{"id":4294,"date":"2018-12-17T13:39:45","date_gmt":"2018-12-17T19:39:45","guid":{"rendered":"https:\/\/archive.local\/?page_id=4294"},"modified":"2020-12-22T16:03:35","modified_gmt":"2020-12-22T22:03:35","slug":"cuntooyinka-fasaxa-u-keen-waayeelka-u-baahan","status":"publish","type":"page","link":"https:\/\/meals-on-wheels.com\/so\/bring-holiday-meals-to-seniors-in-need\/","title":{"rendered":"Sii Hadiyad Sannad-Dhameed ah Waayeelka Baahan"},"content":{"rendered":"<p>You can do your part to bring nutritious food to your neighbors in need this winter. Your contribution will help ensure that everyone in need of warm meals delivered by caring neighbors has access to Meals on Wheels!<\/p>\n<h6>Show your neighbors that you&#8217;re thinking of them by donating below!<\/h6>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_18' style='display:none'><div id='gf_18' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_18' id='gform_18'  action='\/so\/wp-json\/wp\/v2\/pages\/4294#gf_18' data-formid='18' novalidate>\n        <div id='gf_progressbar_wrapper_18' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>3<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_18_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_18' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><li id=\"field_18_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"79d8a5f1\" data-field-span=\"12\"><label id='gfield_label_18_27' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I would like to make a...<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_18_27'>\n\t\t\t<li class='gchoice gchoice_18_27_0'>\n\t\t\t\t<input name='input_27' type='radio' value='one' checked='checked' id='choice_18_27_0' tabindex='3'   \/>\n\t\t\t\t<label for='choice_18_27_0' id='label_18_27_0' class='gform-field-label gform-field-label--type-inline'>One Time Donation<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_27_1'>\n\t\t\t\t<input name='input_27' type='radio' value='month'  id='choice_18_27_1' tabindex='4'   \/>\n\t\t\t\t<label for='choice_18_27_1' id='label_18_27_1' class='gform-field-label gform-field-label--type-inline'>Monthly Donation (Sustaining)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_5\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield_price gfield_price_18_5 gfield_product_18_5 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"c720fbbe\" data-field-span=\"12\"><label id='gfield_label_18_5' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I would like to donate...<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_18_5'>\n\t\t\t<li class='gchoice gchoice_18_5_0'>\n\t\t\t\t<input name='input_5' type='radio' value='30|30'  id='choice_18_5_0' tabindex='5'   \/>\n\t\t\t\t<label for='choice_18_5_0' id='label_18_5_0' class='gform-field-label gform-field-label--type-inline'>$30 = 1 week of meals<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_5_1'>\n\t\t\t\t<input name='input_5' type='radio' value='60|60'  id='choice_18_5_1' tabindex='6'   \/>\n\t\t\t\t<label for='choice_18_5_1' id='label_18_5_1' class='gform-field-label gform-field-label--type-inline'>$60 = 2 weeks of meals<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_5_2'>\n\t\t\t\t<input name='input_5' type='radio' value='90|90'  id='choice_18_5_2' tabindex='7'   \/>\n\t\t\t\t<label for='choice_18_5_2' id='label_18_5_2' class='gform-field-label gform-field-label--type-inline'>$90 = 3 weeks of meals<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_5_3'>\n\t\t\t\t<input name='input_5' type='radio' value='120|120'  id='choice_18_5_3' tabindex='8'   \/>\n\t\t\t\t<label for='choice_18_5_3' id='label_18_5_3' class='gform-field-label gform-field-label--type-inline'>$120 = 1 month of meals<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_5_4'>\n\t\t\t\t<input name='input_5' type='radio' value='240|240'  id='choice_18_5_4' tabindex='9'   \/>\n\t\t\t\t<label for='choice_18_5_4' id='label_18_5_4' class='gform-field-label gform-field-label--type-inline'>$240 = 2 months of meals<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_5_5'>\n\t\t\t\t<input name='input_5' type='radio' value='Other|0'  id='choice_18_5_5' tabindex='10'   \/>\n\t\t\t\t<label for='choice_18_5_5' id='label_18_5_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_28\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield_price gfield_price_18_28 gfield_product_18_28 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"b7ea64e5\" data-field-span=\"12\"><label id='gfield_label_18_28' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I would like to donate...<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_18_28'>\n\t\t\t<li class='gchoice gchoice_18_28_0'>\n\t\t\t\t<input name='input_28' type='radio' value='10|10'  id='choice_18_28_0' tabindex='11'   \/>\n\t\t\t\t<label for='choice_18_28_0' id='label_18_28_0' class='gform-field-label gform-field-label--type-inline'>$10\/mo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_28_1'>\n\t\t\t\t<input name='input_28' type='radio' value='20|20'  id='choice_18_28_1' tabindex='12'   \/>\n\t\t\t\t<label for='choice_18_28_1' id='label_18_28_1' class='gform-field-label gform-field-label--type-inline'>$20\/mo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_28_2'>\n\t\t\t\t<input name='input_28' type='radio' value='50|50'  id='choice_18_28_2' tabindex='13'   \/>\n\t\t\t\t<label for='choice_18_28_2' id='label_18_28_2' class='gform-field-label gform-field-label--type-inline'>$50\/mo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_28_3'>\n\t\t\t\t<input name='input_28' type='radio' value='100|100'  id='choice_18_28_3' tabindex='14'   \/>\n\t\t\t\t<label for='choice_18_28_3' id='label_18_28_3' class='gform-field-label gform-field-label--type-inline'>$100\/mo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_28_4'>\n\t\t\t\t<input name='input_28' type='radio' value='Other|0'  id='choice_18_28_4' tabindex='15'   \/>\n\t\t\t\t<label for='choice_18_28_4' id='label_18_28_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_6\" class=\"gfield gfield--type-product gfield--input-type-price gfield_price gfield_price_18_6 gfield_product_18_6 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"05624ba5\" data-field-span=\"12\"><label id='gfield_label_18_6' class='gfield_label gform-field-label' for='input_18_6'><span class='gform-field-label__text'>Other amount:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_6' id='input_18_6' type='text' value='' class='medium ginput_amount' tabindex='16'  aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_18_7' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' tabindex='17'>Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_18_2' class='gform_page' data-js='page-field-id-7' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_18_2' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><li id=\"field_18_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"90c4787b\" data-field-span=\"12\"><label id='gfield_label_18_17' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>I would like to make this donation in honor or in memory of someone.<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_18_17'>\n\t\t\t<li class='gchoice gchoice_18_17_0'>\n\t\t\t\t<input name='input_17' type='radio' value='Yes'  id='choice_18_17_0' tabindex='18'   \/>\n\t\t\t\t<label for='choice_18_17_0' id='label_18_17_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_17_1'>\n\t\t\t\t<input name='input_17' type='radio' value='No'  id='choice_18_17_1' tabindex='19'   \/>\n\t\t\t\t<label for='choice_18_17_1' id='label_18_17_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_18\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"3e459a67\" data-field-span=\"12\"><h2 class=\"gsection_title\">Honorary Donation<\/h2><\/li><li id=\"field_18_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"a95af991\" data-field-span=\"12\"><label id='gfield_label_18_19' class='gfield_label gform-field-label' for='input_18_19'><span class='gform-field-label__text'>Name of Honoree<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_18_19' type='text' value='' class='medium'   tabindex='20'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"419de511\" data-field-span=\"12\"><label id='gfield_label_18_24' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Would you like us to send the honoree a notification of your gift?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_18_24'>\n\t\t\t<li class='gchoice gchoice_18_24_0'>\n\t\t\t\t<input name='input_24' type='radio' value='Yes'  id='choice_18_24_0' tabindex='21'   \/>\n\t\t\t\t<label for='choice_18_24_0' id='label_18_24_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_24_1'>\n\t\t\t\t<input name='input_24' type='radio' value='No'  id='choice_18_24_1' tabindex='22'   \/>\n\t\t\t\t<label for='choice_18_24_1' id='label_18_24_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_18_24_2'>\n\t\t\t\t<input name='input_24' type='radio' value='I would like to send a notification to a friend or family member of the honoree'  id='choice_18_24_2' tabindex='23'   \/>\n\t\t\t\t<label for='choice_18_24_2' id='label_18_24_2' class='gform-field-label gform-field-label--type-inline'>I would like to send a notification to a friend or family member of the honoree<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_26\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"3c1321f3\" data-field-span=\"12\"><label id='gfield_label_18_26' class='gfield_label gform-field-label' for='input_18_26'><span class='gform-field-label__text'>To whom would you like us to send this notification?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_18_26' type='text' value='' class='medium'   tabindex='24'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_22\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"4e8ed8ef\" data-field-span=\"12\"><label id='gfield_label_18_22' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address to which notification should be sent<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_18_22' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_18_22_1_container' >\n                                        <input type='text' name='input_22.1' id='input_18_22_1' value='' tabindex='25'   aria-required='false'    aria-labelledby=\"input_18_22_1_label gfield_label_18_22\"\/>\n                                        <label for='input_18_22_1' id='input_18_22_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_18_22_2_container' >\n                                        <input type='text' name='input_22.2' id='input_18_22_2' value='' tabindex='26'    aria-required='false'   \/>\n                                        <label for='input_18_22_2' id='input_18_22_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_18_22_3_container' >\n                                    <input type='text' name='input_22.3' id='input_18_22_3' value='' tabindex='27'   aria-required='false'    \/>\n                                    <label for='input_18_22_3' id='input_18_22_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_18_22_4_container' >\n                                        <select name='input_22.4' id='input_18_22_4' tabindex='28'    aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_18_22_4' id='input_18_22_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_18_22_5_container' >\n                                    <input type='text' name='input_22.5' id='input_18_22_5' value='' tabindex='30'   aria-required='false'    \/>\n                                    <label for='input_18_22_5' id='input_18_22_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_22.6' id='input_18_22_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_18_21\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"fe48edea\" data-field-span=\"12\"><label id='gfield_label_18_21' class='gfield_label gform-field-label' for='input_18_21'><span class='gform-field-label__text'>Is there a message you would like to share with this donation?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_18_21' class='textarea medium' tabindex='31'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_18_16' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' tabindex='32'>Previous<\/button> <button type='button' id='gform_next_button_18_16' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' tabindex='33'>Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_18_3' class='gform_page' data-js='page-field-id-16' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_18_3' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><li id=\"field_18_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"fbeb94fd\" data-field-span=\"12\"><label id='gfield_label_18_11' class='gfield_label gform-field-label' for='input_18_11'><span class='gform-field-label__text'>First Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_18_11' type='text' value='' class='medium'   tabindex='34'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_12\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"35e90cb8\" data-field-span=\"12\"><label id='gfield_label_18_12' class='gfield_label gform-field-label' for='input_18_12'><span class='gform-field-label__text'>Last Name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_18_12' type='text' value='' class='medium'   tabindex='35'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_14\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"8e0aad3e\" data-field-span=\"12\"><label id='gfield_label_18_14' class='gfield_label gform-field-label' for='input_18_14'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_14' id='input_18_14' type='email' value='' class='medium' tabindex='36'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_18_15\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"4687c522\" data-field-span=\"12\"><label id='gfield_label_18_15' class='gfield_label gform-field-label' for='input_18_15'><span class='gform-field-label__text'>Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_15' id='input_18_15' type='tel' value='' class='medium' tabindex='37' placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_18_9\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"33d28a2b\" data-field-span=\"12\"><label id='gfield_label_18_9' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_18_9' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_18_9_1_container' >\n                                        <input type='text' name='input_9.1' id='input_18_9_1' value='' tabindex='38'   aria-required='true'    aria-labelledby=\"input_18_9_1_label gfield_label_18_9\"\/>\n                                        <label for='input_18_9_1' id='input_18_9_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_18_9_2_container' >\n                                        <input type='text' name='input_9.2' id='input_18_9_2' value='' tabindex='39'    aria-required='false'   \/>\n                                        <label for='input_18_9_2' id='input_18_9_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_18_9_3_container' >\n                                    <input type='text' name='input_9.3' id='input_18_9_3' value='' tabindex='40'   aria-required='true'    \/>\n                                    <label for='input_18_9_3' id='input_18_9_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_18_9_4_container' >\n                                        <select name='input_9.4' id='input_18_9_4' tabindex='41'    aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' selected='selected'>Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_18_9_4' id='input_18_9_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_18_9_5_container' >\n                                    <input type='text' name='input_9.5' id='input_18_9_5' value='' tabindex='43'   aria-required='true'    \/>\n                                    <label for='input_18_9_5' id='input_18_9_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_9.6' id='input_18_9_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_18_2\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"bac99777\" data-field-span=\"12\"><label id='gfield_label_18_2' class='gfield_label gform-field-label gfield_label_before_complex' for='input_18_2_1'><span class='gform-field-label__text'>Credit Card Information<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_18_2'><span class='ginput_full gform-grid-col' id='input_18_2_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_18_2_supported_creditcards'>Supported Credit Cards: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <input type='text' name='input_2.1' id='input_18_2_1' value='' tabindex='44'  onchange='gformMatchCard(\"input_18_2_1\");' onkeyup='gformMatchCard(\"input_18_2_1\");' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='true'   aria-labelledby=\"input_18_2_1_label gfield_label_18_2\"\/>\n                                    <label for='input_18_2_1' id='input_18_2_1_label' class='gform-field-label gform-field-label--type-sub '>Card Number<\/label>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_18_2_2_container'>\n                                            <span class='ginput_cardinfo_left' id='input_18_2_2_cardinfo_left'>\n                                                <span class='ginput_card_expiration_container ginput_card_field'>\n                                                    \n                                                       <select name='input_2.2[]' id='input_18_2_2_month' tabindex='45'  class='ginput_card_expiration ginput_card_expiration_month' aria-required='true'  >\n                                                           <option value=''>Month<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                       \n                                                   \n                                                   \n                                                       <select name='input_2.2[]' id='input_18_2_2_year' tabindex='46'  class='ginput_card_expiration ginput_card_expiration_year' aria-required='true'  >\n                                                           <option value=''>Year<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' >2040<\/option><option value='2041' >2041<\/option><option value='2042' >2042<\/option><option value='2043' >2043<\/option><option value='2044' >2044<\/option><option value='2045' >2045<\/option>\n                                                       <\/select>\n                                                       \n                                                       \n                                                <\/span>\n                                                 <label for='input_18_2_2_month' class='gform-field-label gform-field-label--type-sub '>Expiration Date<\/label>\n                                            <\/span><span class='ginput_cardinfo_right gform-grid-col' id='input_18_2_2_cardinfo_right'>\n                                                <input type='text' name='input_2.3' id='input_18_2_3' tabindex='47'  class='ginput_card_security_code' value='' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='true'  \/>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                                <label for='input_18_2_3' class='gform-field-label gform-field-label--type-sub '>Security Code<\/label>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_18_2_5_container'>\n                                            <input type='text' name='input_2.5' id='input_18_2_5' value='' tabindex='48'   aria-required='false'  \/>\n                                            <label for='input_18_2_5' id='input_18_2_5_label' class='gform-field-label gform-field-label--type-sub '>Cardholder Name<\/label>\n                                        <\/span> <\/div><\/li><li id=\"field_18_10\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"3b64cbd1\" data-field-span=\"12\"><label id='gfield_label_18_10' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Newsletter<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_18_10'><li class='gchoice gchoice_18_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='I would like to subscribe to the Metro Meals on Wheels Newsletter.' checked='checked' id='choice_18_10_1' tabindex='49'   aria-labelledby=\"label_18_10_1 gfield_label_18_10\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_18_10_1' id='label_18_10_1' class='gform-field-label gform-field-label--type-inline'>I would like to subscribe to the Metro Meals on Wheels Newsletter.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_29\" class=\"gfield gfield--type-total gfield--input-type-total gformdisplaynone gfield_price gfield_price_18_ gfield_total gfield_total_18_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"114ba853\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_18_29' class='gfield_label gform-field-label' for='input_18_29'><span class='gform-field-label__text'>Donation Amount<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<span class='ginput_total ginput_total_18'>$0.00<\/span>\n\t\t\t\t\t\t\t<input type='hidden' name='input_29' id='input_18_29' class='gform_hidden' \/>\n\t\t\t\t\t\t<\/div><\/li><li id=\"field_18_278870\" class=\"gfield gfield--type-text sup-ref-tracking-source field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278870' class='gfield_label gform-field-label' for='input_18_278870'><span class='gform-field-label__text'>Source<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278870' id='input_18_278870' type='text' value='' class=''   tabindex='50'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278871\" class=\"gfield gfield--type-text sup-ref-tracking-ref-params field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278871' class='gfield_label gform-field-label' for='input_18_278871'><span class='gform-field-label__text'>Referral Parameters<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278871' id='input_18_278871' type='text' value='' class=''   tabindex='51'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278872\" class=\"gfield gfield--type-text sup-ref-tracking-referrer field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278872' class='gfield_label gform-field-label' for='input_18_278872'><span class='gform-field-label__text'>Referrer<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278872' id='input_18_278872' type='text' value='' class=''   tabindex='52'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278873\" class=\"gfield gfield--type-text sup-ref-tracking-utm_id field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278873' class='gfield_label gform-field-label' for='input_18_278873'><span class='gform-field-label__text'>utm_id<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278873' id='input_18_278873' type='text' value='' class=''   tabindex='53'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278874\" class=\"gfield gfield--type-text sup-ref-tracking-utm_source field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278874' class='gfield_label gform-field-label' for='input_18_278874'><span class='gform-field-label__text'>utm_source<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278874' id='input_18_278874' type='text' value='' class=''   tabindex='54'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278875\" class=\"gfield gfield--type-text sup-ref-tracking-utm_medium field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278875' class='gfield_label gform-field-label' for='input_18_278875'><span class='gform-field-label__text'>utm_medium<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278875' id='input_18_278875' type='text' value='' class=''   tabindex='55'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278876\" class=\"gfield gfield--type-text sup-ref-tracking-utm_campaign field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"><label id='gfield_label__278876' class='gfield_label gform-field-label' for='input_18_278876'><span class='gform-field-label__text'>utm_campaign<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278876' id='input_18_278876' type='text' value='' class=''   tabindex='56'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_278877\" class=\"gfield 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