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<b style="text-align: left; line-height: 33px; background-color: rgb(255,241,225); font-family: 'Trebuchet MS'; color: rgb(128,69,58); font-size: 28px">Donate &amp; Chai Club</b></td>
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<td width="90" height="18">
<span style="font-size: 13px">
<label for="value3,600" data-dashlane-label="true"><input type="radio" id="value3,600" tabindex="1" onclick="this.form.x_amount.value=this.value;" name="Amount" value="3,600" data-dashlane-rid="231766bddc83444a" data-dashlane-classification="other"> <span style="font-family: 'Trebuchet MS'">$3,600</span></label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value1,800" data-dashlane-label="true"><input type="radio" id="value1,800" tabindex="2" onclick="this.form.x_amount.value=this.value;" name="Amount" value="1,800" data-dashlane-rid="86a17ee0622c03eb" data-dashlane-classification="other"> $1,800</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value1,000" data-dashlane-label="true"><input type="radio" id="value1,000" tabindex="3" onclick="this.form.x_amount.value=this.value;" name="Amount" value="1,000" data-dashlane-rid="bf12bdc3148810a0" data-dashlane-classification="other"> $1,000</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value720" data-dashlane-label="true"><input type="radio" id="value720" tabindex="4" onclick="this.form.x_amount.value=this.value;" name="Amount" value="720" data-dashlane-rid="33132e757f8f58d1" data-dashlane-classification="other"> $720</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value500" data-dashlane-label="true"><input type="radio" id="value500" tabindex="5" onclick="this.form.x_amount.value=this.value;" name="Amount" value="500" data-dashlane-rid="7dd1b10662a2309f" data-dashlane-classification="other"> $500</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value360" data-dashlane-label="true"><input type="radio" id="value360" tabindex="6" onclick="this.form.x_amount.value=this.value;" name="Amount" value="360" data-dashlane-rid="5ee8fce9b9b744df" data-dashlane-classification="other"> $360</label></span></td>
</tr>
<tr>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value180" data-dashlane-label="true"><input type="radio" id="value180" tabindex="7" onclick="this.form.x_amount.value=this.value;" name="Amount" value="180" data-dashlane-rid="4186251aeb7962a3" data-dashlane-classification="other"> $180</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value100" data-dashlane-label="true"><input type="radio" id="value100" tabindex="8" onclick="this.form.x_amount.value=this.value;" name="Amount" value="100" data-dashlane-rid="d8bf075f569e1281" data-dashlane-classification="other"> $100</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value72" data-dashlane-label="true"><input type="radio" id="value72" tabindex="9" onclick="this.form.x_amount.value=this.value;" name="Amount" value="72" data-dashlane-rid="fbf52feb8406a752" data-dashlane-classification="other"> $72</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value54" data-dashlane-label="true"><input type="radio" id="value54" tabindex="10" onclick="this.form.x_amount.value=this.value;" name="Amount" value="54" data-dashlane-rid="8d265aa9a896df46" data-dashlane-classification="other"> $54</label></span></td>
<td width="90" height="18">
<span style="font-family: 'Trebuchet MS'; font-size: 13px">
<label for="value36" data-dashlane-label="true"><input type="radio" id="value36" tabindex="11" onclick="this.form.x_amount.value=this.value;" name="Amount" value="36" data-dashlane-rid="070386743c9ea193" data-dashlane-classification="other"> $36</label></span></td>
<td width="90" height="18"> </td>
</tr>
<tr>
<td width="180" height="18" colspan="2" style="text-align: left"> </td>
<td width="180" height="18" colspan="2" cellpadding="4" style="text-align: center">
<span style="font-family:"><input type="radio" id="valueOther" tabindex="13" checked name="Amount" value="on" data-dashlane-rid="1dd112574de85120" data-dashlane-classification="other"> <strong>                                                                                           <span style="font-size: 14px">Total/Other <span id="OtherValue">$</span></span></strong></span><span id="OtherValue">                                                                                      <input type="text" class="light" tabindex="14" size="6" required="true" name="x_amount" data-dashlane-rid="2fd72bad5faf2b41" data-dashlane-classification="other"></span></td>
<td width="180" height="18" colspan="2" style="text-align: left"> </td>
</tr>
</tbody>
</table>
<p valign="middle" style="text-align: center">
<span style="font-family: 'Trebuchet MS'; font-size: 13px"><br class="Apple-interchange-newline">
</span><span style="font-family: 'Trebuchet MS'; font-size: 13px">
<strong>Please direct my contribution towards:</strong></span><span style="font-family: 'Trebuchet MS'"> </span><select tabindex="18" name="Allocation" data-dashlane-rid="dbd228b60cd47f42" data-dashlane-classification="other">
<option value="None Selected" selected>Choose a Program</option>
<option value="Chai Center">Chai Center - General Donation</option>
<option value="Young Adults">Young Adults</option>
<option value="Hebrew School Tuition">Hebrew School Tuition</option>
<option value="HS Scholarship Fund">Hebrew School Scholarship Fund</option>
<option value="Chai Kidz">Chai Kidz</option>
<option value="Shabbat 4 Kidz">Shabbat 4 Kidz</option>
<option value="Kiddush">Kiddush Sponsorship</option>
<option value="Tuesday Torah Cafe">Tuesday Torah Cafe</option>
<option value="Shabbat Dinners">Shabbat Dinners</option>
<option value="Friendship Circle">Friendship Circle</option>
<option value="Social Services">Social Services</option>
<option value="Passover">Passover</option>
<option value="BMX - Bar Mitzvah eXperience">BMX - Bar Mitzvah eXperience</option>
<option value="BMC - Bat Mitzvah Club">BMC - Bat Mitzvah Club</option>
<option value="CTeen">CTeen</option>
<option value="Jewish Art Calendar">Jewish Art Calendar</option>
<option value="Web Advertising">Web Advertising</option>
<option value="Security">Security</option>
</select><span style="font-family: 'Trebuchet MS'; font-size: 13px">
<font face="'Trebuchet MS'"><b><br>
</b></font></span><font face="'Trebuchet MS'">
<span style="line-height: 15px"><b>                                                                             <i><br>
</i></b></span></font>
                </p>
<p style="text-align: center"><input type="radio" tabindex="19" name="Dedication" value="In Memory" data-dashlane-rid="2a7c62e496759cfd" data-dashlane-classification="other"> In Memory <input type="radio" tabindex="20" name="Dedication" value="In Honor" data-dashlane-rid="ee53964813935710" data-dashlane-classification="other"> In Honor</p>
<p style="text-align: center">
<textarea tabindex="21" cols="1" required="false" style="margin: 2px; width: 500px; height: 32px" name="Details" data-dashlane-rid="afb2f8960e406446" data-dashlane-classification="other"></textarea></p>
<br>
<hr width="70%" size="2" color="#80453A">
<br>
<table width="500" cellspacing="0" cellpadding="5" bordercolor="#80453A" border="3" bgcolor="#F08484" align="center" dir="ltr" style="border-collapse: collapse">
<tbody>
<tr>
<td>
<p style="text-align: center">
<span style="font-size: 20px">
<strong><span style="font-family: 'Trebuchet MS'">Chai Club</span></strong></span></p>
<p style="text-align: justify">The Chai Club is a group of friends of The Chai Center who have committed to contributing at least $18 per month. This commitment enables us to focus on providing wonderful and enriching programs for every Jew in the Brookline area. Our continued growth is made possible by the support we receive from friends like you.</p>
<p style="text-align: justify">It's a great cause with great blessings in return! Plus, Chai Club Members receive discounts for some of our programs (please keep this in mind when donating).</p>
<p style="text-align: left">
<em>Thank you!</em><strong><br>
                        Rabbi Mayshe</strong></p>
<p><input type="checkbox" tabindex="15" name="Chai Club" value="on" data-dashlane-rid="db6c9c38ac6bf863" data-dashlane-classification="other"> <strong style="line-height: 16px; font-family: 'Trebuchet MS'; font-size: 13px">Yes! I would like to become a member of the Chai Club! </strong><strong style="line-height: 16px; font-family: 'Trebuchet MS'; font-size: 13px">Please charge the<em> amount entered above</em> each month until <select tabindex="16" name="Recurring End Month" data-dashlane-rid="e152535165c7afd7" data-dashlane-classification="date,month">
<option value="No Month Selected" selected>Select</option>
<option value="January">January</option>
<option value="February">February</option>
<option value="March">March</option>
<option value="April">April</option>
<option value="May">May</option>
<option value="June">June</option>
<option value="July">July</option>
<option value="August">August</option>
<option value="September">September</option>
<option value="October">October</option>
<option value="November">November</option>
<option value="December">December</option>
</select> <select tabindex="17" name="Recurring End Year" data-dashlane-rid="0af130eb7d9f527c" data-dashlane-classification="date,year,month">
<option value="No End Date" selected>No End Date!</option>
<option value="2012">2012</option>
<option value="2013">2013</option>
<option value="2014">2014</option>
<option value="2015">2015</option>
<option value="2016">2016</option>
<option value="2017">2017</option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
</select></strong></p>
</td>
</tr>
</tbody>
</table>
<p style="text-align: center"><strong>
<em><span style="font-family: 'Trebuchet MS'">For information on other giving opportunities</span></em></strong><span> </span><em>                                                             <span style="font-family: 'Trebuchet MS'">                                                                      <strong><a href="mailto:mayshe@getchai.com?subject=Donation%20Inquiry">email</a> </strong></span><strong>                                                                  <span style="font-family: 'Trebuchet MS'">or call (617) 278 -2424</span></strong></em> </p>
</fieldset>
<p>
<span style="font-family: Trebuchet MS"> </span></p>
<fieldset data-dashlane-rid="4252d92e2955128e" data-dashlane-classification="shipping">
                <legend>
<span style="font-family: 'Trebuchet MS'; color: rgb(127,69,58); font-size: 14px"><strong>Contact Details</strong></span></legend>                                                <br>
<table width="400" cellspacing="0" cellpadding="5" border="0" align="left" dir="ltr" style="width: 547px; border-collapse: collapse; height: 68px">
<tbody>
<tr>
<td width="50%" height="15" style="font-family: Arial; font-size: 10px">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">* First Name <br>
<input type="text" class="light" tabindex="22" size="30" required="true" name="x_first_name" data-dashlane-rid="d3e9bc43a88dfac4" data-dashlane-classification="name,first" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-0"><span id="1779138072933-0" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 263px; top: 1212.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">* Last Name <br>
<input type="text" class="light" tabindex="23" size="30" required="true" name="x_last_name" data-dashlane-rid="1f14ba50970fd4d8" data-dashlane-classification="name,last" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-1"><span id="1779138072933-1" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 536px; top: 1212.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
</tr>
<tr>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">Address <br>
<input type="text" class="light" tabindex="24" size="30" required="false" name="x_address" data-dashlane-rid="6d3b60a594102b3a" data-dashlane-classification="address" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-2"><span id="1779138072933-2" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 263px; top: 1259.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">City <br>
<input type="text" class="light" tabindex="25" size="30" required="false" name="City" data-dashlane-rid="89c55ddbffcabfcc" data-dashlane-classification="address,city" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-3"><span id="1779138072933-3" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 536px; top: 1259.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
</tr>
<tr>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">State <br>
<input type="text" class="light" tabindex="26" size="10" required="false" name="State" data-dashlane-rid="2a633dc0c474c182" data-dashlane-classification="address,region" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-4"><span id="1779138072933-4" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 123px; top: 1306.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">Zip Code <br>
<input type="text" class="light" tabindex="27" size="10" required="false" name="x_zip" data-dashlane-rid="e91e3e5ef4ac8b1f" data-dashlane-classification="address,zip" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-5"><span id="1779138072933-5" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 396px; top: 1306.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
</tr>
<tr>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">Phone <br>
<input type="text" class="light" tabindex="28" size="30" required="false" name="Phone" data-dashlane-rid="6fdf79aa7517214d" data-dashlane-classification="phone" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-6"><span id="1779138072933-6" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 263px; top: 1353.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
<td width="50%" height="15" style="font-family: Arial">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px">* Email <br>
<input type="text" class="light" tabindex="29" size="30" required="true" name="x_email" data-dashlane-rid="87d4420de2426142" data-dashlane-classification="email" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-7"><span id="1779138072933-7" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-known.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 536px; top: 1353.69px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span></strong></td>
</tr>
</tbody>
</table>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<strong>
<span style="font-family: 'Trebuchet MS'; font-size: 13px"> </span></strong></p>
<p align="left">
<font face="'Trebuchet MS'">
<b><input type="radio" tabindex="30" name="Receipt" value="Email" data-dashlane-rid="737af0a76e3b9f26" data-dashlane-classification="other"> You may acknowledge my gift to my email address <br>
</b></font>
                </p>
<p align="left"><input type="radio" tabindex="31" name="Receipt" value="Mail" data-dashlane-rid="78938fe84dfa6511" data-dashlane-classification="other"> <span style="font-family: 'Trebuchet MS'">                                                          <strong>Please acknowledge my gift by mail to the above street address</strong></span></p>
</fieldset>
<p>
<span style="font-family: Trebuchet MS"> </span></p>
<fieldset data-dashlane-rid="c6e422a494d6f041" data-dashlane-classification="payment">
                <legend>
<span style="color: rgb(127,69,58); font-size: 14px"><strong>Payment information</strong></span></legend><span style="font-family: Trebuchet MS">                                                    <em>This form is secure and encrypted</em></span><span style="font-family: Trebuchet MS">                                                       <em>                                                            <img width="20" height="20" border="0" alt="" real_height="256" real_width="256" src="http://www.artistsvalley.com/images/icons/Professional%20Vista%20Software%20Icons%20Var/Secure/256x256/Secure.jpg"></em></span><br>
<span style="font-family: Trebuchet MS"><em>
<strong><br>
</strong></em><strong>Credit Card Type</strong><em>                                                                 <strong><br>
<br syle="height: .1em;">
</strong></em></span>
<table width="100%" cellspacing="0" cellpadding="5" border="0" align="center" dir="ltr" style="border-collapse: collapse">
<tbody>
<tr valign="middle">
<td width="25%">
<p style="text-align: center">
<label data-dashlane-label="true"><img width="124" height="84" border="0" alt="Visa.gif" real_height="100" real_width="148" src="https://w2.chabad.org/media/images/648/yyfF6483778.gif"><br>
<input type="radio" id="visa/" tabindex="32" name="Credit Card Type" value="Visa" data-dashlane-rid="0cd09a4a3b764d7b" data-dashlane-classification="payment,type" data-kwimpalastatus="dead"></label></p>
</td>
<td width="25%">
<p style="text-align: center">
<label data-dashlane-label="true"><img width="124" height="84" border="0" alt="Mastercard.gif" real_height="100" real_width="148" src="https://w2.chabad.org/media/images/648/cbQD6483779.gif"><br>
<input type="radio" tabindex="33" name="Credit Card Type" value="Mastercard" data-dashlane-rid="f220e2c248b5ada1" data-dashlane-classification="payment,type" data-kwimpalastatus="dead"></label></p>
</td>
<td width="25%">
<p style="text-align: center">
<label data-dashlane-label="true"><img width="124" height="84" border="0" alt="Amex.gif" real_height="100" real_width="148" src="https://w2.chabad.org/media/images/648/uehQ6483780.gif"><br>
<input type="radio" tabindex="34" card="" name="Credit Card Type" value="AMEX" data-dashlane-rid="a54c6b315b3249ae" data-dashlane-classification="payment,type" data-kwimpalastatus="dead"></label></p>
</td>
<td width="25%">
<p style="text-align: center">
<label data-dashlane-label="true"><img width="124" height="84" border="0" alt="Discover.gif" real_height="100" real_width="148" src="https://w2.chabad.org/media/images/648/KmXE6483782.gif"><br>
<input type="radio" tabindex="35" name="Credit Card Type" value="Discover" data-dashlane-rid="a053e2fcd6016333" data-dashlane-classification="payment,type" data-kwimpalastatus="dead"></label></p>
</td>
</tr>
</tbody>
</table>
<span style="font-family: Trebuchet MS"><br>
</span><strong>
<span style="font-family: Trebuchet MS">Credit Card number:</span></strong>                                          <span style="font-family: Trebuchet MS">                                                        <input type="text" tabindex="36" size="40" required="false" name="x_card_num" data-dashlane-rid="24b9f619820f51f0" data-dashlane-classification="payment,number,credit_card" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-12"><span id="1779138072933-12" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 485.172px; top: 1793.28px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span></span><span style="font-family: Trebuchet MS"><br>
<br>
<strong>Expiration date</strong><span style="font-size: 10px">                                                              <em>(MM/YYYY)</em></span><strong>:</strong>                                                     <input type="text" tabindex="37" size="10" required="false" name="x_exp_date" data-dashlane-rid="5276b3dd6bd72151" data-dashlane-classification="date,expiration,credit_card,payment,month,year" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-13">  CVV Security Code: <input type="text" tabindex="38" size="4" required="false" name="x_card_code" data-dashlane-rid="323eddf06e23573f" data-dashlane-classification="payment,credit_card,cvv" data-kwimpalastatus="alive" data-kwimpalaid="1779138072933-14"><span id="1779138072933-13" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 296.031px; top: 1836.28px; width: 16px; min-width: 16px; height: 16px; position: absolute;"></span><span id="1779138072933-14" data-dashlanecreated="true" style="color-scheme: initial; forced-color-adjust: initial; math-depth: initial; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; animation-trigger: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; backface-visibility: initial; background: url('chrome-extension://fdjamakpfbbddfjaooikfcpapjohcfmg/content/injected/logo-autofill-unknown.svg') center center / contain no-repeat; background-blend-mode: initial; baseline-shift: initial; baseline-source: initial; block-size: initial; border-block: initial; border-radius: initial; border-collapse: initial; border-end-end-radius: initial; border-end-start-radius: initial; border-inline: initial; border-shape: initial; border-start-end-radius: initial; border-start-start-radius: initial; bottom: initial; box-decoration-break: initial; box-shadow: initial; box-sizing: initial; break-after: initial; break-before: initial; break-inside: initial; buffered-rendering: initial; caption-side: initial; caret-animation: initial; caret-color: initial; caret-shape: initial; clear: initial; clip: initial; clip-path: initial; clip-rule: initial; color-interpolation: initial; color-interpolation-filters: initial; color-rendering: initial; columns: initial; column-fill: initial; gap: initial; column-rule: initial; column-span: initial; contain: initial; contain-intrinsic-block-size: initial; contain-intrinsic-size: initial; contain-intrinsic-inline-size: initial; container: initial; content: initial; content-visibility: initial; corner-shape: initial; corner-block-end-shape: initial; corner-block-start-shape: initial; counter-increment: initial; counter-reset: initial; counter-set: initial; cx: initial; cy: initial; d: initial; dominant-baseline: initial; dynamic-range-limit: initial; empty-cells: initial; field-sizing: initial; fill: initial; fill-opacity: initial; fill-rule: initial; filter: initial; flex: initial; flex-flow: initial; float: initial; flood-color: initial; flood-opacity: initial; grid: initial; grid-area: initial; hyphenate-character: initial; hyphenate-limit-chars: initial; hyphens: initial; image-orientation: initial; image-rendering: initial; initial-letter: initial; inline-size: initial; inset-block: initial; inset-inline: initial; interactivity: initial; interest-delay: initial; interpolate-size: initial; isolation: initial; letter-spacing: initial; lighting-color: initial; line-break: initial; list-style: initial; margin-block: initial; margin: initial; margin-inline: initial; marker: initial; mask: initial; mask-type: initial; math-shift: initial; math-style: initial; max-block-size: initial; max-height: initial; max-inline-size: initial; max-width: initial; min-block-size: initial; min-height: initial; min-inline-size: initial; mix-blend-mode: initial; object-fit: initial; object-position: initial; object-view-box: initial; offset: initial; order: initial; orphans: initial; outline: initial; outline-offset: initial; overflow-anchor: initial; overflow-block: initial; overflow-clip-margin: initial; overflow-inline: initial; overflow-wrap: initial; overflow: initial; overlay: initial; overscroll-behavior-block: initial; overscroll-behavior-inline: initial; overscroll-behavior: initial; padding-block: initial; padding: initial; padding-inline: initial; page: initial; page-orientation: initial; paint-order: initial; perspective: initial; perspective-origin: initial; pointer-events: initial; position-try: initial; position-visibility: initial; print-color-adjust: initial; quotes: initial; r: initial; reading-flow: initial; reading-order: initial; resize: initial; right: initial; rotate: initial; ruby-align: initial; ruby-position: initial; rx: initial; ry: initial; scale: initial; scroll-behavior: initial; scroll-initial-target: initial; scroll-margin-block: initial; scroll-margin: initial; scroll-margin-inline: initial; scroll-marker-group: initial; scroll-padding-block: initial; scroll-padding: initial; scroll-padding-inline: initial; scroll-snap-align: initial; scroll-snap-stop: initial; scroll-snap-type: initial; scroll-target-group: initial; scroll-timeline: initial; scrollbar-color: initial; scrollbar-gutter: initial; scrollbar-width: initial; shape-image-threshold: initial; shape-margin: initial; shape-outside: initial; shape-rendering: initial; size: initial; speak: initial; stop-color: initial; stop-opacity: initial; stroke: initial; stroke-dasharray: initial; stroke-dashoffset: initial; stroke-linecap: initial; stroke-linejoin: initial; stroke-miterlimit: initial; stroke-opacity: initial; stroke-width: initial; tab-size: initial; table-layout: initial; text-align: initial; text-align-last: initial; text-anchor: initial; text-autospace: initial; text-box: initial; text-combine-upright: initial; text-decoration: initial; text-decoration-skip-ink: initial; text-emphasis: initial; text-emphasis-position: initial; text-indent: initial; text-justify: initial; text-overflow: initial; text-shadow: initial; text-transform: initial; text-underline-offset: initial; text-underline-position: initial; text-wrap: initial; timeline-scope: initial; timeline-trigger: initial; touch-action: initial; transform: initial; transform-box: initial; transform-origin: initial; transform-style: initial; transition: initial; translate: initial; trigger-scope: initial; user-select: initial; vector-effect: initial; vertical-align: initial; view-timeline: initial; view-transition-class: initial; view-transition-group: initial; view-transition-name: initial; view-transition-scope: initial; border-spacing: initial; -webkit-box-align: initial; -webkit-box-decoration-break: initial; -webkit-box-direction: initial; -webkit-box-flex: initial; -webkit-box-ordinal-group: initial; -webkit-box-orient: initial; -webkit-box-pack: initial; -webkit-box-reflect: initial; -webkit-line-break: initial; -webkit-line-clamp: initial; -webkit-mask-box-image: initial; -webkit-rtl-ordering: initial; -webkit-ruby-position: initial; -webkit-tap-highlight-color: initial; -webkit-text-combine: initial; -webkit-text-decorations-in-effect: initial; -webkit-text-fill-color: initial; -webkit-text-security: initial; -webkit-text-stroke: initial; -webkit-user-drag: initial; white-space-collapse: initial; widows: initial; will-change: initial; word-break: initial; word-spacing: initial; x: initial; y: initial; z-index: auto; border-width: medium; border-style: none; border-color: currentcolor; border-image: initial; visibility: visible; opacity: 1; cursor: pointer; display: inline; left: 517.281px; top: 1836.28px; width: 15px; min-width: 15px; height: 16px; position: absolute;"></span></span>                                                <a onclick_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt="%20onclick_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt%3D%22%2520onclick_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt%253D%2522%252520onclick_fckprotectedatt_fckprotectedatt_fckprotectedatt_fckprotectedatt%25253D%252522%25252520onclick_fckprotectedatt_fckprotectedatt_fckprotectedatt%2525253D%25252522%2525252520onclick_fckprotectedatt_fckprotectedatt%252525253D%2525252522%252525252520onclick_fckprotectedatt%25252525253D%252525252522%25252525252520onclick%2525252525253D%25252525252522window.open('%2525252525252Ftools%2525252525252Fdonate%2525252525252FCVVInfo.htm'%2525252525252C'CVVInfo'%2525252525252C'width%2525252525253D440%2525252525252Cheight%2525252525253D480%2525252525252Cresizable%2525252525253Dno%2525252525252Cstatus%2525252525253Dno%2525252525252Cscrollbars%2525252525253Dyes')%2525252525253B%25252525252520return%25252525252520false%2525252525253B%25252525252522%252525252522%2525252522%25252522%252522%2522%22" href="https://getchaicom.clhosting.org/tools/donate/CVVInfo.htm">                                                  <font face="'Trebuchet MS'">                                                            <img width="16" height="18" border="0" alt="" real_height="114" real_width="100" src="http://www.ciwcertified.com/_images/icons/icon_question.jpg"></font><em style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px"><br class="Apple-interchange-newline">
</em></a>
<div>
<font face="Arial, Helvetica, sans-serif">
<i><br>
</i></font>
                </div>
<hr>
<p>
<strong><em>Or...</em> Pay with Paypal</strong></p>
<p>
<span style="font-family: Trebuchet MS"><input type="radio" tabindex="39" name="Credit Card Type" value="Paypal" data-dashlane-rid="49baca44b757720b" data-dashlane-classification="payment,type" data-kwimpalastatus="dead"> I would like to pay with Paypal <br>
</span></p>
<p><a target="_blank" href="https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&amp;hosted_button_id=KYTDUZ8LFYCX6">
<img height="50" border="0" alt="paypal-donate.jpg" src="https://w2.chabad.org/media/images/640/kBHR6405439.jpg"></a> </p>
<p>Clicking the Paypal button will direct you to Paypal's website to complete the transaction.</p>
<p>
<em><strong>Please note:</strong> After completing your payment with Paypal, please click submit on this page to complete your contribution!</em></p>
<hr style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; font-size: 13px">
<p style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<strong><em>Or...</em> Pay with a Check</strong></p>
<table width="100%" cellspacing="0" cellpadding="5" border="0" align="left" dir="ltr" style="border-collapse: collapse">
<tbody>
<tr valign="top">
<td>
<p> <span style="font-family: 'Trebuchet MS'"><input type="radio" tabindex="40" name="Credit Card Type" value="Check" data-dashlane-rid="d91cb05720994390" data-dashlane-classification="payment,type" data-kwimpalastatus="dead"> I would like to pay with a check   <br>
</span></p>
<p style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px"><img width="124" height="84" border="0" alt="paypal-donate.jpg" real_height="125" real_width="185" src="https://w2.chabad.org/media/images/648/dUIi6483790.gif"> </p>
</td>
<td>
<p style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<span style="font-family: 'Trebuchet MS'">Please mail your check (or bring it in) to:</span></p>
<p style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<span style="font-family: 'Trebuchet MS'">
<strong>The Chai Center</strong></span></p>
<p style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<span style="font-family: 'Trebuchet MS'">105 ST Paul St.</span></p>
<p style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<span style="font-family: 'Trebuchet MS'">Brookline, MA 02446 </span></p>
</td>
</tr>
</tbody>
</table>
<p style="background-color: rgb(255,241,225)">
<font face="'Lucida Grande'">
<span style="line-height: normal; font-size: 11px"><br>
</span></font>
                </p>
<p style="text-align: center; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<span style="font-family: 'Trebuchet MS'"> <em>When donating by check, please fill out the form and click submit to complete your pledge.</em></span></p>
<p style="text-align: center; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif; font-size: 13px">
<span style="font-size: 18px">
<strong><span style="font-family: 'Trebuchet MS'"> <em>                                                                                    <span style="font-size: 18px">                                                                                          <strong style="text-align: left; line-height: 16px; background-color: rgb(255,241,225); font-family: Arial, Helvetica, sans-serif, 'MS sans serif'; color: rgb(127,69,58)">Thank You!</strong></span></em></span></strong></span></p>
</fieldset>
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</tbody>
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