chrome/test/data/autofill/heuristics/input/16_crbug_87517.html - Issue 7531023: Improve Autofill heuristics when detecting labels from previous elements.

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Issue 7531023: Improve Autofill heuristics when detecting labels from previous elements. (Closed) Base URL: svn://svn.chromium.org/chrome/trunk/src

Patch Set: Address review comments Created 9 years, 5 months ago

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Index: chrome/test/data/autofill/heuristics/input/16_crbug_87517.html

diff --git a/chrome/test/data/autofill/heuristics/input/16_crbug_87517.html b/chrome/test/data/autofill/heuristics/input/16_crbug_87517.html

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index 0000000000000000000000000000000000000000..e33cbe3bc282aa0f4a05f3a844b657fd11b9909b

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@@ -0,0 +1,1229 @@

+

+<table align="center" id="btable" width="810">

+ <tr>

+ <td valign="top" align="center" id="btable">

+ <h1>

+ MATHCOUNTS Foundation

+ </h1>

+ <h2>

+ Online Donation Form

+ </h2>

+ </td>

+ </tr>

+ <tr>

+ <td></td>

+ </tr>

+ <tr>

+ <td>

+ <form name="donation" method="post" id="donation">

+

+ <input type="hidden" name="IsSubmitted" value="Yes"> <input type="hidden" name="BaseURL" value=""> <span>

+ <textarea name="f1" id="f1" value="" rows="2" cols="3">

+</textarea></span>

+ <table border="0">

+ <tr>

+ <td width="310">

+ <table>

+ <tr>

+ <td width="20">

+ <img src="#">

+ </td>

+ <td valign="middle" width="330">

+ <div>

+ Contact Information

+ </div>

+ </td>

+ </tr>

+ </table>

+ <div>

+ Name <span>*</span><br>

+ <input name="dnrfirst" value="" type="text" size="15" maxlength="50" tabindex="1"> <input name="dnrlast" value="" type="text" size="15" maxlength="50" tabindex="2"><br>

+ Company<br>

+ <input name="company" value="" type="text" size="36" maxlength="100" tabindex="3"><br>

+ Address 1 <span>*</span><br>

+ <input name="dadd1" id="dadd1" value="" type="text" size="36" maxlength="155" tabindex="4" autocomplete="off"><br>

+ Address 2<br>

+ <input name="dadd2" id="dadd2" type="text" value="" size="36" maxlength="155" tabindex="5"><br>

+ City / State / Zip <span>*</span><br>

+ <input name="dcity" id="dcity" value="" type="text" size="12" maxlength="60" tabindex="6">   <select name="dstate" id="dstate" tabindex="6">

+ <option id="USA-AL" value="AL">

+ AL

+ </option>

+ <option id="USA-AK" value="AK">

+ AK

+ </option>

+ <option id="USA-AZ" value="AZ">

+ AZ

+ </option>

+ <option id="USA-AR" value="AR">

+ AR

+ </option>

+ <option id="USA-CA" value="CA">

+ CA

+ </option>

+ <option id="USA-CO" value="CO">

+ CO

+ </option>

+ <option id="USA-CT" value="CT">

+ CT

+ </option>

+ <option id="USA-DE" value="DE">

+ DE

+ </option>

+ <option id="USA-DC" value="DC">

+ DC

+ </option>

+ <option id="USA-FL" value="FL">

+ FL

+ </option>

+ <option id="USA-GA" value="GA">

+ GA

+ </option>

+ <option id="USA-GU" value="GU">

+ GU

+ </option>

+ <option id="USA-HI" value="HI">

+ HI

+ </option>

+ <option id="USA-ID" value="ID">

+ ID

+ </option>

+ <option id="USA-IL" value="IL">

+ IL

+ </option>

+ <option id="USA-IN" value="IN">

+ IN

+ </option>

+ <option id="USA-IA" value="IA">

+ IA

+ </option>

+ <option id="USA-KS" value="KS">

+ KS

+ </option>

+ <option id="USA-KY" value="KY">

+ KY

+ </option>

+ <option id="USA-LA" value="LA">

+ LA

+ </option>

+ <option id="USA-ME" value="ME">

+ ME

+ </option>

+ <option id="USA-MD" value="MD">

+ MD

+ </option>

+ <option id="USA-MA" value="MA">

+ MA

+ </option>

+ <option id="USA-MI" value="MI">

+ MI

+ </option>

+ <option id="USA-MN" value="MN">

+ MN

+ </option>

+ <option id="USA-MS" value="MS">

+ MS

+ </option>

+ <option id="USA-MO" value="MO">

+ MO

+ </option>

+ <option id="USA-MT" value="MT">

+ MT

+ </option>

+ <option id="USA-NE" value="NE">

+ NE

+ </option>

+ <option id="USA-NV" value="NV">

+ NV

+ </option>

+ <option id="USA-NH" value="NH">

+ NH

+ </option>

+ <option id="USA-NJ" value="NJ">

+ NJ

+ </option>

+ <option id="USA-NM" value="NM">

+ NM

+ </option>

+ <option id="USA-NY" value="NY">

+ NY

+ </option>

+ <option id="USA-NC" value="NC">

+ NC

+ </option>

+ <option id="USA-ND" value="ND">

+ ND

+ </option>

+ <option id="USA-OH" value="OH">

+ OH

+ </option>

+ <option id="USA-OK" value="OK">

+ OK

+ </option>

+ <option id="USA-OR" value="OR">

+ OR

+ </option>

+ <option id="USA-PA" value="PA">

+ PA

+ </option>

+ <option id="USA-PR" value="PR">

+ PR

+ </option>

+ <option id="USA-RI" value="RI">

+ RI

+ </option>

+ <option id="USA-SC" value="SC">

+ SC

+ </option>

+ <option id="USA-SD" value="SD">

+ SD

+ </option>

+ <option id="USA-TN" value="TN">

+ TN

+ </option>

+ <option id="USA-TX" value="TX">

+ TX

+ </option>

+ <option id="USA-UT" value="UT">

+ UT

+ </option>

+ <option id="USA-VT" value="VT">

+ VT

+ </option>

+ <option id="USA-VA" value="VA">

+ VA

+ </option>

+ <option id="USA-VI" value="VI">

+ VI

+ </option>

+ <option id="USA-WA" value="WA">

+ WA

+ </option>

+ <option id="USA-WV" value="WV">

+ WV

+ </option>

+ <option id="USA-WI" value="WI">

+ WI

+ </option>

+ <option id="USA-WY" value="WY">

+ WY

+ </option>

+ <option>

+ ----

+ </option>

+ <option id="CAN-AB" value="AB">

+ AB

+ </option>

+ <option id="CAN-BC" value="BC">

+ BC

+ </option>

+ <option id="CAN-MB" value="MB">

+ MB

+ </option>

+ <option id="CAN-NB" value="NB">

+ NB

+ </option>

+ <option id="CAN-NL" value="NL">

+ NL

+ </option>

+ <option id="CAN-NT" value="NT">

+ NT

+ </option>

+ <option id="CAN-NS" value="NS">

+ NS

+ </option>

+ <option id="CAN-NU" value="NU">

+ NU

+ </option>

+ <option id="CAN-PE" value="PE">

+ PE

+ </option>

+ <option id="CAN-SK" value="SK">

+ SK

+ </option>

+ <option id="CAN-ON" value="ON">

+ ON

+ </option>

+ <option id="CAN-QC" value="QC">

+ QC

+ </option>

+ <option id="CAN-YT" value="YT">

+ YT

+ </option>

+ <option>

+ ----

+ </option>

+ <option id="OS-AA" value="AA">

+ AA

+ </option>

+ <option id="OS-AE" value="AE">

+ AE

+ </option>

+ <option id="OS-AP" value="AP">

+ AP

+ </option>

+ </select>   <input name="dzip" id="dzip" value="" type="text" size="8" maxlength="10" tabindex="7"><br>

+ Country<br>

+ <select name="CC_COUNTRY">

+ <option value="Albania">

+ Albania

+ </option>

+ <option value="Algeria">

+ Algeria

+ </option>

+ <option value="American Samoa">

+ American Samoa

+ </option>

+ <option value="Andorra">

+ Andorra

+ </option>

+ <option value="Anguilla">

+ Anguilla

+ </option>

+ <option value="Antigua">

+ Antigua

+ </option>

+ <option value="Argentina">

+ Argentina

+ </option>

+ <option value="Aruba">

+ Aruba

+ </option>

+ <option value="Australia">

+ Australia

+ </option>

+ <option value="Austria">

+ Austria

+ </option>

+ <option value="Azores">

+ Azores

+ </option>

+ <option value="Bahamas">

+ Bahamas

+ </option>

+ <option value="Bahrain">

+ Bahrain

+ </option>

+ <option value="Bangladesh">

+ Bangladesh

+ </option>

+ <option value="Barbados">

+ Barbados

+ </option>

+ <option value="Belgium">

+ Belgium

+ </option>

+ <option value="Belize">

+ Belize

+ </option>

+ <option value="Belarus">

+ Belarus

+ </option>

+ <option value="Benin">

+ Benin

+ </option>

+ <option value="Bermuda">

+ Bermuda

+ </option>

+ <option value="Bolivia">

+ Bolivia

+ </option>

+ <option value="Bonaire">

+ Bonaire

+ </option>

+ <option value="Botswana">

+ Botswana

+ </option>

+ <option value="Brazil">

+ Brazil

+ </option>

+ <option value="Brunei">

+ Brunei

+ </option>

+ <option value="Bulgaria">

+ Bulgaria

+ </option>

+ <option value="Burkina Faso">

+ Burkina Faso

+ </option>

+ <option value="Burundi">

+ Burundi

+ </option>

+ <option value="Cambodia">

+ Cambodia

+ </option>

+ <option value="Cameroon">

+ Cameroon

+ </option>

+ <option value="Canada">

+ Canada

+ </option>

+ <option value="Canary Islands">

+ Canary Islands

+ </option>

+ <option value="Cape Verde Islands">

+ Cape Verde Islands

+ </option>

+ <option value="Cayman Islands">

+ Cayman Islands

+ </option>

+ <option value="Channel Islands">

+ Channel Islands

+ </option>

+ <option value="Chile">

+ Chile

+ </option>

+ <option value="China">

+ China

+ </option>

+ <option value="Colombia">

+ Colombia

+ </option>

+ <option value="Congo">

+ Congo

+ </option>

+ <option value="Cook Islands">

+ Cook Islands

+ </option>

+ <option value="Costa Rica">

+ Costa Rica

+ </option>

+ <option value="Croatia">

+ Croatia

+ </option>

+ <option value="Curacao">

+ Curacao

+ </option>

+ <option value="Cyprus">

+ Cyprus

+ </option>

+ <option value="Czech Republic">

+ Czech Republic

+ </option>

+ <option value="Denmark">

+ Denmark

+ </option>

+ <option value="Djibouti">

+ Djibouti

+ </option>

+ <option value="Dominica">

+ Dominica

+ </option>

+ <option value="Dominican Republic">

+ Dominican Republic

+ </option>

+ <option value="Ecuador">

+ Ecuador

+ </option>

+ <option value="Egypt">

+ Egypt

+ </option>

+ <option value="El Salvador">

+ El Salvador

+ </option>

+ <option value="England">

+ England

+ </option>

+ <option value="Equitorial Guinea">

+ Equitorial Guinea

+ </option>

+ <option value="Eritrea">

+ Eritrea

+ </option>

+ <option value="Estonia">

+ Estonia

+ </option>

+ <option value="Ethiopia">

+ Ethiopia

+ </option>

+ <option value="Faeroe Islands">

+ Faeroe Islands

+ </option>

+ <option value="Fiji">

+ Fiji

+ </option>

+ <option value="Finland">

+ Finland

+ </option>

+ <option value="France">

+ France

+ </option>

+ <option value="French Guiana">

+ French Guiana

+ </option>

+ <option value="French Polynesia">

+ French Polynesia

+ </option>

+ <option value="Gabon">

+ Gabon

+ </option>

+ <option value="Gambia">

+ Gambia

+ </option>

+ <option value="Georgia">

+ Georgia

+ </option>

+ <option value="Germany">

+ Germany

+ </option>

+ <option value="Ghana">

+ Ghana

+ </option>

+ <option value="Gibraltar">

+ Gibraltar

+ </option>

+ <option value="Greece">

+ Greece

+ </option>

+ <option value="Greenland">

+ Greenland

+ </option>

+ <option value="Grenada">

+ Grenada

+ </option>

+ <option value="Guadeloupe">

+ Guadeloupe

+ </option>

+ <option value="Guam">

+ Guam

+ </option>

+ <option value="Guatemala">

+ Guatemala

+ </option>

+ <option value="Guinea">

+ Guinea

+ </option>

+ <option value="Guinea-Bissau">

+ Guinea-Bissau

+ </option>

+ <option value="Guyana">

+ Guyana

+ </option>

+ <option value="Haiti">

+ Haiti

+ </option>

+ <option value="Holland">

+ Holland

+ </option>

+ <option value="Honduras">

+ Honduras

+ </option>

+ <option value="Hong Kong">

+ Hong Kong

+ </option>

+ <option value="Hungary">

+ Hungary

+ </option>

+ <option value="Iceland">

+ Iceland

+ </option>

+ <option value="India">

+ India

+ </option>

+ <option value="Indonesia">

+ Indonesia

+ </option>

+ <option value="Ireland">

+ Ireland

+ </option>

+ <option value="Israel">

+ Israel

+ </option>

+ <option value="Italy">

+ Italy

+ </option>

+ <option value="Ivory Coast">

+ Ivory Coast

+ </option>

+ <option value="Jamaica">

+ Jamaica

+ </option>

+ <option value="Japan">

+ Japan

+ </option>

+ <option value="Jordan">

+ Jordan

+ </option>

+ <option value="Kazakhstan">

+ Kazakhstan

+ </option>

+ <option value="Kenya">

+ Kenya

+ </option>

+ <option value="Kiribati">

+ Kiribati

+ </option>

+ <option value="Kosrae">

+ Kosrae

+ </option>

+ <option value="Kuwait">

+ Kuwait

+ </option>

+ <option value="Kyrgyzstan">

+ Kyrgyzstan

+ </option>

+ <option value="Laos">

+ Laos

+ </option>

+ <option value="Latvia">

+ Latvia

+ </option>

+ <option value="Lebanon">

+ Lebanon

+ </option>

+ <option value="Lesotho">

+ Lesotho

+ </option>

+ <option value="Liberia">

+ Liberia

+ </option>

+ <option value="Liechtenstein">

+ Liechtenstein

+ </option>

+ <option value="Lithuania">

+ Lithuania

+ </option>

+ <option value="Luxembourg">

+ Luxembourg

+ </option>

+ <option value="Macau">

+ Macau

+ </option>

+ <option value="Macedonia">

+ Macedonia

+ </option>

+ <option value="Madagascar">

+ Madagascar

+ </option>

+ <option value="Madeira">

+ Madeira

+ </option>

+ <option value="Malawi">

+ Malawi

+ </option>

+ <option value="Malaysia">

+ Malaysia

+ </option>

+ <option value="Maldives">

+ Maldives

+ </option>

+ <option value="Mali">

+ Mali

+ </option>

+ <option value="Malta">

+ Malta

+ </option>

+ <option value="Marshall Islands">

+ Marshall Islands

+ </option>

+ <option value="Martinique">

+ Martinique

+ </option>

+ <option value="Mauritania">

+ Mauritania

+ </option>

+ <option value="Mauritius">

+ Mauritius

+ </option>

+ <option value="Mexico">

+ Mexico

+ </option>

+ <option value="Moldova">

+ Moldova

+ </option>

+ <option value="Monaco">

+ Monaco

+ </option>

+ <option value="Montserrat">

+ Montserrat

+ </option>

+ <option value="Morocco">

+ Morocco

+ </option>

+ <option value="Mozambique">

+ Mozambique

+ </option>

+ <option value="Myanmar">

+ Myanmar

+ </option>

+ <option value="Namibia">

+ Namibia

+ </option>

+ <option value="Nepal">

+ Nepal

+ </option>

+ <option value="Netherlands">

+ Netherlands

+ </option>

+ <option value="New Caledonia">

+ New Caledonia

+ </option>

+ <option value="New Zealand">

+ New Zealand

+ </option>

+ <option value="Nicaragua">

+ Nicaragua

+ </option>

+ <option value="Niger">

+ Niger

+ </option>

+ <option value="Nigeria">

+ Nigeria

+ </option>

+ <option value="Norfolk Island">

+ Norfolk Island

+ </option>

+ <option value="Northern Ireland">

+ Northern Ireland

+ </option>

+ <option value="Norway">

+ Norway

+ </option>

+ <option value="Oman">

+ Oman

+ </option>

+ <option value="Pakistan">

+ Pakistan

+ </option>

+ <option value="Palau">

+ Palau

+ </option>

+ <option value="Panama">

+ Panama

+ </option>

+ <option value="Papua New Guinea">

+ Papua New Guinea

+ </option>

+ <option value="Paraguay">

+ Paraguay

+ </option>

+ <option value="Peru">

+ Peru

+ </option>

+ <option value="Philippines">

+ Philippines

+ </option>

+ <option value="Poland">

+ Poland

+ </option>

+ <option value="Ponape">

+ Ponape

+ </option>

+ <option value="Portugal">

+ Portugal

+ </option>

+ <option value="Puerto Rico">

+ Puerto Rico

+ </option>

+ <option value="Qatar">

+ Qatar

+ </option>

+ <option value="Reunion">

+ Reunion

+ </option>

+ <option value="Romania">

+ Romania

+ </option>

+ <option value="Rota">

+ Rota

+ </option>

+ <option value="Russia">

+ Russia

+ </option>

+ <option value="Rwanda">

+ Rwanda

+ </option>

+ <option value="Saba">

+ Saba

+ </option>

+ <option value="Saipan">

+ Saipan

+ </option>

+ <option value="Saudi Arabia">

+ Saudi Arabia

+ </option>

+ <option value="Scotland">

+ Scotland

+ </option>

+ <option value="Senegal">

+ Senegal

+ </option>

+ <option value="Seychelles">

+ Seychelles

+ </option>

+ <option value="Sierra Leone">

+ Sierra Leone

+ </option>

+ <option value="Singapore">

+ Singapore

+ </option>

+ <option value="Slovakia">

+ Slovakia

+ </option>

+ <option value="Slovenia">

+ Slovenia

+ </option>

+ <option value="Solomon Islands">

+ Solomon Islands

+ </option>

+ <option value="South Africa">

+ South Africa

+ </option>

+ <option value="South Korea">

+ South Korea

+ </option>

+ <option value="Spain">

+ Spain

+ </option>

+ <option value="Sri Lanka">

+ Sri Lanka

+ </option>

+ <option value="St. Barthelemy">

+ St. Barthelemy

+ </option>

+ <option value="St. Christopher">

+ St. Christopher

+ </option>

+ <option value="St. Croix">

+ St. Croix

+ </option>

+ <option value="St. Eustatius">

+ St. Eustatius

+ </option>

+ <option value="St. John">

+ St. John

+ </option>

+ <option value="St. Lucia">

+ St. Lucia

+ </option>

+ <option value="St. Maarten">

+ St. Maarten

+ </option>

+ <option value="St. Martin">

+ St. Martin

+ </option>

+ <option value="St. Thomas">

+ St. Thomas

+ </option>

+ <option value="Sudan">

+ Sudan

+ </option>

+ <option value="Suriname">

+ Suriname

+ </option>

+ <option value="Swaziland">

+ Swaziland

+ </option>

+ <option value="Sweden">

+ Sweden

+ </option>

+ <option value="Switzerland">

+ Switzerland

+ </option>

+ <option value="Syria">

+ Syria

+ </option>

+ <option value="Tahiti">

+ Tahiti

+ </option>

+ <option value="Taiwan">

+ Taiwan

+ </option>

+ <option value="Tajikistan">

+ Tajikistan

+ </option>

+ <option value="Tanzania">

+ Tanzania

+ </option>

+ <option value="Thailand">

+ Thailand

+ </option>

+ <option value="Tinian">

+ Tinian

+ </option>

+ <option value="Togo">

+ Togo

+ </option>

+ <option value="Tonga">

+ Tonga

+ </option>

+ <option value="Tortola">

+ Tortola

+ </option>

+ <option value="Trinidad and Tobago">

+ Trinidad and Tobago

+ </option>

+ <option value="Truk">

+ Truk

+ </option>

+ <option value="Tunisia">

+ Tunisia

+ </option>

+ <option value="Turkey">

+ Turkey

+ </option>

+ <option value="Tuvalu">

+ Tuvalu

+ </option>

+ <option value="Uganda">

+ Uganda

+ </option>

+ <option value="Ukraine">

+ Ukraine

+ </option>

+ <option value="Union Island">

+ Union Island

+ </option>

+ <option value="United Arab Emirates">

+ United Arab Emirates

+ </option>

+ <option value="United Kingdom">

+ United Kingdom

+ </option>

+ <option value="United States" selected>

+ United States

+ </option>

+ <option value="Uruguay">

+ Uruguay

+ </option>

+ <option value="US Virgin Islands">

+ US Virgin Islands

+ </option>

+ <option value="Uzbekistan">

+ Uzbekistan

+ </option>

+ <option value="Vanuatu">

+ Vanuatu

+ </option>

+ <option value="Venezuela">

+ Venezuela

+ </option>

+ <option value="Vietnam">

+ Vietnam

+ </option>

+ <option value="Virgin Gorda">

+ Virgin Gorda

+ </option>

+ <option value="Wake Island">

+ Wake Island

+ </option>

+ <option value="Wales">

+ Wales

+ </option>

+ <option value="Western Samoa">

+ Western Samoa

+ </option>

+ <option value="Yap">

+ Yap

+ </option>

+ <option value="Yemen">

+ Yemen

+ </option>

+ <option value="Zaire">

+ Zaire

+ </option>

+ <option value="Zambia">

+ Zambia

+ </option>

+ <option value="Zimbabwe">

+ Zimbabwe

+ </option>

+ </select><br>

+ Telephone<br>

+ <input name="dphone" value="" type="text" size="36" maxlength="20" tabindex="8"><br>

+ Email <span>*</span><br>

+ <input name="demail" value="" type="text" size="36" maxlength="155" tabindex="9"><br>

+ <br>

+ </div>

+ </td>

+ <td>

+ <div>

+ <table border="0">

+ <tr>

+ <td>

+ <img src="#" alt="Number 2">

+ </td>

+ <td valign="middle" width="350">

+ <div>

+  Donation Information

+ </div>

+ </td>

+ </tr>

+ </table>

+ <div>

+ <b>Gift amount in USD <span>($10 minimum)</span><br>

+ $<input name="amt" id="amt" type="text" value="" size="5" maxlength="25" tabindex="10">.00</b>

+ <p>

+ <input type="checkbox" name="tributeSelect" tabindex="11" value="on"> My donation is In Honor or In Memory of someone special

+ </p>

+ <p>

+

+ <input name="DonationType" type="radio" value="OneTime" checked tabindex="12">This is a one time donation<br>

+ <input name="DonationType" type="radio" value="Recurs" tabindex="13">I would like to make this a recurring donation deducted <select name="ccrecurring" tabindex="14">

+ <option value="Monthly">

+ Monthly

+ </option>

+ <option value="Quarterly">

+ Quarterly

+ </option>

+ <option value="Annually">

+ Annually

+ </option>

+ </select>

+ </p>

+ <p>

+ <b>Comments</b><br>

+ <span>( You may enter up to 500 characters. )   <input value="500" name="remLen" size="3" maxlength="3" readonly="readonly"> characters left</span><br>

+ <textarea name="Comments" rows="3" cols="45" wrap="physical" onkeydown="textCounter(this.form.Comments,this.form.remLen,500);" onkeyup="textCounter(this.form.Comments,this.form.remLen,500);" tabindex="17">

+</textarea>

+ </p>

+ </div>

+ </td>

+ </tr>

+ <tr>

+ <td colspan="2">

+ <div id="div_tribute" style='display: none;'><br>

+ <table border="0">

+ <tr>

+ <td width="20">

+ <img src="#">

+ </td>

+ <td valign="middle" width="330">

+ <div>

+ Tribute Information:

+ </div>

+ </td>

+ </tr>

+ </table>

+ <div>

+ <table>

+ <tr>

+ <td>

+ <table>

+ <tr>

+ <td></td>

+ <td>

+ <input type="radio" name="tribute" value="IHO" tabindex="18">In Honor Of     <input type="radio" name="tribute" value="IMO" tabindex="19">In Memory Of

+ </td>

+ </tr>

+ <tr>

+ <td>

+ Name:

+ </td>

+ <td>

+ <input type="text" name="Tribute_Name" maxlength="100" size="35" value="" tabindex="20">

+ </td>

+ </tr>

+ <tr>

+ <td>

+ Occasion:

+ </td>

+ <td>

+ <input type="text" name="Tribute_occasion" maxlength="100" size="35" value="" tabindex="21">

+ </td>

+ </tr>

+ <tr>

+ <td colspan="2" align="left">

+ <input type="checkbox" name="Tribute_Disclosure" value="on" tabindex="22">I wish to remain anonymous<br>

+ <input type="checkbox" name="Tribute_Notification" value="on" tabindex="23">Please send a notification of my gift to the following address:

+ </td>

+ </tr>

+ </table>

+ </td>

+ <td>

+ <div id="div_notify" style='display: none;'>

+ <div>

+ <table>

+ <tr>

+ <td colspan="2" align="right">

+ <input type="radio" name="Tribute_IncludeAmount" tabindex="24" value="1">Include the amount    <input type="radio" name="Tribute_IncludeAmount" checked tabindex="25" value="0">Do not include the amount

+ </td>

+ </tr>

+ <tr>

+ <td>

+ Name:

+ </td>

+ <td>

+ <input type="text" name="Tribute_NotifyName" maxlength="100" size="40" value="" tabindex="26">

+ </td>

+ </tr>

+ <tr>

+ <td>

+ Email:

+ </td>

+ <td>

+ <input type="text" name="Tribute_Email" maxlength="50" size="40" value="" tabindex="27">

+ </td>

+ </tr>

+ <tr>

+ <td>

+ Street:

+ </td>

+ <td>

+ <input type="text" name="Tribute_NotifyAddr" maxlength="200" size="40" value="" tabindex="28">

+ </td>

+ </tr>

+ <tr>

+ <td>

+ City / St. / Zip:

+ </td>

+ <td>

+ <input type="text" name="Tribute_NotifyCity" maxlength="60" size="15" value="" tabindex="29">   <input type="text" name="Tribute_NotifyState" maxlength="10" size="2" value="" tabindex="30">   <input type="text" name="Tribute_NotifyZip" maxlength="10" size="10" value="" tabindex="31">

+ </td>

+ </tr>

+ </table>

+ </div>

+ </td>

+ </tr>

+ </table>

+ </div>

+

+ </td>

+ </tr>

+ <tr>

+ <td colspan="2">

+

+ <br>

+ <table border="0">

+ <tr>

+ <td width="20">

+ <div id="div_payment">

+ <img src='images/icons/red4.png'>

+ </div>

+ <div id="div_paymentmain">

+ <img src='images/icons/red3.png'>

+ </div>

+ </td>

+ <td valign="middle" width="330">

+ <div>

+ Payment Information:

+ </div>

+ </td>

+ </tr>

+ </table>

+ <div>

+ <table>

+ <tr>

+ <td width="10"></td>

+ <td>

+ <p>

+ <b>Credit Card Information</b><br>

+ <img src="#"><br>

+ <br>

+ Credit Card Type <span>*</span><br>

+ <select name="cctype" tabindex="32">

+ <option value="Visa">

+ Visa

+ </option>

+ <option value="MasterCard">

+ MasterCard

+ </option>

+ <option value="AmericanExpress">

+ American Express

+ </option>

+ </select><br>

+ Credit Card Number <span>*</span><br>

+ <input name="ccard" type="text" value="" size="25" maxlength="25" tabindex="32" autocomplete="off"><br>

+ CSC Number <span>* <a href="#">What Is This?</a></span><br>

+ <input tabindex="33" name="csc" type="text" value="" size="25" maxlength="4" autocomplete="off"><br>

+ Expiration Date <span>*</span><br>

+ Month <select name="ExpMon" tabindex="34">

+ <option value="1">

+ 1

+ </option>

+ <option value="2">

+ 2

+ </option>

+ <option value="3">

+ 3

+ </option>

+ <option value="4">

+ 4

+ </option>

+ <option value="5">

+ 5

+ </option>

+ <option value="6">

+ 6

+ </option>

+ <option value="7">

+ 7

+ </option>

+ <option value="8">

+ 8

+ </option>

+ <option value="9">

+ 9

+ </option>

+ <option value="10">

+ 10

+ </option>

+ <option value="11">

+ 11

+ </option>

+ <option value="12">

+ 12

+ </option>

+ </select> Year <select name="ExpYear" size="1" tabindex="35">

+ <option value="11">

+ 2011

+ </option>

+ <option value="12">

+ 2012

+ </option>

+ <option value="13">

+ 2013

+ </option>

+ <option value="14">

+ 2014

+ </option>

+ <option value="15">

+ 2015

+ </option>

+ <option value="16">

+ 2016

+ </option>

+ <option value="17">

+ 2017

+ </option>

+ <option value="18">

+ 2018

+ </option>

+ <option value="19">

+ 2019

+ </option>

+ </select><br>

+ </p>

+ </td>

+ <td width="150"></td>

+ <td>

+ <p>

+ <b>Billing Address</b> - <input type="checkbox" name="SameAddress" value="checkbox" tabindex="36">Same As Contact Address<br>

+ <br>

+ Address 1 <span>*</span><br>

+ <input name="CC_Addr" id="CC_Addr" value="" type="text" size="36" maxlength="155" tabindex="37"><br>

+ Address 2<br>

+ <input name="CC_Addr2" id="CC_Addr2" type="text" value="" size="36" maxlength="155" tabindex="38"><br>

+ City / State / Zip <span>*</span><br>

+ <input name="CC_City" id="CC_City" value="" type="text" size="12" maxlength="60" tabindex="39">   <input name="CC_State" id="CC_State" value="" type="text" size="2" maxlength="10" tabindex="40">   <input name="CC_Zip" id="CC_Zip" value="" type="text" size="10" maxlength="10" tabindex="41">

+ </p>

+ <p>

+ <b>Thank you for your support!</b>

+ </p>

+ <p>

+ <input type="image" src="#" name="Action" value="Submit" tabindex="42">

+ </p>

+ </td>

+ </tr>

+ </table>

+ </div>

+ </td>

+ </tr>

+ </table>

+ </form>

+ </td>

+ </tr>

+</table>

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