Happy Birthday


[give_form id="29882"]
<div id="give-form-29882-wrap" class="give-form-wrap give-display-button give-display-button-only give-recurring-form-wrap give-recurring-form-donor"> <h2 class="give-form-title">Leaders Speak about Meir Panim</h2><div id="give-form-content-29882" class="give-form-content-wrap give_pre_form-content"></div> <form id="give-form-29882-1" class="give-form give-form-29882 give-form-type-multi float-labels-enabled give-recurring-form" action="https://give.meirpanim.org/product/happy-birthday/?payment-mode=stripe" data-id="29882-1" data-currency_symbol="&#36;" data-currency_code="USD" data-currency_position="before" data-thousands_separator="," data-decimal_separator="." data-number_decimals="2" data-publishable-key="pk_live_SMtnnvlq4TpJelMdklNha8iD" data-account="acct_1BwwETLjb9lKtTy7" data-give_cs_base_amounts="{&quot;1&quot;:&quot;54.00&quot;,&quot;3&quot;:&quot;180.00&quot;,&quot;4&quot;:&quot;540.00&quot;,&quot;5&quot;:&quot;1000.00&quot;,&quot;custom&quot;:0}" method="post"> <!-- The following field is for robots only, invisible to humans: --> <span class="give-hidden" style="display: none !important;"> <label for="give-form-honeypot-29882"></label> <input id="give-form-honeypot-29882" type="text" name="give-honeypot" class="give-honeypot give-hidden"/> </span> <input type="hidden" name="give-form-id-prefix" value="29882-1"/> <input type="hidden" name="give-form-id" value="29882"/> <input type="hidden" name="give-form-title" value="Leaders Speak about Meir Panim"/> <input type="hidden" name="give-current-url" value="https://give.meirpanim.org/product/happy-birthday/"/> <input type="hidden" name="give-form-url" value="https://give.meirpanim.org/product/happy-birthday/"/> <input type="hidden" name="give-form-minimum" value="5.00"/> <input type="hidden" name="give-form-maximum" value="999999.99"/> <input type="hidden" name="give-form-hash" value="1f7c672d48" data-time="1618606665" data-nonce-life="86400" data-donor-session="0"/><input type="hidden" name="give-price-id" value="1"/> <input type="hidden" name="give-recurring-logged-in-only" class="give-recurring-logged-in-only" value=""/> <input type="hidden" name="give-logged-in-only" class="give-logged-in-only" value="1"/> <input type="hidden" name="_give_is_donation_recurring" class="_give_is_donation_recurring" id="_give_is_donation_recurring" value="1" data-_give_recurring="yes_donor" data-_give_checkbox_default="yes" data-_give_price_option="" /><input type="hidden" name="give_recurring_donation_details" class="give_recurring_donation_details" id="give_recurring_donation_details" value="{&quot;give_recurring_option&quot;:&quot;yes_donor&quot;}" /> <div class="give-total-wrap"> <div class="give-donation-amount form-row-wide"> <span class="give-currency-symbol give-currency-position-before">&#36;</span> <label class="give-hidden" for="give-amount">Donation Amount:</label> <input class="give-text-input give-amount-top" id="give-amount" name="give-amount" type="tel" placeholder="" value="54.00" autocomplete="off"> </div> </div> <fieldset class="give-currency-switcher-wrap form-row form-row-wide" data-give_form_id="29882"> <legend class="give-cs-msg-legend give-hidden">&nbsp;</legend> <select name="give-cs-currency" class="give-cs-select-currency give-hidden"> <option value="USD" selected='selected'> US Dollars </option> <option value="EUR" > Euros </option> <option value="GBP" > Pounds Sterling </option> <option value="AUD" > Australian Dollars </option> <option value="BRL" > Brazilian Real </option> <option value="CAD" > Canadian Dollars </option> <option value="CZK" > Czech Koruna </option> <option value="DKK" > Danish Krone </option> <option value="HKD" > Hong Kong Dollar </option> <option value="ILS" > Israeli Shekel </option> <option value="NZD" > New Zealand Dollar </option> <option value="ZAR" > South African Rand </option> <option value="SEK" > Swedish Krona </option> <option value="CHF" > Swiss Franc </option> <option value="ANG" > Netherlands Antillean guilder </option> <option value="CNY" > Chinese yuan </option> <option value="XPF" > CFP franc </option> </select> <input type="hidden" name="give-cs-base-currency" value="USD"/> <input type="hidden" name="give-cs-exchange-rate" value="0"/> <input type="hidden" name="give-cs-form-currency" value="USD"/> <div class="give-currency-switcher-msg-wrap give-hidden"> <span class="give-currency-switcher-msg " data-rawtext="The current exchange rate is 1.00 {base_currency} equals {new_currency_rate} {new_currency}."> </span> </div> </fieldset> <ul id="give-donation-level-button-wrap" class="give-donation-levels-wrap give-list-inline"><li><button type="button" data-price-id="1" class="give-donation-level-btn give-btn give-btn-level-1 give-default-level" value="54.00" data-default="1">$54</button></li><li><button type="button" data-price-id="3" class="give-donation-level-btn give-btn give-btn-level-3 " value="180.00" data-default="0">$180</button></li><li><button type="button" data-price-id="4" class="give-donation-level-btn give-btn give-btn-level-4 " value="540.00" data-default="0">$540</button></li><li><button type="button" data-price-id="5" class="give-donation-level-btn give-btn give-btn-level-5 " value="1,000.00" data-default="0">$1000</button></li><li><button type="button" data-price-id="custom" class="give-donation-level-btn give-btn give-btn-level-custom" value="custom">Custom Amount</button></li></ul> <input type="hidden" value="1" class="give-fee-disable"/> <fieldset class="give-fee-recovery-donors-choice give-fee-message form-row" id="give-fee-recovery-wrap-29882"> <legend class="give-fee-message-legend" style="display: none;">Would you like to help cover the processing fees?</legend> <label for="give_fee_mode_checkbox-29882" class="give-fee-message-label" data-feemessage="I&#039;d like to help cover the transaction fees of {fee_amount} for my donation." style="font-weight:normal; cursor: pointer;" > <input name="give_fee_mode_checkbox" type="checkbox" id="give_fee_mode_checkbox-29882" class="give_fee_mode_checkbox" value="0" /> <span class="give-fee-message-label-text">I&#039;d like to help cover the transaction fees of 0 for my donation.</span> </label> </fieldset> <div class="give-recurring-donors-choice"> <input id="give-admin_choice-29882" class="give-recurring-period" name="give-recurring-period" type="checkbox" data-period-label="Monthly" data-period="month" data-interval="1" checked /> <label for="give-admin_choice-29882">**Help Israelis all year with a monthly donation**</label> </div> <input id="give-stripe-payment-method-29882-1" type="hidden" name="give_stripe_payment_method" value=""><input type="hidden" name="give-fee-recovery-settings" value="{&quot;fee_data&quot;:{&quot;all_gateways&quot;:{&quot;percentage&quot;:&quot;3.900000&quot;,&quot;base_amount&quot;:&quot;0.300000&quot;,&quot;give_fee_disable&quot;:false,&quot;give_fee_status&quot;:true,&quot;is_break_down&quot;:true,&quot;maxAmount&quot;:0}},&quot;give_fee_status&quot;:true,&quot;give_fee_disable&quot;:false,&quot;is_break_down&quot;:true,&quot;fee_mode&quot;:&quot;donor_opt_in&quot;,&quot;is_fee_mode&quot;:true,&quot;fee_recovery&quot;:true}" /> <fieldset id="give-payment-mode-select" > <legend class="give-payment-mode-label">Select Payment Method <span class="give-loading-text"><span class="give-loading-animation"></span> </span> </legend> <div id="give-payment-mode-wrap"> <ul id="give-gateway-radio-list"> <li class="give-gateway-option-selected"> <input type="radio" name="payment-mode" class="give-gateway" id="give-gateway-stripe-29882-1" value="stripe" checked='checked'> <label for="give-gateway-stripe-29882-1" class="give-gateway-option" id="give-gateway-option-stripe"> Credit/Debit Card</label> </li> <li> <input type="radio" name="payment-mode" class="give-gateway" id="give-gateway-paypal-29882-1" value="paypal"> <label for="give-gateway-paypal-29882-1" class="give-gateway-option" id="give-gateway-option-paypal"> PayPal</label> </li> </ul> </div> </fieldset> <div id="give_purchase_form_wrap"> <fieldset id="give_checkout_user_info" class=""> <legend> Personal Info </legend> <p id="give-first-name-wrap" class="form-row form-row-first form-row-responsive"> <label class="give-label" for="give-first"> First Name <span class="give-required-indicator">*</span> <span class="give-tooltip hint--top hint--medium hint--bounce" aria-label="First Name is used to personalize your donation record." rel="tooltip"><i class="give-icon give-icon-question"></i></span> </label> <input class="give-input required" type="text" name="give_first" autocomplete="given-name" placeholder="First Name" id="give-first" value="" required aria-required="true" /> </p> <p id="give-last-name-wrap" class="form-row form-row-last form-row-responsive"> <label class="give-label" for="give-last"> Last Name <span class="give-required-indicator">*</span> <span class="give-tooltip hint--top hint--medium hint--bounce" aria-label="Last Name is used to personalize your donation record." rel="tooltip"><i class="give-icon give-icon-question"></i></span> </label> <input class="give-input required" type="text" name="give_last" autocomplete="family-name" id="give-last" placeholder="Last Name" value="" required aria-required="true" /> </p> <p id="give-email-wrap" class="form-row form-row-wide"> <label class="give-label" for="give-email"> Email Address <span class="give-required-indicator">*</span> <span class="give-tooltip hint--top hint--medium hint--bounce" aria-label="We will send the donation receipt to this address." rel="tooltip"><i class="give-icon give-icon-question"></i></span> </label> <input class="give-input required" type="email" name="give_email" autocomplete="email" placeholder="Email Address" id="give-email" value="" required aria-required="true" /> </p> </fieldset> <fieldset id="give-ffm-section" data-fields="mailing_address|city|state|zip_code|country|home_phone_number|cell_phone_number"> <div id="mailing_address-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-full "><label class="give-label" for="ffm-mailing_address">Mailing Address </label> <input class="textfield" id="ffm-mailing_address" type="text" data-required="no" data-type="text" name="mailing_address" placeholder="" value="" /> </div><div id="city-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-one-third "><label class="give-label" for="ffm-city">City </label> <input class="textfield" id="ffm-city" type="text" data-required="no" data-type="text" name="city" placeholder="" value="" /> </div><div id="state-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-one-third "><label class="give-label" for="ffm-state">State </label> <input class="textfield" id="ffm-state" type="text" data-required="no" data-type="text" name="state" placeholder="" value="" /> </div><div id="zip_code-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-one-third "><label class="give-label" for="ffm-zip_code">Zip Code </label> <input class="textfield" id="ffm-zip_code" type="text" data-required="no" data-type="text" name="zip_code" placeholder="" value="" /> </div><div id="country-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-full "><label class="give-label" for="ffm-country">Country </label> <input class="textfield" id="ffm-country" type="text" data-required="no" data-type="text" name="country" placeholder="" value="" /> </div><div id="home_phone_number-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-half "><label class="give-label" for="ffm-home_phone_number">Home Phone Number </label> <input class="phone" id="ffm-home_phone_number" type="tel" data-required="no" data-type="tel" name="home_phone_number" placeholder="" value=""/> </div><div id="cell_phone_number-wrap" class="form-row give-ffm-form-row-responsive give-ffm-form-row-half "><label class="give-label" for="ffm-cell_phone_number">Cell Phone Number </label> <input class="phone js-phone-domestic" id="ffm-cell_phone_number" type="tel" data-required="no" data-type="tel" name="cell_phone_number" placeholder="" value=""/> </div> <input class="hiddenfield" id="ffm-page_url" type="hidden" name="page_url" value=""/> </fieldset> <fieldset id="give_cc_fields" class="give-do-validate"> <legend> Credit/Debit Card Info </legend> <div id="give_secure_site_wrapper"> <span class="give-icon padlock"></span> <span> This is a secure SSL encrypted payment. </span> </div> <div id="give-stripe-single-cc-fields-29882-1" class="give-stripe-single-cc-field-wrap"></div> </fieldset> <fieldset id="give-tributes-dedicate-donation-29882" class="give-tributes-dedicate-donation"> <!-- Give - Tributes Start --> <input type="hidden" class="give-tributes-type" name="give_tributes_type" value="In honor of" /> <legend>Dedicate this Donation</legend> <div id="give-tributes-options-29882"> <ul id="give-tributes-show-wrap-29882" class="give-tributes-show-wrap"> <li class="give-tributes-show-wrap-li"> <input class="give-input" type="radio" id="give-tributes-yes-29882" name="give_tributes_show_dedication" value="yes" /> <label for="give-tributes-yes-29882" class="give-tributes-yes"> Yes, please</label> </li> <li class="give-tributes-show-wrap-li"> <input class="give-input" type="radio" id="give-tributes-no-29882" name="give_tributes_show_dedication" checked="checked" value="no" /> <label for="give-tributes-no-29882" class="give-tributes-no"> No, thank you</label> </li> </ul> </div> <div id="give-tributes-type-wrap-29882" class="has_radios give_tributes_type_wrap"> <!-- Give - Tributes type wrap start --><label class="give-tributes-label" for="give-tribute-type-29882" id="give-tribute-type-29882">Dedication Type</label><ul id="give-tributes-type-radio-list-29882" class="give-tribute-radio-ul"><li><input type="radio" id="give-tributes-type-radio-in-honor-of-29882" name="give_tributes_radio_type" data-tribute-type="In honor of" class="give-tribute-type-radio" value="In honor of" checked="checked"><label for="give-tributes-type-radio-in-honor-of-29882" class="give-tributes-type-radio">In honor of</label></li><li><input type="radio" id="give-tributes-type-radio-in-memory-of-29882" name="give_tributes_radio_type" data-tribute-type="In memory of" class="give-tribute-type-radio" value="In memory of" ><label for="give-tributes-type-radio-in-memory-of-29882" class="give-tributes-type-radio">In memory of</label></li><li><input type="radio" id="give-tributes-type-radio-get-well-soon-for-29882" name="give_tributes_radio_type" data-tribute-type="Get well soon for" class="give-tribute-type-radio" value="Get well soon for" ><label for="give-tributes-type-radio-get-well-soon-for-29882" class="give-tributes-type-radio">Get well soon for</label></li></ul></div> <!-- Give - Tributes type wrap end --> <div id="give-tributes-info-wrap-29882" class="give_tributes_info_wrap"><!-- Give - Tributes Info Wrap Start --> <h3 class="give-section-break give-tributes-legend">Honoree Details</h3> <p id="give-tributes-first-name-wrap-29882" class="form-row form-row-first form-row-responsive"> <label class="give-label" for="give-tributes-first-name-29882"> First Name <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The first name of the honoree."></span> </label> <input class="give-input required" type="text" name="give_tributes_first_name" placeholder="Honoree First Name" id="give-tributes-first-name-29882" value="" /> </p> <p id="give-tributes-last-name-wrap-29882" class="form-row form-row-last form-row-responsive"> <label class="give-label" for="give-tributes-last-name-29882"> Last Name <span class="give-tooltip give-icon give-icon-question" data-tooltip="The last name of the honoree."></span> </label> <input class="give-input " type="text" name="give_tributes_last_name" placeholder="Honoree Last Name" id="give-tributes-last-name-29882" value="" /> </p> </div><!-- Give - Tributes Info Wrap End --> <div id="give-tributes-grab-info-wrap-29882" class="give_tributes_grab_info_wrap"><!-- Give - Tributes Grab Info Start --> <label for="i-would-like-to" class="give-tribute-type give-tributes-label">Would you like us to notify anyone of your donation?</label> <ul id="give-tributes-grab-info-29882" class="give-tributes-grab-info"> <li> <input class="give-input" id="give-tributes-mail-a-card-29882" type="radio" name="give_tributes_would_to" value="send_mail_card" /> <label for="give-tributes-mail-a-card-29882" class="give-tributes-would-to"> Yes, mail a card</label> </li> <li> <input class="give-input" id="give-tributes-send-an-ecard-29882" type="radio" name="give_tributes_would_to" value="send_eCard" /> <label for="give-tributes-send-an-ecard-29882" class="give-tributes-would-to"> Yes, send an eCard</label> </li> <li> <input class="give-input" id="give-tributes-none-29882" type="radio" name="give_tributes_would_to" checked="checked" value="none" /> <label for="give-tributes-none-29882" class="give-tributes-would-to"> No thanks</label> </li> </ul> </div><!-- Give - Tributes Info Wrap End --> <div class="give-tributes-notification-lists" id="give-tributes-notification-list-29882"><!-- Give - Tributes eCard Notification list Start --> <div id="give-tributes-send-ecard-fields-29882" class="give_tributes_send_ecard_fields"><!-- Give - Tributes eCard Fields Start --> <h3 class="give-section-break give-tributes-legend">Notification Details <div class="give-tributes-add-recipient"> <span data-tooltip="Add Notification" class="give-tributes-clone-field give-tooltip" data-action="add"><span class="give-icon give-icon-plus"></span></span> <span href="javascript:void(0);" data-tooltip="Remove this notification" class="give-tributes-clone-field give-tooltip" data-action="remove"><span class="give-icon give-icon-minus"></span></span> </div> </h3> <div id="give-tributes-ecard-personalized-message-29882" class="form-row form-row-responsive give_tributes_ecard_personalized_message"> <label class="give-label" for="give-tributes-ecard-personalized-message-area-29882"> Personalized Message <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="This is the personalized notification message that is sent to the recipient."></span> </label> <textarea maxlength="1255" name="give_tributes_ecard_notify[recipient][personalized][]" id="give-tributes-ecard-personalized-message-area-29882" class="give-tributes-personalized-message large-text"></textarea> <span id="give-tributes-ecard-personalized-message-left-29882" class="give-tributes-ecard-personalized-message-left">1255 Characters left</span> </div> <div id="give-tributes-ecard-notify-first-name-wrap-29882" class="form-row form-row-first form-row-responsive"> <label class="give-label" for="give-tributes-ecard-notify-first-name-29882"> First Name <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The first name of the recipient."></span> </label> <input class="give-input required" type="text" name="give_tributes_ecard_notify[recipient][first_name][]" placeholder="Recipient First Name" id="give-tributes-ecard-notify-first-name-29882" value="" /> </div> <div id="give-tributes-ecard-notify-last-name-wrap-29882" class="form-row form-row-last form-row-responsive"> <label class="give-label" for="give-tributes-ecard-notify-last-name-29882"> Last Name <span class="give-tooltip give-icon give-icon-question" data-tooltip="The last name of the recipient."></span> </label> <input class="give-input " type="text" name="give_tributes_ecard_notify[recipient][last_name][]" placeholder="Recipient Last Name" id="give-tributes-ecard-notify-last-name-29882" value="" /> </div> <div id="give-tributes-ecard-email-29882" class="form-row form-row-wide form-row-responsive give_tributes_ecard_email"> <label class="give-label" for="give-tributes-send-ecard-email-29882"> Email Address <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="This is the email address of the notification recipient."></span> </label> <input class="give-input required" type="email" name="give_tributes_ecard_notify[recipient][email][]" placeholder="Recipient Email Address" id="give-tributes-send-ecard-email-29882" value="" /> </div> </div><!-- Give - Tributes eCard Fields End --> </div><!-- Give - Tributes eCard Notification list End --> <div id="give-tributes-mail-card-fields-29882" class="give_tributes_mail_card_fields"><!-- Give - Tributes Mail a Card Fields Start --> <h3 class="give-section-break give-tributes-legend">Notification Details</h3> <p id="give-tributes-mail-card-personalized-message-29882" class="form-row form-row-wide form-row-responsive give_tributes_mail_card_personalized_message"> <label class="give-label" for="give-tributes-mail-card-personalized-message-area-29882"> Personalized Message <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="This is the personalized notification message that is sent inside the card."> </span> </label> <textarea maxlength="1255" name="give-tributes-mail-card-personalized-message" id="give-tributes-mail-card-personalized-message-area-29882" class="large-text required"></textarea> <span id="give-tributes-mail-card-personalized-message-left-29882" class="give-tributes-mail-card-personalized-message-left"> 1255 Characters left </span> </p> <p id="give-tributes-mail-card-notify-first-name-wrap-29882" class="form-row form-row-first form-row-responsive"> <label class="give-label" for="give-tributes-mail-card-notify-first-name-29882"> First Name <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The first name of the recipient being notifed of your donation."></span> </label> <input class="give-input required" type="text" name="give_tributes_mail_card_notify_first_name" placeholder="Recipient First Name" id="give-tributes-mail-card-notify-first-name-29882" value="" /> </p> <p id="give-tributes-mail-card-notify-last-name-wrap-29882" class="form-row form-row-last form-row-responsive"> <label class="give-label" for="give-tributes-mail-card-notify-last-name-29882"> Last Name <span class="give-tooltip give-icon give-icon-question" data-tooltip="The last name of the recipient being notifed of your donation."></span> </label> <input class="give-input " type="text" name="give_tributes_mail_card_notify_last_name" placeholder="Recipient Last Name" id="give-tributes-mail-card-notify-last-name-29882" value="" /> </p> <p id="give-tributes-mail-card-country-29882" class="form-row form-row-wide form-row-responsive give_tributes_mail_card_country"> <label for="give_tributes_address_country_29882"> Country <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The recipient&#039;s country."></span> </label> <select name="give_tributes_address_country" id="give_tributes_address_country_29882" class="select give-select required"> <option value="US" selected='selected'>United States</option> <option value="CA" >Canada</option> <option value="GB" >United Kingdom</option> <option value="AF" >Afghanistan</option> <option value="AL" >Albania</option> <option value="DZ" >Algeria</option> <option value="AS" >American Samoa</option> <option value="AD" >Andorra</option> <option value="AO" >Angola</option> <option value="AI" >Anguilla</option> <option value="AQ" >Antarctica</option> <option value="AG" >Antigua and Barbuda</option> <option value="AR" >Argentina</option> <option value="AM" >Armenia</option> <option value="AW" >Aruba</option> <option value="AU" >Australia</option> <option value="AT" >Austria</option> <option value="AZ" >Azerbaijan</option> <option value="BS" >Bahamas</option> <option value="BH" >Bahrain</option> <option value="BD" >Bangladesh</option> <option value="BB" >Barbados</option> <option value="BY" >Belarus</option> <option value="BE" >Belgium</option> <option value="BZ" >Belize</option> <option value="BJ" >Benin</option> <option value="BM" >Bermuda</option> <option value="BT" >Bhutan</option> <option value="BO" >Bolivia</option> <option value="BA" >Bosnia and Herzegovina</option> <option value="BW" >Botswana</option> <option value="BV" >Bouvet Island</option> <option value="BR" >Brazil</option> <option value="IO" >British Indian Ocean Territory</option> <option value="BN" >Brunei Darrussalam</option> <option value="BG" >Bulgaria</option> <option value="BF" >Burkina Faso</option> <option value="BI" >Burundi</option> <option value="KH" >Cambodia</option> <option value="CM" >Cameroon</option> <option value="CV" >Cape Verde</option> <option value="KY" >Cayman Islands</option> <option value="CF" >Central African Republic</option> <option value="TD" >Chad</option> <option value="CL" >Chile</option> <option value="CN" >China</option> <option value="CX" >Christmas Island</option> <option value="CC" >Cocos Islands</option> <option value="CO" >Colombia</option> <option value="KM" >Comoros</option> <option value="CD" >Congo, Democratic People&#039;s Republic</option> <option value="CG" >Congo, Republic of</option> <option value="CK" >Cook Islands</option> <option value="CR" >Costa Rica</option> <option value="CI" >Cote d&#039;Ivoire</option> <option value="HR" >Croatia/Hrvatska</option> <option value="CU" >Cuba</option> <option value="CY" >Cyprus Island</option> <option value="CZ" >Czech Republic</option> <option value="DK" >Denmark</option> <option value="DJ" >Djibouti</option> <option value="DM" >Dominica</option> <option value="DO" >Dominican Republic</option> <option value="TP" >East Timor</option> <option value="EC" >Ecuador</option> <option value="EG" >Egypt</option> <option value="GQ" >Equatorial Guinea</option> <option value="SV" >El Salvador</option> <option value="ER" >Eritrea</option> <option value="EE" >Estonia</option> <option value="ET" >Ethiopia</option> <option value="FK" >Falkland Islands</option> <option value="FO" >Faroe Islands</option> <option value="FJ" >Fiji</option> <option value="FI" >Finland</option> <option value="FR" >France</option> <option value="GF" >French Guiana</option> <option value="PF" >French Polynesia</option> <option value="TF" >French Southern Territories</option> <option value="GA" >Gabon</option> <option value="GM" >Gambia</option> <option value="GE" >Georgia</option> <option value="DE" >Germany</option> <option value="GR" >Greece</option> <option value="GH" >Ghana</option> <option value="GI" >Gibraltar</option> <option value="GL" >Greenland</option> <option value="GD" >Grenada</option> <option value="GP" >Guadeloupe</option> <option value="GU" >Guam</option> <option value="GT" >Guatemala</option> <option value="GG" >Guernsey</option> <option value="GN" >Guinea</option> <option value="GW" >Guinea-Bissau</option> <option value="GY" >Guyana</option> <option value="HT" >Haiti</option> <option value="HM" >Heard and McDonald Islands</option> <option value="VA" >Holy See (City Vatican State)</option> <option value="HN" >Honduras</option> <option value="HK" >Hong Kong</option> <option value="HU" >Hungary</option> <option value="IS" >Iceland</option> <option value="IN" >India</option> <option value="ID" >Indonesia</option> <option value="IR" >Iran</option> <option value="IQ" >Iraq</option> <option value="IE" >Ireland</option> <option value="IM" >Isle of Man</option> <option value="IL" >Israel</option> <option value="IT" >Italy</option> <option value="JM" >Jamaica</option> <option value="JP" >Japan</option> <option value="JE" >Jersey</option> <option value="JO" >Jordan</option> <option value="KZ" >Kazakhstan</option> <option value="KE" >Kenya</option> <option value="KI" >Kiribati</option> <option value="KW" >Kuwait</option> <option value="KG" >Kyrgyzstan</option> <option value="LA" >Lao People&#039;s Democratic Republic</option> <option value="LV" >Latvia</option> <option value="LB" >Lebanon</option> <option value="LS" >Lesotho</option> <option value="LR" >Liberia</option> <option value="LY" >Libyan Arab Jamahiriya</option> <option value="LI" >Liechtenstein</option> <option value="LT" >Lithuania</option> <option value="LU" >Luxembourg</option> <option value="MO" >Macau</option> <option value="MK" >Macedonia</option> <option value="MG" >Madagascar</option> <option value="MW" >Malawi</option> <option value="MY" >Malaysia</option> <option value="MV" >Maldives</option> <option value="ML" >Mali</option> <option value="MT" >Malta</option> <option value="MH" >Marshall Islands</option> <option value="MQ" >Martinique</option> <option value="MR" >Mauritania</option> <option value="MU" >Mauritius</option> <option value="YT" >Mayotte</option> <option value="MX" >Mexico</option> <option value="FM" >Micronesia</option> <option value="MD" >Moldova, Republic of</option> <option value="MC" >Monaco</option> <option value="MN" >Mongolia</option> <option value="ME" >Montenegro</option> <option value="MS" >Montserrat</option> <option value="MA" >Morocco</option> <option value="MZ" >Mozambique</option> <option value="MM" >Myanmar</option> <option value="NA" >Namibia</option> <option value="NR" >Nauru</option> <option value="NP" >Nepal</option> <option value="NL" >Netherlands</option> <option value="AN" >Netherlands Antilles</option> <option value="NC" >New Caledonia</option> <option value="NZ" >New Zealand</option> <option value="NI" >Nicaragua</option> <option value="NE" >Niger</option> <option value="NG" >Nigeria</option> <option value="NU" >Niue</option> <option value="NF" >Norfolk Island</option> <option value="KP" >North Korea</option> <option value="MP" >Northern Mariana Islands</option> <option value="NO" >Norway</option> <option value="OM" >Oman</option> <option value="PK" >Pakistan</option> <option value="PW" >Palau</option> <option value="PS" >Palestinian Territories</option> <option value="PA" >Panama</option> <option value="PG" >Papua New Guinea</option> <option value="PY" >Paraguay</option> <option value="PE" >Peru</option> <option value="PH" >Philippines</option> <option value="PN" >Pitcairn Island</option> <option value="PL" >Poland</option> <option value="PT" >Portugal</option> <option value="PR" >Puerto Rico</option> <option value="QA" >Qatar</option> <option value="RE" >Reunion Island</option> <option value="RO" >Romania</option> <option value="RU" >Russian Federation</option> <option value="RW" >Rwanda</option> <option value="SH" >Saint Helena</option> <option value="KN" >Saint Kitts and Nevis</option> <option value="LC" >Saint Lucia</option> <option value="PM" >Saint Pierre and Miquelon</option> <option value="VC" >Saint Vincent and the Grenadines</option> <option value="SM" >San Marino</option> <option value="ST" >Sao Tome and Principe</option> <option value="SA" >Saudi Arabia</option> <option value="SN" >Senegal</option> <option value="RS" >Serbia</option> <option value="SC" >Seychelles</option> <option value="SL" >Sierra Leone</option> <option value="SG" >Singapore</option> <option value="SK" >Slovak Republic</option> <option value="SI" >Slovenia</option> <option value="SB" >Solomon Islands</option> <option value="SO" >Somalia</option> <option value="ZA" >South Africa</option> <option value="GS" >South Georgia</option> <option value="KR" >South Korea</option> <option value="ES" >Spain</option> <option value="LK" >Sri Lanka</option> <option value="SD" >Sudan</option> <option value="SR" >Suriname</option> <option value="SJ" >Svalbard and Jan Mayen Islands</option> <option value="SZ" >Eswatini</option> <option value="SE" >Sweden</option> <option value="CH" >Switzerland</option> <option value="SY" >Syrian Arab Republic</option> <option value="TW" >Taiwan</option> <option value="TJ" >Tajikistan</option> <option value="TZ" >Tanzania</option> <option value="TG" >Togo</option> <option value="TK" >Tokelau</option> <option value="TO" >Tonga</option> <option value="TH" >Thailand</option> <option value="TT" >Trinidad and Tobago</option> <option value="TN" >Tunisia</option> <option value="TR" >Turkey</option> <option value="TM" >Turkmenistan</option> <option value="TC" >Turks and Caicos Islands</option> <option value="TV" >Tuvalu</option> <option value="UG" >Uganda</option> <option value="UA" >Ukraine</option> <option value="AE" >United Arab Emirates</option> <option value="UY" >Uruguay</option> <option value="UM" >US Minor Outlying Islands</option> <option value="UZ" >Uzbekistan</option> <option value="VU" >Vanuatu</option> <option value="VE" >Venezuela</option> <option value="VN" >Vietnam</option> <option value="VG" >Virgin Islands (British)</option> <option value="VI" >Virgin Islands (USA)</option> <option value="WF" >Wallis and Futuna Islands</option> <option value="EH" >Western Sahara</option> <option value="WS" >Western Samoa</option> <option value="YE" >Yemen</option> <option value="YU" >Yugoslavia</option> <option value="ZM" >Zambia</option> <option value="ZW" >Zimbabwe</option> </select> </p> <p id="give-tributes-mail-card-address1-29882" class="form-row form-row-wide form-row-responsive give_tributes_mail_card_address1"> <label class="give-label" for="give-tributes-mail-card-address1-29882"> Address Line 1 <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The recipient&#039;s mailing address."> </span> </label> <input class="give-input give_tributes_mail_card_address_1 required" type="text" name="give_tributes_mail_card_address_1" placeholder="Recipient Address Line 1" id="give-tributes-mail-card-address1-29882" value="" /> </p> <p id="give-tributes-mail-card-address2-29882" class="form-row form-row-responsive form-row-wide give_tributes_mail_card_address2"> <label class="give-label" for="give-tributes-mail-card-address2-29882"> Address Line 2 <span class="give-tooltip give-icon give-icon-question" data-tooltip="Additional address information for the recipient."> </span> </label> <input class="give-input give_tributes_mail_card_address_2" type="text" name="give_tributes_mail_card_address_2" placeholder="Recipient Address Line 2" id="give-tributes-mail-card-address2-29882" value="" /> </p> <p id="give-tributes-mail-card-city-29882" class="form-row form-row-responsive give_tributes_mail_card_city form-row-wide"> <label class="give-label" for="give-tributes-mail-card-city-29882"> City <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The recipient&#039;s city."> </span> </label> <input class="give-input required" type="text" name="give_tributes_mail_card_city" placeholder="Recipient City" id="give-tributes-mail-card-city-29882" value="" /> </p> <p id="give-tributes-mail-card-state-29882" class="form-row form-row-responsive give_tributes_mail_card_state form-row-first "> <label class="give_tributes_address_state_label" for="give_tributes_address_state_29882"> State <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The recipient&#039;s state, province, or county."> </span> </label> <select data-key="state" name="give_tributes_address_state" id="give_tributes_address_state_29882" class="text give-input required"> <option value="" selected='selected'></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="CZ">Canal Zone</option><option value="CM">Commonwealth of the Northern Mariana Islands</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="PI">Philippine Islands</option><option value="PR">Puerto Rico</option><option value="TT">Trust Territory of the Pacific Islands</option><option value="VI">Virgin Islands</option><option value="AA">Armed Forces - Americas</option><option value="AE">Armed Forces - Europe, Canada, Middle East, Africa</option><option value="AP">Armed Forces - Pacific</option> </select> </p> <p id="give-tributes-mail-card-zipcode-29882" class="form-row form-row-responsive give_tributes_mail_card_zipcode form-row-last give_tributes_adjust_zip"> <label class="give-label" for="give-tributes-mail-card-zipcode-29882"> Zip/Postal Code <span class="give-required-indicator">*</span> <span class="give-tooltip give-icon give-icon-question" data-tooltip="The recipient&#039;s zip or postal code."> </span> </label> <input class="give-input required" type="text" name="give_tributes_mail_card_zipcode" placeholder="Recipient Zip/Postal Code" id="give-tributes-mail-card-zipcode-29882" value="" /> </p> </div><!-- Give - Tributes Mail a Card Fields End --> </fieldset> <!-- Give - Tributes End --> <div id="give-stripe-payment-errors-29882-1"></div> <fieldset id="give_purchase_submit" class="give-donation-submit"> <p id="give-final-total-wrap" class="form-wrap "> <span class="give-donation-total-label"> Total: </span> <span class="give-final-total-amount" data-total="54.00"> &#36;54.00 </span> <span id="give-recurring-modal-period-wrap" class=""><span id="give-recurring-modal-period">Monthly</span></span> </p> <p class="fee-break-down-message fee-break-down-message-29882" data-breakdowntext="{amount} donation plus {fee_amount} to help cover fees." style="display: none;">{amount} donation plus {fee_amount} to help cover fees.</p> <input type="hidden" name="give_action" value="purchase"/> <input type="hidden" name="give-gateway" value="stripe"/> <div class="give-submit-button-wrap give-clearfix"> <input type="submit" class="give-submit give-btn" id="give-purchase-button" name="give-purchase" value="I WANT TO GIVE" data-before-validation-label="I WANT TO GIVE"/> <span class="give-loading-animation"></span> </div> </fieldset> </div> <div id="give-stripe-ideal-donation-errors"></div> </form> <button type="button" class="give-btn give-btn-modal">OR, MAKE A DONATION UNDER $100</button> </div><!--end #give-form-29882--> <!--<script> // Get variable from query string in URL function giveGetQueryVariable(variable) { var query = window.location.search.substring(1); var vars = query.split('&'); for (var i=0;i<vars.length;i++) { var pair = vars[i].split('='); if(pair[0] == variable){return pair[1];} } return(false); } jQuery(document).ready(function( $ ) { // Get the amount from the URL var getamount = giveGetQueryVariable('amount'); var amount = '45.00'; // Set fallback in case URL variable isn't set if ( getamount !== false ) { amount = getamount; } // Populate the amount field, then update the total if ( $('#give-amount').length > 0 ) { $('#give-amount') .val(amount) .focus() .trigger('blur'); } }); </script>-->