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1 NAME_FIRST | dnrfirst | Name * | | 1 NAME_FIRST | dnrfirst | Name * | |
2 NAME_LAST | dnrlast | Name * | | 2 NAME_LAST | dnrlast | Name * | |
3 COMPANY_NAME | company | Company | | 3 COMPANY_NAME | company | Company | |
4 ADDRESS_HOME_LINE1 | dadd1 | Address 1 * | | 4 ADDRESS_HOME_LINE1 | dadd1 | Address 1 * | |
5 ADDRESS_HOME_LINE2 | dadd2 | Address 2 | | 5 ADDRESS_HOME_LINE2 | dadd2 | Address 2 | |
6 ADDRESS_HOME_CITY | dcity | City / State / Zip * | | 6 ADDRESS_HOME_CITY | dcity | City / State / Zip * | |
7 ADDRESS_HOME_STATE | dstate | Name * | AL | 7 ADDRESS_HOME_STATE | dstate | Name * | AL |
8 ADDRESS_HOME_ZIP | dzip | Name * | | 8 ADDRESS_HOME_ZIP | dzip | Name * | |
9 ADDRESS_HOME_COUNTRY | CC_COUNTRY | Country | United States | 9 ADDRESS_HOME_COUNTRY | CC_COUNTRY | Country | United States |
10 PHONE_HOME_WHOLE_NUMBER | dphone | Telephone | | 10 PHONE_HOME_WHOLE_NUMBER | dphone | Telephone | |
11 EMAIL_ADDRESS | demail | Email * | | 11 EMAIL_ADDRESS | demail | Email * | |
12 UNKNOWN_TYPE | amt | $ | | 12 UNKNOWN_TYPE | amt | $ | |
| 13 UNKNOWN_TYPE | tributeSelect | Name * | on |
| 14 UNKNOWN_TYPE | DonationType | Name * | OneTime |
| 15 UNKNOWN_TYPE | DonationType | This is a one time donation | Recurs |
13 UNKNOWN_TYPE | ccrecurring | I would like to make this a recurring donation dedu
cted | Monthly | 16 UNKNOWN_TYPE | ccrecurring | I would like to make this a recurring donation dedu
cted | Monthly |
14 UNKNOWN_TYPE | remLen | ( You may enter up to 500 characters. ) | 500 | 17 UNKNOWN_TYPE | remLen | ( You may enter up to 500 characters. ) | 500 |
| 18 UNKNOWN_TYPE | tribute | | IHO |
| 19 UNKNOWN_TYPE | tribute | In Honor Of | IMO |
15 NAME_FULL | Tribute_Name | Name: | | 20 NAME_FULL | Tribute_Name | Name: | |
16 UNKNOWN_TYPE | Tribute_occasion | Occasion: | | 21 UNKNOWN_TYPE | Tribute_occasion | Occasion: | |
| 22 UNKNOWN_TYPE | Tribute_Disclosure | Occasion: | on |
| 23 UNKNOWN_TYPE | Tribute_Notification | I wish to remain anonymous | on |
| 24 UNKNOWN_TYPE | Tribute_IncludeAmount | | 1 |
| 25 UNKNOWN_TYPE | Tribute_IncludeAmount | Include the amount | 0 |
17 NAME_FULL | Tribute_NotifyName | Name: | | 26 NAME_FULL | Tribute_NotifyName | Name: | |
18 EMAIL_ADDRESS | Tribute_Email | Email: | | 27 EMAIL_ADDRESS | Tribute_Email | Email: | |
19 ADDRESS_HOME_LINE1 | Tribute_NotifyAddr | Street: | | 28 ADDRESS_HOME_LINE1 | Tribute_NotifyAddr | Street: | |
20 ADDRESS_HOME_CITY | Tribute_NotifyCity | City / St. / Zip: | | 29 ADDRESS_HOME_CITY | Tribute_NotifyCity | City / St. / Zip: | |
21 ADDRESS_HOME_STATE | Tribute_NotifyState | City / St. / Zip: | | 30 ADDRESS_HOME_STATE | Tribute_NotifyState | City / St. / Zip: | |
22 ADDRESS_HOME_ZIP | Tribute_NotifyZip | City / St. / Zip: | | 31 ADDRESS_HOME_ZIP | Tribute_NotifyZip | City / St. / Zip: | |
23 CREDIT_CARD_TYPE | cctype | Credit Card Type * | Visa | 32 CREDIT_CARD_TYPE | cctype | Credit Card Type * | Visa |
24 CREDIT_CARD_NUMBER | ccard | Credit Card Number * | | 33 CREDIT_CARD_NUMBER | ccard | Credit Card Number * | |
25 CREDIT_CARD_VERIFICATION_CODE | csc | CSC Number * What Is This? | | 34 CREDIT_CARD_VERIFICATION_CODE | csc | CSC Number * What Is This? | |
26 CREDIT_CARD_EXP_MONTH | ExpMon | Month | 1 | 35 CREDIT_CARD_EXP_MONTH | ExpMon | Month | 1 |
27 CREDIT_CARD_EXP_4_DIGIT_YEAR | ExpYear | Year | 11 | 36 CREDIT_CARD_EXP_4_DIGIT_YEAR | ExpYear | Year | 11 |
| 37 UNKNOWN_TYPE | SameAddress | Billing Address - | checkbox |
28 ADDRESS_HOME_LINE1 | CC_Addr | Address 1 * | | 38 ADDRESS_HOME_LINE1 | CC_Addr | Address 1 * | |
29 ADDRESS_HOME_LINE2 | CC_Addr2 | Address 2 | | 39 ADDRESS_HOME_LINE2 | CC_Addr2 | Address 2 | |
30 ADDRESS_HOME_CITY | CC_City | City / State / Zip * | | 40 ADDRESS_HOME_CITY | CC_City | City / State / Zip * | |
31 ADDRESS_HOME_STATE | CC_State | Credit Card Information | | 41 ADDRESS_HOME_STATE | CC_State | Credit Card Information | |
32 ADDRESS_HOME_ZIP | CC_Zip | Credit Card Information | | 42 ADDRESS_HOME_ZIP | CC_Zip | Credit Card Information | |
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