Generic Donate HTML Page
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<title>XXXXXXXXXX organisation: Donations</title>
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<body>
<table width="800" border="0" cellpadding="0" cellspacing="0">
<tr valign="top">
<td width="128" rowspan="2"></td>
<td width="48" rowspan="2"> </td>
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<td width="624" height="360" valign="top"><p><br>
<span class="SubHeading"><a href="index.html" tppabs="index.html">Home</a> > Donate online... </span></p>
<TABLE align="center" width=100%>
<FORM action="https://payments.verisign.com.au/payflowlink" method="post" name="inthewingsform" ORDERFORM=False SHOWCONFIRM=False>
<TR>
<TD align="center" colspan=2></TD>
</TR>
<TR>
<TD align="center" colspan=2><p class="Plain"><span class="TextHeading">XXXXXXXX ONLINE DONATION
FORM</span><br>
Please fill out the form below to make a credit card donation today <br>
and help care for XXXXXXXXXXXXXXX precious wildlife. (It's secure, quick and easy!)</p>
<p align="right" class="Plain style2">Note: All donations of $2 or more are tax deductible. <br>
Fields marked with a <FONT COLOR="#333333"><FONT COLOR="#26e500">*</FONT></FONT> are required for receipting and acknowledgement. </p>
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<TD align="left" class="MAINTXT1"></TD>
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<TR>
<TD align="left" class="Plain"><FONT COLOR="#333333">Yes, I would like to donate the amount of <FONT COLOR="#26e500">*</FONT></FONT></TD>
<TD align="right" class="Plain">$
<input id="AMOUNT" name="AMOUNT" type="text" size="30">
</TD>
</tr>
<TR>
<TD height="22" align="left" class="Plain">Payment for <FONT COLOR="#26e500">* </FONT></TD>
<TD align="right" class="Plain"><SELECT id="USER3" name="USER3" class="MAINTXT1" style="width:31ex" >
<option value="Web - Donation Payment" selected>Donation
<option value="Web - Membership Payment">Membership
<option value="Web - Orders Payment">Orders/Supplies
<option value="Web - Training Payment">Training
</SELECT>
</TD>
</TR>
<TR>
<TD height="22" align="left" class="Plain">Member No. </TD>
<TD align="right" class="Plain"><span class="Plain">
<INPUT input id="CUSTID" name="CUSTID" class="MAINTXT1" TYPE="text" size=30>
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<TD align="left" class="Plain"> First Name <FONT COLOR="#26e500">*</FONT> </TD>
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<TD align="left" class="MAINTXT1"><span class="Plain">Last Name <FONT COLOR="#26e500">*</FONT> </span></TD>
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<TD align="left" class="MAINTXT1"><span class="Plain">Address <FONT COLOR="#26e500">*</FONT></FONT> </span></TD>
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<TD align="left" class="MAINTXT1"><span class="Plain">Suburb/ Town <FONT COLOR="#26e500">*</FONT></FONT> </span> </TD>
<TD align="right" class="MAINTXT1"><span class="Plain">
<INPUT class="MAINTXT1" TYPE="text" id="CITY" name="CITY" size=30>
</span> </TD>
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<TR>
<TD align="left" class="MAINTXT1"><span class="Plain"><FONT COLOR="#333333">State <FONT COLOR="#26e500">*</FONT></FONT> </span></TD>
<TD align="right" class="MAINTXT1"><span class="Plain">
<SELECT id="STATE" name="STATE" class="MAINTXT1" style="width:31ex" >
<OPTION value="">Select State
<OPTION value="ACT">Australian Capital Territory
<OPTION value="NSW">New South Wales
<OPTION value="NT">Northern Territory
<OPTION value="QLD">Queensland
<OPTION value="SA">South Australia
<OPTION value="TAS">Tasmania
<OPTION value="VIC" selected>Victoria
<OPTION value="WA">Western Australia
</SELECT>
</span></TD>
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<TD align="left" class="MAINTXT1"></td>
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<TD align="left" class="Plain"><FONT COLOR="#333333">Postcode <FONT COLOR="#26e500">*</FONT></FONT> </TD>
<TD align="right" class="MAINTXT1"><span class="Plain">
<INPUT class="MAINTXT1" TYPE="text" id="ZIP" name="ZIP" size=30>
</span> </TD>
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<TR>
<TD align="left" class="Plain"> Country</FONT> <FONT COLOR="#26e500">*</FONT></FONT></TD>
<TD align="right" class="MAINTXT1"><span class="Plain">
<input id="COUNTRY" name="COUNTRY" type="text" value="Australia" size="30">
</span></TD>
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<TR>
<TD align="left" class="Plain"> Phone contact</TD>
<TD align="right" class="Plain"><span class="Plain">
<input id="PHONE" name="PHONE" type="text" size="30">
</span></TD>
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<TR>
<TD align="left" class="Plain"> Email contact <FONT COLOR="#333333"><FONT COLOR="#26e500">*</FONT></FONT></FONT></TD>
<TD align="right" class="Plain"><span class="Plain">
<input id="EMAIL" name="EMAIL" type="text" size="30">
</span></TD>
</TR>
<TR>
<TD align="left" class="Plain">Description of payment or comment (optional)<br>
<span class="style2">(eg donation in honour/ memory of...)</span></TD>
<TD align="right" class="Plain"><textarea id="DESCRIPTION" name="DESCRIPTION" cols="23" class="MAINTXT1"></textarea></TD>
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<TD align="center" style="padding:2" valign="top"><TABLE width=100% cellpadding="3">
<TR>
<TD align="right" class="MAINTXT1"><p><FONT COLOR="#333333"></FONT>
<input type="hidden" name="LOGIN" value="xxxxx organisation xxxxxxx">
<input type="hidden" name="PARTNER" value="VSA">
<input type="hidden" name="TYPE" value="S">
<input type="hidden" name="SHOWCONFIRM" value="False">
<input type="hidden" name="METHOD" value="CC">
<input type="hidden" id="NAME" name="NAME">
<input type="hidden" id="NAMETOSHIP" name="NAMETOSHIP">
<INPUT type="submit" value="Donate Now" class="MAINTXT1" ORDERFORM=False SHOWCONFIRM=False onclick="return validateForm();">
</p>
<p align="left">
<!--<script src=https://seal.verisign.com/getseal?host_name=www.atyp.com.au&size=S&use_flash=YES&use_transparent=YES></script></script>-->
If you experience any difficulties using this form, please contact <a href="mailto:xxxxxx@xxxxxxx.org.au">XXXXXXXX</a> by email or call 999 999 999 or <a href="mailto:yyyyyyyy@yyyyyyyy.org.au">YYYYYYYYY</a> by email or on 9999 9999 9999.<br>
For more information about donations & other donation methods (eg mail) please click <a href="donations.html" tppabs="donations.html">here</a>. </p>
<p> </p></TD>
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