{% if page.headline.size > 0 %}
{% endif %}
{% if page.donation_v2.content.size > 0 %}
{% endif %}
{{ page.headline }}
{{ page.donation_v2.content }}
{% if page.donations_count < 1 %}
{% else %}
{% endif %}
{% elsif page.donation_v2.has_donor_goal? %}
{% if page.donors_count < 2 %}
{% else %}
{% endif %}
{% endif %}
{% form_for donation %}
{% error_messages_for donation %}
{% if page.donation_v2.has_merchant_account? == false %}
No bank account: This page will not work until you add a bank account
Testing mode: Transactions will not be processed. Use your regular credit card to test, you will not actually be charged.
{% if request.current_order %}
{% else %}
{% endif %}
Your order
-
{% for item in request.current_order.items %}
- {% if item.num_time_periods and item.time_period_type %} {{ item.quantity }} {{ item.name }} @ {{ item.amount }} - billed automatically every {{ item.num_time_periods }} {{item.time_period_type }} {% else %} {{ item.quantity }} {{ item.name }} @ {{ item.amount }} {% endif %} {% endfor %}
Amount
{% if page.donation_v2.amount_in_cents != 0 %}
{% endif %}
{{ page.donation_v2.amount_formatted }}
{% else %}{{ page.donation_v2.form_amount_options }}
{% endif %}
{% if page.donation_v2.accepts_variable_amounts? or page.donation_v2.donation_frequency == "any" %}
{% endif %}
{% if page.donation_v2.donation_frequency == "monthly" %}
Paid monthly
Pay With
{% if page.donation_v2.express_payment_activated? %}
{% endif %}
If you use Apple Pay, your confirmation prompt may refer to our processor, "NationBuilder"
You're almost done! Submit {% if request.current_order %}payment {% else %}donation {% endif %}below.
Payment method information has been saved. Change payment method
{% payment_field 'card' %}
Your Information
{% email_field "email", class:"text form-control" %}
{% text_field "first_name", class:"text form-control" %}
{% text_field "last_name", class:"text form-control" %}
{% phone_field "billing_address.phone_number", class:"text form-control" %}
Edit ,
{% collection_select "billing_address.country_code", page.donation_v2.countries, "code", "name", class:"select form-control" %}
{% text_field "billing_address.address1", class:"text form-control" %}
{% text_field "billing_address.address2", class:"text form-control" %}
{% text_field "billing_address.address3", class:"text not-us-or-canada hide form-control" %}
{% text_field "billing_address.city", class:"text form-control" %}
{% text_field "billing_address.zip", class:"text form-control" %}
{% if page.donation_v2.merchant_account.is_employer_and_occupation_required? %}
{% if page.donation_v2.merchant_account.is_employer_address_required? %}
{% elsif page.donation_v2.merchant_account.is_employer_city_required? %}
{% endif %}
{% endif %}
{% if page.donation_v2.merchant_account.is_corporate_contribution_required? %}
{% endif %}
{% for cf in custom_fields.donation %}
{% assign custom_field = cf[1] %}
{% assign custom_field_id = 'custom_values.' | append: custom_field.slug %}
Employer Info
{% text_field "employer", class:"text form-control" %}
{% text_field "occupation", class:"text form-control" %}
{% collection_select "work_address.country_code", page.donation_v2.countries, "code", "name", class:"select form-control" %}
{% text_field "work_address.address1", class:"text form-control" %}
{% text_field "work_address.address2", class:"text form-control" %}
{% text_field "work_address.city", class:"text form-control" %}
{% text_field "work_address.state", class:"text form-control" %}
{% text_field "work_address.zip", class:"text form-control" %}
{% collection_select "work_address.country_code", page.donation_v2.countries, "code", "name", class:"select form-control" %}
{% text_field "work_address.city", class:"text form-control" %}
{% text_field "work_address.zip", class:"text form-control" %}
Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.
{% check_box "is_corporate_contribution", class:"checkbox" %}
{% if custom_field.is_text? %}
{% endfor %}
{% unless page.show_consent_form? %}
{% text_field custom_field_id, class:"text form-control" %}
{% elsif custom_field.is_number? %}
{% number_field custom_field_id, class:"text form-control" %}
{% elsif custom_field.is_boolean? %}
{% check_box custom_field_id, class:"checkbox" %}
{% elsif custom_field.is_multiple_choice? %}
{% collection_select custom_field_id, custom_fields.donation[custom_field.slug].multiple_choice_options, class:"select form-control" %}
{% endif %}
{% check_box "email_opt_in" %}
Contributions are not tax deductible.
{% else %}
Contributions are tax deductible.
{% endif %}
{% if page.donation_v2.merchant_account.has_contribution_rules? %}
{% endif %}
{% if site.ask_to_publish_to_stream? %}
{% endif %}
Contribution rules
{{ page.donation_v2.merchant_account.contribution_rules }}
{% check_box "is_confirmed", class:"checkbox" %}
{% check_box "is_private", class:"checkbox" %}
{% if request.current_order %}
{{page.donation_v2.ticket_purchase_total}}
{% else %}
{% if page.donation_v2.confirmation_amount %}
{{ page.donation_v2.currency_symbol }}{{ page.donation_v2.confirmation_amount }}
{% else %}
{{ page.donation_v2.currency_symbol }}Please select an amount
{% endif %}
{% if page.donation_v2.donation_frequency == "one-time" %}
{% elsif page.donation_v2.donation_frequency == "monthly" %}
{% if page.show_consent_form? %}
{% include "consent_form" %}
{% endif %}
paid monthly
{% elsif page.donation_v2.donation_frequency == "annual" %}
paid annually
{% else %}
{% if page.donation_v2.interval_monthly? %}paid monthly{% endif %}
{% endif %}
{% endif %}
{% if request.current_order %}
{% submit_tag "Process payment", class:"submit-button btn btn-primary btn-lg" %}
{% else %}
{% submit_tag "Donate now", class:"submit-button btn btn-primary btn-lg" %}
{% endif %}