthis_button_twitter"></a>
<a class="addthis_button_google_plusone_share"></a>
<a class="addthis_button_linkedin"></a>
<a class="addthis_button_email"></a>
<a class="addthis_button_compact"></a><a class="addthis_counter addthis_bubble_style"></a>
</div>
<script type="text/javascript" src="//s7.addthis.com/js/300/addthis_widget.js#pubid=xa-51db24731187326e"></script>
<!-- AddThis Button END -->


<!-- AddThis Button END -->
<!-- for DEV-4240 start -->
<script type="text/javascript">
    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;
            }
        }

        //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].id != 'donationLevel_0'){
                    levels[i].onclick = function(){
                        donationAmount.value = '';
                    }
                }
            }
        }//DEV-4716 end
    }
</script>
<!-- for DEV-4240 end -->











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