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| 1 <!-- https://www.givedirect.org/give/givefrm.asp?CID=1721 --> |
| 2 <table align="center" id="btable" width="810"> |
| 3 <tr> |
| 4 <td valign="top" align="center" id="btable"> |
| 5 <h1> |
| 6 MATHCOUNTS Foundation |
| 7 </h1> |
| 8 <h2> |
| 9 Online Donation Form |
| 10 </h2> |
| 11 </td> |
| 12 </tr> |
| 13 <tr> |
| 14 <td></td> |
| 15 </tr> |
| 16 <tr> |
| 17 <td> |
| 18 <form name="donation" method="post" id="donation"> |
| 19 <!--begin the form--> |
| 20 <input type="hidden" name="IsSubmitted" value="Yes"> <input type="hidden
" name="BaseURL" value=""> <span> |
| 21 <textarea name="f1" id="f1" value="" rows="2" cols="3"> |
| 22 </textarea></span> |
| 23 <table border="0"> |
| 24 <tr> |
| 25 <td width="310"> |
| 26 <table> |
| 27 <tr> |
| 28 <td width="20"> |
| 29 <img src="#"> |
| 30 </td> |
| 31 <td valign="middle" width="330"> |
| 32 <div> |
| 33 Contact Information |
| 34 </div> |
| 35 </td> |
| 36 </tr> |
| 37 </table> |
| 38 <div> |
| 39 <div> |
| 40 Name <span>*</span><br> |
| 41 <input name="dnrfirst" value="" type="text" size="15" maxlengt
h="50" tabindex="1"> <input name="dnrlast" value="" type="text" size="15" m
axlength="50" tabindex="2"><br> |
| 42 Company<br> |
| 43 <input name="company" value="" type="text" size="36" maxlength
="100" tabindex="3"><br> |
| 44 Address 1 <span>*</span><br> |
| 45 <input name="dadd1" id="dadd1" value="" type="text" size="36"
maxlength="155" tabindex="4" autocomplete="off"><br> |
| 46 Address 2<br> |
| 47 <input name="dadd2" id="dadd2" type="text" value="" size="36"
maxlength="155" tabindex="5"><br> |
| 48 City / State / Zip <span>*</span><br> |
| 49 <input name="dcity" id="dcity" value="" type="text" size="12"
maxlength="60" tabindex="6"> <select name="dstate" id="dstate" tabindex="
6"> |
| 50 <option id="USA-AL" value="AL"> |
| 51 AL |
| 52 </option> |
| 53 <option id="USA-AK" value="AK"> |
| 54 AK |
| 55 </option> |
| 56 <option id="USA-AZ" value="AZ"> |
| 57 AZ |
| 58 </option> |
| 59 <option id="USA-AR" value="AR"> |
| 60 AR |
| 61 </option> |
| 62 <option id="USA-CA" value="CA"> |
| 63 CA |
| 64 </option> |
| 65 <option id="USA-CO" value="CO"> |
| 66 CO |
| 67 </option> |
| 68 <option id="USA-CT" value="CT"> |
| 69 CT |
| 70 </option> |
| 71 <option id="USA-DE" value="DE"> |
| 72 DE |
| 73 </option> |
| 74 <option id="USA-DC" value="DC"> |
| 75 DC |
| 76 </option> |
| 77 <option id="USA-FL" value="FL"> |
| 78 FL |
| 79 </option> |
| 80 <option id="USA-GA" value="GA"> |
| 81 GA |
| 82 </option> |
| 83 <option id="USA-GU" value="GU"> |
| 84 GU |
| 85 </option> |
| 86 <option id="USA-HI" value="HI"> |
| 87 HI |
| 88 </option> |
| 89 <option id="USA-ID" value="ID"> |
| 90 ID |
| 91 </option> |
| 92 <option id="USA-IL" value="IL"> |
| 93 IL |
| 94 </option> |
| 95 <option id="USA-IN" value="IN"> |
| 96 IN |
| 97 </option> |
| 98 <option id="USA-IA" value="IA"> |
| 99 IA |
| 100 </option> |
| 101 <option id="USA-KS" value="KS"> |
| 102 KS |
| 103 </option> |
| 104 <option id="USA-KY" value="KY"> |
| 105 KY |
| 106 </option> |
| 107 <option id="USA-LA" value="LA"> |
| 108 LA |
| 109 </option> |
| 110 <option id="USA-ME" value="ME"> |
| 111 ME |
| 112 </option> |
| 113 <option id="USA-MD" value="MD"> |
| 114 MD |
| 115 </option> |
| 116 <option id="USA-MA" value="MA"> |
| 117 MA |
| 118 </option> |
| 119 <option id="USA-MI" value="MI"> |
| 120 MI |
| 121 </option> |
| 122 <option id="USA-MN" value="MN"> |
| 123 MN |
| 124 </option> |
| 125 <option id="USA-MS" value="MS"> |
| 126 MS |
| 127 </option> |
| 128 <option id="USA-MO" value="MO"> |
| 129 MO |
| 130 </option> |
| 131 <option id="USA-MT" value="MT"> |
| 132 MT |
| 133 </option> |
| 134 <option id="USA-NE" value="NE"> |
| 135 NE |
| 136 </option> |
| 137 <option id="USA-NV" value="NV"> |
| 138 NV |
| 139 </option> |
| 140 <option id="USA-NH" value="NH"> |
| 141 NH |
| 142 </option> |
| 143 <option id="USA-NJ" value="NJ"> |
| 144 NJ |
| 145 </option> |
| 146 <option id="USA-NM" value="NM"> |
| 147 NM |
| 148 </option> |
| 149 <option id="USA-NY" value="NY"> |
| 150 NY |
| 151 </option> |
| 152 <option id="USA-NC" value="NC"> |
| 153 NC |
| 154 </option> |
| 155 <option id="USA-ND" value="ND"> |
| 156 ND |
| 157 </option> |
| 158 <option id="USA-OH" value="OH"> |
| 159 OH |
| 160 </option> |
| 161 <option id="USA-OK" value="OK"> |
| 162 OK |
| 163 </option> |
| 164 <option id="USA-OR" value="OR"> |
| 165 OR |
| 166 </option> |
| 167 <option id="USA-PA" value="PA"> |
| 168 PA |
| 169 </option> |
| 170 <option id="USA-PR" value="PR"> |
| 171 PR |
| 172 </option> |
| 173 <option id="USA-RI" value="RI"> |
| 174 RI |
| 175 </option> |
| 176 <option id="USA-SC" value="SC"> |
| 177 SC |
| 178 </option> |
| 179 <option id="USA-SD" value="SD"> |
| 180 SD |
| 181 </option> |
| 182 <option id="USA-TN" value="TN"> |
| 183 TN |
| 184 </option> |
| 185 <option id="USA-TX" value="TX"> |
| 186 TX |
| 187 </option> |
| 188 <option id="USA-UT" value="UT"> |
| 189 UT |
| 190 </option> |
| 191 <option id="USA-VT" value="VT"> |
| 192 VT |
| 193 </option> |
| 194 <option id="USA-VA" value="VA"> |
| 195 VA |
| 196 </option> |
| 197 <option id="USA-VI" value="VI"> |
| 198 VI |
| 199 </option> |
| 200 <option id="USA-WA" value="WA"> |
| 201 WA |
| 202 </option> |
| 203 <option id="USA-WV" value="WV"> |
| 204 WV |
| 205 </option> |
| 206 <option id="USA-WI" value="WI"> |
| 207 WI |
| 208 </option> |
| 209 <option id="USA-WY" value="WY"> |
| 210 WY |
| 211 </option> |
| 212 <option> |
| 213 ---- |
| 214 </option> |
| 215 <option id="CAN-AB" value="AB"> |
| 216 AB |
| 217 </option> |
| 218 <option id="CAN-BC" value="BC"> |
| 219 BC |
| 220 </option> |
| 221 <option id="CAN-MB" value="MB"> |
| 222 MB |
| 223 </option> |
| 224 <option id="CAN-NB" value="NB"> |
| 225 NB |
| 226 </option> |
| 227 <option id="CAN-NL" value="NL"> |
| 228 NL |
| 229 </option> |
| 230 <option id="CAN-NT" value="NT"> |
| 231 NT |
| 232 </option> |
| 233 <option id="CAN-NS" value="NS"> |
| 234 NS |
| 235 </option> |
| 236 <option id="CAN-NU" value="NU"> |
| 237 NU |
| 238 </option> |
| 239 <option id="CAN-PE" value="PE"> |
| 240 PE |
| 241 </option> |
| 242 <option id="CAN-SK" value="SK"> |
| 243 SK |
| 244 </option> |
| 245 <option id="CAN-ON" value="ON"> |
| 246 ON |
| 247 </option> |
| 248 <option id="CAN-QC" value="QC"> |
| 249 QC |
| 250 </option> |
| 251 <option id="CAN-YT" value="YT"> |
| 252 YT |
| 253 </option> |
| 254 <option> |
| 255 ---- |
| 256 </option> |
| 257 <option id="OS-AA" value="AA"> |
| 258 AA |
| 259 </option> |
| 260 <option id="OS-AE" value="AE"> |
| 261 AE |
| 262 </option> |
| 263 <option id="OS-AP" value="AP"> |
| 264 AP |
| 265 </option> |
| 266 </select> <input name="dzip" id="dzip" value="" type="t
ext" size="8" maxlength="10" tabindex="7"><br> |
| 267 Country<br> |
| 268 <select name="CC_COUNTRY"> |
| 269 <option value="Albania"> |
| 270 Albania |
| 271 </option> |
| 272 <option value="Algeria"> |
| 273 Algeria |
| 274 </option> |
| 275 <option value="American Samoa"> |
| 276 American Samoa |
| 277 </option> |
| 278 <option value="Andorra"> |
| 279 Andorra |
| 280 </option> |
| 281 <option value="Anguilla"> |
| 282 Anguilla |
| 283 </option> |
| 284 <option value="Antigua"> |
| 285 Antigua |
| 286 </option> |
| 287 <option value="Argentina"> |
| 288 Argentina |
| 289 </option> |
| 290 <option value="Aruba"> |
| 291 Aruba |
| 292 </option> |
| 293 <option value="Australia"> |
| 294 Australia |
| 295 </option> |
| 296 <option value="Austria"> |
| 297 Austria |
| 298 </option> |
| 299 <option value="Azores"> |
| 300 Azores |
| 301 </option> |
| 302 <option value="Bahamas"> |
| 303 Bahamas |
| 304 </option> |
| 305 <option value="Bahrain"> |
| 306 Bahrain |
| 307 </option> |
| 308 <option value="Bangladesh"> |
| 309 Bangladesh |
| 310 </option> |
| 311 <option value="Barbados"> |
| 312 Barbados |
| 313 </option> |
| 314 <option value="Belgium"> |
| 315 Belgium |
| 316 </option> |
| 317 <option value="Belize"> |
| 318 Belize |
| 319 </option> |
| 320 <option value="Belarus"> |
| 321 Belarus |
| 322 </option> |
| 323 <option value="Benin"> |
| 324 Benin |
| 325 </option> |
| 326 <option value="Bermuda"> |
| 327 Bermuda |
| 328 </option> |
| 329 <option value="Bolivia"> |
| 330 Bolivia |
| 331 </option> |
| 332 <option value="Bonaire"> |
| 333 Bonaire |
| 334 </option> |
| 335 <option value="Botswana"> |
| 336 Botswana |
| 337 </option> |
| 338 <option value="Brazil"> |
| 339 Brazil |
| 340 </option> |
| 341 <option value="Brunei"> |
| 342 Brunei |
| 343 </option> |
| 344 <option value="Bulgaria"> |
| 345 Bulgaria |
| 346 </option> |
| 347 <option value="Burkina Faso"> |
| 348 Burkina Faso |
| 349 </option> |
| 350 <option value="Burundi"> |
| 351 Burundi |
| 352 </option> |
| 353 <option value="Cambodia"> |
| 354 Cambodia |
| 355 </option> |
| 356 <option value="Cameroon"> |
| 357 Cameroon |
| 358 </option> |
| 359 <option value="Canada"> |
| 360 Canada |
| 361 </option> |
| 362 <option value="Canary Islands"> |
| 363 Canary Islands |
| 364 </option> |
| 365 <option value="Cape Verde Islands"> |
| 366 Cape Verde Islands |
| 367 </option> |
| 368 <option value="Cayman Islands"> |
| 369 Cayman Islands |
| 370 </option> |
| 371 <option value="Channel Islands"> |
| 372 Channel Islands |
| 373 </option> |
| 374 <option value="Chile"> |
| 375 Chile |
| 376 </option> |
| 377 <option value="China"> |
| 378 China |
| 379 </option> |
| 380 <option value="Colombia"> |
| 381 Colombia |
| 382 </option> |
| 383 <option value="Congo"> |
| 384 Congo |
| 385 </option> |
| 386 <option value="Cook Islands"> |
| 387 Cook Islands |
| 388 </option> |
| 389 <option value="Costa Rica"> |
| 390 Costa Rica |
| 391 </option> |
| 392 <option value="Croatia"> |
| 393 Croatia |
| 394 </option> |
| 395 <option value="Curacao"> |
| 396 Curacao |
| 397 </option> |
| 398 <option value="Cyprus"> |
| 399 Cyprus |
| 400 </option> |
| 401 <option value="Czech Republic"> |
| 402 Czech Republic |
| 403 </option> |
| 404 <option value="Denmark"> |
| 405 Denmark |
| 406 </option> |
| 407 <option value="Djibouti"> |
| 408 Djibouti |
| 409 </option> |
| 410 <option value="Dominica"> |
| 411 Dominica |
| 412 </option> |
| 413 <option value="Dominican Republic"> |
| 414 Dominican Republic |
| 415 </option> |
| 416 <option value="Ecuador"> |
| 417 Ecuador |
| 418 </option> |
| 419 <option value="Egypt"> |
| 420 Egypt |
| 421 </option> |
| 422 <option value="El Salvador"> |
| 423 El Salvador |
| 424 </option> |
| 425 <option value="England"> |
| 426 England |
| 427 </option> |
| 428 <option value="Equitorial Guinea"> |
| 429 Equitorial Guinea |
| 430 </option> |
| 431 <option value="Eritrea"> |
| 432 Eritrea |
| 433 </option> |
| 434 <option value="Estonia"> |
| 435 Estonia |
| 436 </option> |
| 437 <option value="Ethiopia"> |
| 438 Ethiopia |
| 439 </option> |
| 440 <option value="Faeroe Islands"> |
| 441 Faeroe Islands |
| 442 </option> |
| 443 <option value="Fiji"> |
| 444 Fiji |
| 445 </option> |
| 446 <option value="Finland"> |
| 447 Finland |
| 448 </option> |
| 449 <option value="France"> |
| 450 France |
| 451 </option> |
| 452 <option value="French Guiana"> |
| 453 French Guiana |
| 454 </option> |
| 455 <option value="French Polynesia"> |
| 456 French Polynesia |
| 457 </option> |
| 458 <option value="Gabon"> |
| 459 Gabon |
| 460 </option> |
| 461 <option value="Gambia"> |
| 462 Gambia |
| 463 </option> |
| 464 <option value="Georgia"> |
| 465 Georgia |
| 466 </option> |
| 467 <option value="Germany"> |
| 468 Germany |
| 469 </option> |
| 470 <option value="Ghana"> |
| 471 Ghana |
| 472 </option> |
| 473 <option value="Gibraltar"> |
| 474 Gibraltar |
| 475 </option> |
| 476 <option value="Greece"> |
| 477 Greece |
| 478 </option> |
| 479 <option value="Greenland"> |
| 480 Greenland |
| 481 </option> |
| 482 <option value="Grenada"> |
| 483 Grenada |
| 484 </option> |
| 485 <option value="Guadeloupe"> |
| 486 Guadeloupe |
| 487 </option> |
| 488 <option value="Guam"> |
| 489 Guam |
| 490 </option> |
| 491 <option value="Guatemala"> |
| 492 Guatemala |
| 493 </option> |
| 494 <option value="Guinea"> |
| 495 Guinea |
| 496 </option> |
| 497 <option value="Guinea-Bissau"> |
| 498 Guinea-Bissau |
| 499 </option> |
| 500 <option value="Guyana"> |
| 501 Guyana |
| 502 </option> |
| 503 <option value="Haiti"> |
| 504 Haiti |
| 505 </option> |
| 506 <option value="Holland"> |
| 507 Holland |
| 508 </option> |
| 509 <option value="Honduras"> |
| 510 Honduras |
| 511 </option> |
| 512 <option value="Hong Kong"> |
| 513 Hong Kong |
| 514 </option> |
| 515 <option value="Hungary"> |
| 516 Hungary |
| 517 </option> |
| 518 <option value="Iceland"> |
| 519 Iceland |
| 520 </option> |
| 521 <option value="India"> |
| 522 India |
| 523 </option> |
| 524 <option value="Indonesia"> |
| 525 Indonesia |
| 526 </option> |
| 527 <option value="Ireland"> |
| 528 Ireland |
| 529 </option> |
| 530 <option value="Israel"> |
| 531 Israel |
| 532 </option> |
| 533 <option value="Italy"> |
| 534 Italy |
| 535 </option> |
| 536 <option value="Ivory Coast"> |
| 537 Ivory Coast |
| 538 </option> |
| 539 <option value="Jamaica"> |
| 540 Jamaica |
| 541 </option> |
| 542 <option value="Japan"> |
| 543 Japan |
| 544 </option> |
| 545 <option value="Jordan"> |
| 546 Jordan |
| 547 </option> |
| 548 <option value="Kazakhstan"> |
| 549 Kazakhstan |
| 550 </option> |
| 551 <option value="Kenya"> |
| 552 Kenya |
| 553 </option> |
| 554 <option value="Kiribati"> |
| 555 Kiribati |
| 556 </option> |
| 557 <option value="Kosrae"> |
| 558 Kosrae |
| 559 </option> |
| 560 <option value="Kuwait"> |
| 561 Kuwait |
| 562 </option> |
| 563 <option value="Kyrgyzstan"> |
| 564 Kyrgyzstan |
| 565 </option> |
| 566 <option value="Laos"> |
| 567 Laos |
| 568 </option> |
| 569 <option value="Latvia"> |
| 570 Latvia |
| 571 </option> |
| 572 <option value="Lebanon"> |
| 573 Lebanon |
| 574 </option> |
| 575 <option value="Lesotho"> |
| 576 Lesotho |
| 577 </option> |
| 578 <option value="Liberia"> |
| 579 Liberia |
| 580 </option> |
| 581 <option value="Liechtenstein"> |
| 582 Liechtenstein |
| 583 </option> |
| 584 <option value="Lithuania"> |
| 585 Lithuania |
| 586 </option> |
| 587 <option value="Luxembourg"> |
| 588 Luxembourg |
| 589 </option> |
| 590 <option value="Macau"> |
| 591 Macau |
| 592 </option> |
| 593 <option value="Macedonia"> |
| 594 Macedonia |
| 595 </option> |
| 596 <option value="Madagascar"> |
| 597 Madagascar |
| 598 </option> |
| 599 <option value="Madeira"> |
| 600 Madeira |
| 601 </option> |
| 602 <option value="Malawi"> |
| 603 Malawi |
| 604 </option> |
| 605 <option value="Malaysia"> |
| 606 Malaysia |
| 607 </option> |
| 608 <option value="Maldives"> |
| 609 Maldives |
| 610 </option> |
| 611 <option value="Mali"> |
| 612 Mali |
| 613 </option> |
| 614 <option value="Malta"> |
| 615 Malta |
| 616 </option> |
| 617 <option value="Marshall Islands"> |
| 618 Marshall Islands |
| 619 </option> |
| 620 <option value="Martinique"> |
| 621 Martinique |
| 622 </option> |
| 623 <option value="Mauritania"> |
| 624 Mauritania |
| 625 </option> |
| 626 <option value="Mauritius"> |
| 627 Mauritius |
| 628 </option> |
| 629 <option value="Mexico"> |
| 630 Mexico |
| 631 </option> |
| 632 <option value="Moldova"> |
| 633 Moldova |
| 634 </option> |
| 635 <option value="Monaco"> |
| 636 Monaco |
| 637 </option> |
| 638 <option value="Montserrat"> |
| 639 Montserrat |
| 640 </option> |
| 641 <option value="Morocco"> |
| 642 Morocco |
| 643 </option> |
| 644 <option value="Mozambique"> |
| 645 Mozambique |
| 646 </option> |
| 647 <option value="Myanmar"> |
| 648 Myanmar |
| 649 </option> |
| 650 <option value="Namibia"> |
| 651 Namibia |
| 652 </option> |
| 653 <option value="Nepal"> |
| 654 Nepal |
| 655 </option> |
| 656 <option value="Netherlands"> |
| 657 Netherlands |
| 658 </option> |
| 659 <option value="New Caledonia"> |
| 660 New Caledonia |
| 661 </option> |
| 662 <option value="New Zealand"> |
| 663 New Zealand |
| 664 </option> |
| 665 <option value="Nicaragua"> |
| 666 Nicaragua |
| 667 </option> |
| 668 <option value="Niger"> |
| 669 Niger |
| 670 </option> |
| 671 <option value="Nigeria"> |
| 672 Nigeria |
| 673 </option> |
| 674 <option value="Norfolk Island"> |
| 675 Norfolk Island |
| 676 </option> |
| 677 <option value="Northern Ireland"> |
| 678 Northern Ireland |
| 679 </option> |
| 680 <option value="Norway"> |
| 681 Norway |
| 682 </option> |
| 683 <option value="Oman"> |
| 684 Oman |
| 685 </option> |
| 686 <option value="Pakistan"> |
| 687 Pakistan |
| 688 </option> |
| 689 <option value="Palau"> |
| 690 Palau |
| 691 </option> |
| 692 <option value="Panama"> |
| 693 Panama |
| 694 </option> |
| 695 <option value="Papua New Guinea"> |
| 696 Papua New Guinea |
| 697 </option> |
| 698 <option value="Paraguay"> |
| 699 Paraguay |
| 700 </option> |
| 701 <option value="Peru"> |
| 702 Peru |
| 703 </option> |
| 704 <option value="Philippines"> |
| 705 Philippines |
| 706 </option> |
| 707 <option value="Poland"> |
| 708 Poland |
| 709 </option> |
| 710 <option value="Ponape"> |
| 711 Ponape |
| 712 </option> |
| 713 <option value="Portugal"> |
| 714 Portugal |
| 715 </option> |
| 716 <option value="Puerto Rico"> |
| 717 Puerto Rico |
| 718 </option> |
| 719 <option value="Qatar"> |
| 720 Qatar |
| 721 </option> |
| 722 <option value="Reunion"> |
| 723 Reunion |
| 724 </option> |
| 725 <option value="Romania"> |
| 726 Romania |
| 727 </option> |
| 728 <option value="Rota"> |
| 729 Rota |
| 730 </option> |
| 731 <option value="Russia"> |
| 732 Russia |
| 733 </option> |
| 734 <option value="Rwanda"> |
| 735 Rwanda |
| 736 </option> |
| 737 <option value="Saba"> |
| 738 Saba |
| 739 </option> |
| 740 <option value="Saipan"> |
| 741 Saipan |
| 742 </option> |
| 743 <option value="Saudi Arabia"> |
| 744 Saudi Arabia |
| 745 </option> |
| 746 <option value="Scotland"> |
| 747 Scotland |
| 748 </option> |
| 749 <option value="Senegal"> |
| 750 Senegal |
| 751 </option> |
| 752 <option value="Seychelles"> |
| 753 Seychelles |
| 754 </option> |
| 755 <option value="Sierra Leone"> |
| 756 Sierra Leone |
| 757 </option> |
| 758 <option value="Singapore"> |
| 759 Singapore |
| 760 </option> |
| 761 <option value="Slovakia"> |
| 762 Slovakia |
| 763 </option> |
| 764 <option value="Slovenia"> |
| 765 Slovenia |
| 766 </option> |
| 767 <option value="Solomon Islands"> |
| 768 Solomon Islands |
| 769 </option> |
| 770 <option value="South Africa"> |
| 771 South Africa |
| 772 </option> |
| 773 <option value="South Korea"> |
| 774 South Korea |
| 775 </option> |
| 776 <option value="Spain"> |
| 777 Spain |
| 778 </option> |
| 779 <option value="Sri Lanka"> |
| 780 Sri Lanka |
| 781 </option> |
| 782 <option value="St. Barthelemy"> |
| 783 St. Barthelemy |
| 784 </option> |
| 785 <option value="St. Christopher"> |
| 786 St. Christopher |
| 787 </option> |
| 788 <option value="St. Croix"> |
| 789 St. Croix |
| 790 </option> |
| 791 <option value="St. Eustatius"> |
| 792 St. Eustatius |
| 793 </option> |
| 794 <option value="St. John"> |
| 795 St. John |
| 796 </option> |
| 797 <option value="St. Lucia"> |
| 798 St. Lucia |
| 799 </option> |
| 800 <option value="St. Maarten"> |
| 801 St. Maarten |
| 802 </option> |
| 803 <option value="St. Martin"> |
| 804 St. Martin |
| 805 </option> |
| 806 <option value="St. Thomas"> |
| 807 St. Thomas |
| 808 </option> |
| 809 <option value="Sudan"> |
| 810 Sudan |
| 811 </option> |
| 812 <option value="Suriname"> |
| 813 Suriname |
| 814 </option> |
| 815 <option value="Swaziland"> |
| 816 Swaziland |
| 817 </option> |
| 818 <option value="Sweden"> |
| 819 Sweden |
| 820 </option> |
| 821 <option value="Switzerland"> |
| 822 Switzerland |
| 823 </option> |
| 824 <option value="Syria"> |
| 825 Syria |
| 826 </option> |
| 827 <option value="Tahiti"> |
| 828 Tahiti |
| 829 </option> |
| 830 <option value="Taiwan"> |
| 831 Taiwan |
| 832 </option> |
| 833 <option value="Tajikistan"> |
| 834 Tajikistan |
| 835 </option> |
| 836 <option value="Tanzania"> |
| 837 Tanzania |
| 838 </option> |
| 839 <option value="Thailand"> |
| 840 Thailand |
| 841 </option> |
| 842 <option value="Tinian"> |
| 843 Tinian |
| 844 </option> |
| 845 <option value="Togo"> |
| 846 Togo |
| 847 </option> |
| 848 <option value="Tonga"> |
| 849 Tonga |
| 850 </option> |
| 851 <option value="Tortola"> |
| 852 Tortola |
| 853 </option> |
| 854 <option value="Trinidad and Tobago"> |
| 855 Trinidad and Tobago |
| 856 </option> |
| 857 <option value="Truk"> |
| 858 Truk |
| 859 </option> |
| 860 <option value="Tunisia"> |
| 861 Tunisia |
| 862 </option> |
| 863 <option value="Turkey"> |
| 864 Turkey |
| 865 </option> |
| 866 <option value="Tuvalu"> |
| 867 Tuvalu |
| 868 </option> |
| 869 <option value="Uganda"> |
| 870 Uganda |
| 871 </option> |
| 872 <option value="Ukraine"> |
| 873 Ukraine |
| 874 </option> |
| 875 <option value="Union Island"> |
| 876 Union Island |
| 877 </option> |
| 878 <option value="United Arab Emirates"> |
| 879 United Arab Emirates |
| 880 </option> |
| 881 <option value="United Kingdom"> |
| 882 United Kingdom |
| 883 </option> |
| 884 <option value="United States" selected> |
| 885 United States |
| 886 </option> |
| 887 <option value="Uruguay"> |
| 888 Uruguay |
| 889 </option> |
| 890 <option value="US Virgin Islands"> |
| 891 US Virgin Islands |
| 892 </option> |
| 893 <option value="Uzbekistan"> |
| 894 Uzbekistan |
| 895 </option> |
| 896 <option value="Vanuatu"> |
| 897 Vanuatu |
| 898 </option> |
| 899 <option value="Venezuela"> |
| 900 Venezuela |
| 901 </option> |
| 902 <option value="Vietnam"> |
| 903 Vietnam |
| 904 </option> |
| 905 <option value="Virgin Gorda"> |
| 906 Virgin Gorda |
| 907 </option> |
| 908 <option value="Wake Island"> |
| 909 Wake Island |
| 910 </option> |
| 911 <option value="Wales"> |
| 912 Wales |
| 913 </option> |
| 914 <option value="Western Samoa"> |
| 915 Western Samoa |
| 916 </option> |
| 917 <option value="Yap"> |
| 918 Yap |
| 919 </option> |
| 920 <option value="Yemen"> |
| 921 Yemen |
| 922 </option> |
| 923 <option value="Zaire"> |
| 924 Zaire |
| 925 </option> |
| 926 <option value="Zambia"> |
| 927 Zambia |
| 928 </option> |
| 929 <option value="Zimbabwe"> |
| 930 Zimbabwe |
| 931 </option> |
| 932 </select><br> |
| 933 Telephone<br> |
| 934 <input name="dphone" value="" type="text" size="36" maxlength=
"20" tabindex="8"><br> |
| 935 Email <span>*</span><br> |
| 936 <input name="demail" value="" type="text" size="36" maxlength=
"155" tabindex="9"><br> |
| 937 <br> |
| 938 </div> |
| 939 </div> |
| 940 </td> |
| 941 <td> |
| 942 <div> |
| 943 <table border="0"> |
| 944 <tr> |
| 945 <td> |
| 946 <img src="#" alt="Number 2"> |
| 947 </td> |
| 948 <td valign="middle" width="350"> |
| 949 <div> |
| 950 Donation Information |
| 951 </div> |
| 952 </td> |
| 953 </tr> |
| 954 </table> |
| 955 <div> |
| 956 <b>Gift amount in USD <span>($10 minimum)</span><br> |
| 957 $<input name="amt" id="amt" type="text" value="" size="5" maxl
ength="25" tabindex="10">.00</b> |
| 958 <p> |
| 959 <input type="checkbox" name="tributeSelect" tabindex="11" va
lue="on"> My donation is In Honor or In Memory of someone special |
| 960 </p> |
| 961 <p> |
| 962 <!--<b>Donation Preference</b><br>--> |
| 963 <input name="DonationType" type="radio" value="OneTime" che
cked tabindex="12">This is a one time donation<br> |
| 964 <input name="DonationType" type="radio" value="Recurs" tabin
dex="13">I would like to make this a recurring donation deducted <select name="c
crecurring" tabindex="14"> |
| 965 <option value="Monthly"> |
| 966 Monthly |
| 967 </option> |
| 968 <option value="Quarterly"> |
| 969 Quarterly |
| 970 </option> |
| 971 <option value="Annually"> |
| 972 Annually |
| 973 </option> |
| 974 </select> |
| 975 </p> |
| 976 <p> |
| 977 <b>Comments</b><br> |
| 978 <span>( You may enter up to 500 characters. ) &nb
sp;<input value="500" name="remLen" size="3" maxlength="3" readonly="readonly">
characters left</span><br> |
| 979 <textarea name="Comments" rows="3" cols="45" wrap="physical"
onkeydown="textCounter(this.form.Comments,this.form.remLen,500);" onkeyup="text
Counter(this.form.Comments,this.form.remLen,500);" tabindex="17"> |
| 980 </textarea> |
| 981 </p> |
| 982 </div> |
| 983 </div> |
| 984 </td> |
| 985 </tr> |
| 986 <tr> |
| 987 <td colspan="2"> |
| 988 <div id="div_tribute" style='display: none;'><br> |
| 989 <table border="0"> |
| 990 <tr> |
| 991 <td width="20"> |
| 992 <img src="#"> |
| 993 </td> |
| 994 <td valign="middle" width="330"> |
| 995 <div> |
| 996 Tribute Information: |
| 997 </div> |
| 998 </td> |
| 999 </tr> |
| 1000 </table> |
| 1001 <div> |
| 1002 <table> |
| 1003 <tr> |
| 1004 <td> |
| 1005 <table> |
| 1006 <tr> |
| 1007 <td></td> |
| 1008 <td> |
| 1009 <input type="radio" name="tribute" value="IHO" tabin
dex="18">In Honor Of <input type="radio" name="tribute" value
="IMO" tabindex="19">In Memory Of |
| 1010 </td> |
| 1011 </tr> |
| 1012 <tr> |
| 1013 <td> |
| 1014 Name: |
| 1015 </td> |
| 1016 <td> |
| 1017 <input type="text" name="Tribute_Name" maxlength="10
0" size="35" value="" tabindex="20"> |
| 1018 </td> |
| 1019 </tr> |
| 1020 <tr> |
| 1021 <td> |
| 1022 Occasion: |
| 1023 </td> |
| 1024 <td> |
| 1025 <input type="text" name="Tribute_occasion" maxlength
="100" size="35" value="" tabindex="21"> |
| 1026 </td> |
| 1027 </tr> |
| 1028 <tr> |
| 1029 <td colspan="2" align="left"> |
| 1030 <input type="checkbox" name="Tribute_Disclosure" val
ue="on" tabindex="22">I wish to remain anonymous<br> |
| 1031 <input type="checkbox" name="Tribute_Notification" v
alue="on" tabindex="23">Please send a notification of my gift to the following a
ddress: |
| 1032 </td> |
| 1033 </tr> |
| 1034 </table> |
| 1035 </td> |
| 1036 <td> |
| 1037 <div id="div_notify" style='display: none;'> |
| 1038 <div> |
| 1039 <table> |
| 1040 <tr> |
| 1041 <td colspan="2" align="right"> |
| 1042 <input type="radio" name="Tribute_IncludeAmount" t
abindex="24" value="1">Include the amount <input type="radio" name=
"Tribute_IncludeAmount" checked tabindex="25" value="0">Do not include the amoun
t |
| 1043 </td> |
| 1044 </tr> |
| 1045 <tr> |
| 1046 <td> |
| 1047 Name: |
| 1048 </td> |
| 1049 <td> |
| 1050 <input type="text" name="Tribute_NotifyName" maxle
ngth="100" size="40" value="" tabindex="26"> |
| 1051 </td> |
| 1052 </tr> |
| 1053 <tr> |
| 1054 <td> |
| 1055 Email: |
| 1056 </td> |
| 1057 <td> |
| 1058 <input type="text" name="Tribute_Email" maxlength=
"50" size="40" value="" tabindex="27"> |
| 1059 </td> |
| 1060 </tr> |
| 1061 <tr> |
| 1062 <td> |
| 1063 Street: |
| 1064 </td> |
| 1065 <td> |
| 1066 <input type="text" name="Tribute_NotifyAddr" maxle
ngth="200" size="40" value="" tabindex="28"> |
| 1067 </td> |
| 1068 </tr> |
| 1069 <tr> |
| 1070 <td> |
| 1071 City / St. / Zip: |
| 1072 </td> |
| 1073 <td> |
| 1074 <input type="text" name="Tribute_NotifyCity" maxle
ngth="60" size="15" value="" tabindex="29"> <input type="text" name="Trib
ute_NotifyState" maxlength="10" size="2" value="" tabindex="30"> <input t
ype="text" name="Tribute_NotifyZip" maxlength="10" size="10" value="" tabindex="
31"> |
| 1075 </td> |
| 1076 </tr> |
| 1077 </table> |
| 1078 </div> |
| 1079 </td> |
| 1080 </tr> |
| 1081 </table> |
| 1082 </div><!-- End Hide Notify Div --> |
| 1083 <!-- End TributeBox Div --><!-- End Hide Tribute Div --> |
| 1084 </td> |
| 1085 </tr> |
| 1086 <tr> |
| 1087 <td colspan="2"> |
| 1088 <!-- ///PAYMENT BOX --> |
| 1089 <br> |
| 1090 <table border="0"> |
| 1091 <tr> |
| 1092 <td width="20"> |
| 1093 <div id="div_payment"> |
| 1094 <img src='images/icons/red4.png'> |
| 1095 </div> |
| 1096 <div id="div_paymentmain"> |
| 1097 <img src='images/icons/red3.png'> |
| 1098 </div> |
| 1099 </td> |
| 1100 <td valign="middle" width="330"> |
| 1101 <div> |
| 1102 Payment Information: |
| 1103 </div> |
| 1104 </td> |
| 1105 </tr> |
| 1106 </table> |
| 1107 <div> |
| 1108 <table> |
| 1109 <tr> |
| 1110 <td width="10"></td> |
| 1111 <td> |
| 1112 <p> |
| 1113 <b>Credit Card Information</b><br> |
| 1114 <img src="#"><br> |
| 1115 <br> |
| 1116 Credit Card Type <span>*</span><br> |
| 1117 <select name="cctype" tabindex="32"> |
| 1118 <option value="Visa"> |
| 1119 Visa |
| 1120 </option> |
| 1121 <option value="MasterCard"> |
| 1122 MasterCard |
| 1123 </option> |
| 1124 <option value="AmericanExpress"> |
| 1125 American Express |
| 1126 </option> |
| 1127 </select><br> |
| 1128 Credit Card Number <span>*</span><br> |
| 1129 <input name="ccard" type="text" value="" size="25" maxle
ngth="25" tabindex="32" autocomplete="off"><br> |
| 1130 CSC Number <span>* <a href="#">What Is This?</a></span><
br> |
| 1131 <input tabindex="33" name="csc" type="text" value="" siz
e="25" maxlength="4" autocomplete="off"><br> |
| 1132 Expiration Date <span>*</span><br> |
| 1133 Month <select name="ExpMon" tabindex="34"> |
| 1134 <option value="1"> |
| 1135 1 |
| 1136 </option> |
| 1137 <option value="2"> |
| 1138 2 |
| 1139 </option> |
| 1140 <option value="3"> |
| 1141 3 |
| 1142 </option> |
| 1143 <option value="4"> |
| 1144 4 |
| 1145 </option> |
| 1146 <option value="5"> |
| 1147 5 |
| 1148 </option> |
| 1149 <option value="6"> |
| 1150 6 |
| 1151 </option> |
| 1152 <option value="7"> |
| 1153 7 |
| 1154 </option> |
| 1155 <option value="8"> |
| 1156 8 |
| 1157 </option> |
| 1158 <option value="9"> |
| 1159 9 |
| 1160 </option> |
| 1161 <option value="10"> |
| 1162 10 |
| 1163 </option> |
| 1164 <option value="11"> |
| 1165 11 |
| 1166 </option> |
| 1167 <option value="12"> |
| 1168 12 |
| 1169 </option> |
| 1170 </select> Year <select name="ExpYear" size="1" tabindex=
"35"> |
| 1171 <option value="11"> |
| 1172 2011 |
| 1173 </option> |
| 1174 <option value="12"> |
| 1175 2012 |
| 1176 </option> |
| 1177 <option value="13"> |
| 1178 2013 |
| 1179 </option> |
| 1180 <option value="14"> |
| 1181 2014 |
| 1182 </option> |
| 1183 <option value="15"> |
| 1184 2015 |
| 1185 </option> |
| 1186 <option value="16"> |
| 1187 2016 |
| 1188 </option> |
| 1189 <option value="17"> |
| 1190 2017 |
| 1191 </option> |
| 1192 <option value="18"> |
| 1193 2018 |
| 1194 </option> |
| 1195 <option value="19"> |
| 1196 2019 |
| 1197 </option> |
| 1198 </select><br> |
| 1199 </p> |
| 1200 </td> |
| 1201 <td width="150"></td> |
| 1202 <td> |
| 1203 <p> |
| 1204 <b>Billing Address</b> - <input type="checkbox" name="Sa
meAddress" value="checkbox" tabindex="36">Same As Contact Address<br> |
| 1205 <br> |
| 1206 Address 1 <span>*</span><br> |
| 1207 <input name="CC_Addr" id="CC_Addr" value="" type="text"
size="36" maxlength="155" tabindex="37"><br> |
| 1208 Address 2<br> |
| 1209 <input name="CC_Addr2" id="CC_Addr2" type="text" value="
" size="36" maxlength="155" tabindex="38"><br> |
| 1210 City / State / Zip <span>*</span><br> |
| 1211 <input name="CC_City" id="CC_City" value="" type="text"
size="12" maxlength="60" tabindex="39"> <input name="CC_State" id="CC_Sta
te" value="" type="text" size="2" maxlength="10" tabindex="40"> <input na
me="CC_Zip" id="CC_Zip" value="" type="text" size="10" maxlength="10" tabindex="
41"> |
| 1212 </p> |
| 1213 <p> |
| 1214 <b>Thank you for your support!</b> |
| 1215 </p> |
| 1216 <p> |
| 1217 <input type="image" src="#" name="Action" value="Submit"
tabindex="42"> |
| 1218 </p> |
| 1219 </td> |
| 1220 </tr> |
| 1221 </table> |
| 1222 </div><!-- End Payment Box div --> |
| 1223 </td> |
| 1224 </tr> |
| 1225 </table> |
| 1226 </form> |
| 1227 </td> |
| 1228 </tr> |
| 1229 </table> |
| OLD | NEW |
|---|
Chromium Code Reviews
Issue 7531023:
Improve Autofill heuristics when detecting labels from previous elements. (Closed)
Base URL: svn://svn.chromium.org/chrome/trunk/src