{"id":17913,"date":"2020-12-31T13:57:21","date_gmt":"2020-12-31T18:57:21","guid":{"rendered":"https:\/\/nche.com\/?page_id=17913"},"modified":"2023-12-10T12:05:15","modified_gmt":"2023-12-10T17:05:15","slug":"support-home-education-in-nc-with-monthly-donations","status":"publish","type":"page","link":"https:\/\/nche.com\/uk\/support-home-education-in-nc-with-monthly-donations\/","title":{"rendered":"\u041f\u0456\u0434\u0442\u0440\u0438\u043c\u0443\u0439\u0442\u0435 \u0434\u043e\u043c\u0430\u0448\u043d\u044e \u043e\u0441\u0432\u0456\u0442\u0443 \u0432 \u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456\u0439 \u041a\u0430\u0440\u043e\u043b\u0456\u043d\u0456 \u0449\u043e\u043c\u0456\u0441\u044f\u0447\u043d\u0438\u043c\u0438 \u043f\u043e\u0436\u0435\u0440\u0442\u0432\u0430\u043c\u0438"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_5,3_5,1_5&#8243; _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_5&#8243; _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_column][et_pb_column type=&#8221;3_5&#8243; _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_image src=&#8221;<a href=\"https:\/\/nche.com\/wp-content\/uploads\/2023\/12\/Give-to-NCHE.-1.png&#038;#8221\">https:\/\/nche.com\/wp-content\/uploads\/2023\/12\/Give-to-NCHE.-1.png&#038;#8221<\/a>; title_text=&#8221;Give to NCHE. (1)&#8221; _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][et_pb_text _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||-3px|||&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2 style=\"text-align: center;\"><span style=\"color: #545454;\">Support NCHE with a Monthly Donation<\/span><\/h2>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p style=\"text-align: center;\"><span style=\"color: #545454;\">[NCHE is a member and donor-supported 501(c)(3) non profit. <br \/>Donations are tax-deductible to the extent allowed by law.]<\/span><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_5&#8243; _builder_version=&#8221;4.23.1&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_column][\/et_pb_row][et_pb_row 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class='ginput_container ginput_container_text'><input name='input_24' id='input_170_24' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_170_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c080931d\" data-field-span=\"12\"><legend id='gfield_label_170_1' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_170_1'>\n                            \n                            <span 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id='input_170_1_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_170_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4b12d39c\" data-field-span=\"12\"><label id='gfield_label_170_3' class='gfield_label gform-field-label' for='input_170_3'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_170_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_170_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7933943f\" data-field-span=\"12\"><label id='gfield_label_170_7' class='gfield_label gform-field-label' for='input_170_7'><span class='gform-field-label__text'>Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_170_7' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_170_2\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above 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aria-labelledby=\"input_170_2_1_label gfield_label_170_2\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_170_2_2_container' >\n                                        <label for='input_170_2_2' id='input_170_2_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_2.2' id='input_170_2_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_170_2_3_container' >\n                                    <label for='input_170_2_3' id='input_170_2_3_label' class='gform-field-label gform-field-label--type-sub '>\u041c\u0456\u0441\u0442\u043e<\/label>\n                                    <input type='text' name='input_2.3' id='input_170_2_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_170_2_4_container' >\n                                        <label for='input_170_2_4' id='input_170_2_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_2.4' id='input_170_2_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430' >\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='\u0413\u0440\u0443\u0437\u0456\u044f' >\u0413\u0440\u0443\u0437\u0456\u044f<\/option><option value='\u0413\u0443\u0430\u043c' >\u0413\u0443\u0430\u043c<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='\u0406\u043d\u0434\u0456\u0430\u043d\u0430' >\u0406\u043d\u0434\u0456\u0430\u043d\u0430<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456' >\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='\u041d\u044c\u044e-\u0419\u043e\u0440\u043a' >\u041d\u044c\u044e-\u0419\u043e\u0440\u043a<\/option><option value='North Carolina' selected='selected'>North Carolina<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e' >\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432' >\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_170_2_5_container' >\n                                    <label for='input_170_2_5' id='input_170_2_5_label' class='gform-field-label gform-field-label--type-sub '>Zip\/ Postal Code<\/label>\n                                    <input type='text' name='input_2.5' id='input_170_2_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_2.6' id='input_170_2_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_170_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"bcaee607\" data-field-span=\"12\"><legend id='gfield_label_170_30' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How would you like your donation to be publicized?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_170_30'>\n\t\t\t<div class='gchoice gchoice_170_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Please publicize this donation as anonymous.'  id='choice_170_30_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_170_30_0 gfield_label_170_30\"   \/>\n\t\t\t\t\t<label for='choice_170_30_0' id='label_170_30_0' class='gform-field-label gform-field-label--type-inline'>Please publicize this donation as anonymous.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_170_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='You may use my name when publicizing this donation.'  id='choice_170_30_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_170_30_1' id='label_170_30_1' class='gform-field-label gform-field-label--type-inline'>You may use my name when publicizing this donation.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_170_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"ba77fa8b\" data-field-span=\"12\"><legend id='gfield_label_170_28' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>GREENHOUSE Magazine<\/span><\/legend><div class='gfield_description' id='gfield_description_170_28'>NCHE offers donors the opportunity to receive the GREENHOUSE magazine. It brings words of encouragement, methods of homeschooling, stories of student success and news to keep homeschoolers informed. NCHE prints three issues annually (spring and fall plus an annual graduate issue)<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_170_28'>\n\t\t\t<div class='gchoice gchoice_170_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes, I would like to have the GREENHOUSE mailed to my address for a year.'  id='choice_170_28_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_170_28\" aria-labelledby=\"label_170_28_0 gfield_label_170_28\"   \/>\n\t\t\t\t\t<label for='choice_170_28_0' id='label_170_28_0' class='gform-field-label gform-field-label--type-inline'>Yes, I would like to have the GREENHOUSE mailed to my address for a year.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_170_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No, I don&#039;t want to have the GREENHOUSE mailed to my address for a year.'  id='choice_170_28_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_170_28_1' id='label_170_28_1' class='gform-field-label gform-field-label--type-inline'>No, I don't want to have the GREENHOUSE mailed to my address for a year.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_170_26\" class=\"gfield gfield--type-product gfield--input-type-price gfield_price gfield_price_170_26 gfield_product_170_26 gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"3d58e843\" data-field-span=\"12\"><label id='gfield_label_170_26' class='gfield_label gform-field-label' for='input_170_26'><span class='gform-field-label__text'>Monthly Donation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_170_26'>Enter the amount you would like to donate every month. Your card will be charged this amount every 30 days.<\/div><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_26' id='input_170_26' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_170_26\" \/>\n\t\t\t\t<\/div><\/div><fieldset id=\"field_170_31\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"1141aae5\" data-field-span=\"12\"><legend id='gfield_label_170_31' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>3% Fee<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_170_31'><div class='gchoice gchoice_170_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='I&#039;d like to donate an additional 3% to cover the processing fee.'  id='choice_170_31_1'    aria-labelledby=\"label_170_31_1 gfield_label_170_31\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_170_31_1' id='label_170_31_1' class='gform-field-label gform-field-label--type-inline'>I'd like to donate an additional 3% to cover the processing fee.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_170_33\" class=\"gfield gfield--type-tax gfield--input-type-tax gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1df82e77\" data-field-span=\"12\"><label id='gfield_label_170_33' class='gfield_label gform-field-label' for='input_170_33'><span class='gform-field-label__text'>Processing Fee<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_170_33'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_33' id='input_170_33' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='3' data-amounttype='percent'\n                    data-productstype='all' data-products='[]' \/>\n            <\/div><\/div><div id=\"field_170_34\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_170_ gfield_total gfield_total_170_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"b05551da\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_170_34' class='gfield_label gform-field-label' for='input_170_34'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_34' id='input_170_34' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_170'  \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_170_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"38e80b53\" data-field-span=\"12\">Send an email to nche@nche.com when you want to stop your monthly contribution.<\/div><div id=\"field_170_23\" class=\"gfield gfield--type-total gfield--input-type-total gfield_price gfield_price_170_ gfield_total gfield_total_170_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"07ff1f6c\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_170_23' class='gfield_label gform-field-label' for='input_170_23'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_23' id='input_170_23' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_170'  \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_170_13\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1e784b22\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_13' id='input_170_13' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_170_14\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1f2f0490\" data-field-span=\"12\"><legend id='gfield_label_170_14' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Billing Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    <div id='input_170_14_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_170_14_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='2' data-source-field-label='Address' data-destination-field-label='Billing Address' name='input_14_copy_values_activated'   checked='checked'\/>\n                                        <label for='input_170_14_copy_values_activated' id='input_170_14_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Billing address is same as above<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_170_14' style='display:none;'>\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_170_14_1_container' >\n                                        <label for='input_170_14_1' id='input_170_14_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_14.1' id='input_170_14_1' value=''    aria-required='true'    aria-labelledby=\"input_170_14_1_label gfield_label_170_14\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_170_14_2_container' >\n                                        <label for='input_170_14_2' id='input_170_14_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_14.2' id='input_170_14_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_170_14_3_container' >\n                                    <label for='input_170_14_3' id='input_170_14_3_label' class='gform-field-label gform-field-label--type-sub '>\u041c\u0456\u0441\u0442\u043e<\/label>\n                                    <input type='text' name='input_14.3' id='input_170_14_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_170_14_4_container' >\n                                        <label for='input_170_14_4' id='input_170_14_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_14.4' id='input_170_14_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430' >\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='\u0413\u0440\u0443\u0437\u0456\u044f' >\u0413\u0440\u0443\u0437\u0456\u044f<\/option><option value='\u0413\u0443\u0430\u043c' >\u0413\u0443\u0430\u043c<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='\u0406\u043d\u0434\u0456\u0430\u043d\u0430' >\u0406\u043d\u0434\u0456\u0430\u043d\u0430<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456' >\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='\u041d\u044c\u044e-\u0419\u043e\u0440\u043a' >\u041d\u044c\u044e-\u0419\u043e\u0440\u043a<\/option><option value='North Carolina' selected='selected'>North Carolina<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e' >\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432' >\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_170_14_5_container' >\n                                    <label for='input_170_14_5' id='input_170_14_5_label' class='gform-field-label gform-field-label--type-sub '>Zip\/ Postal Code<\/label>\n                                    <input type='text' name='input_14.5' id='input_170_14_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_14.6' id='input_170_14_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_170_12\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"16f17f99\" data-field-span=\"12\"><legend id='gfield_label_170_12' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Credit Card<\/span><\/legend><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_170_12'><span class='ginput_full gform-grid-col' id='input_170_12_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_170_12_supported_creditcards'>\u041f\u0456\u0434\u0442\u0440\u0438\u043c\u0443\u044e\u0442\u044c\u0441\u044f \u043a\u0440\u0435\u0434\u0438\u0442\u043d\u0456 \u043a\u0430\u0440\u0442\u043a\u0438: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <label for='input_170_12_1' id='input_170_12_1_label' class='gform-field-label gform-field-label--type-sub '>Card Number<\/label>\n                                    <input type='text' name='input_12.1' id='input_170_12_1' value=''   onchange='gformMatchCard(\"input_170_12_1\");' onkeyup='gformMatchCard(\"input_170_12_1\");' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'   aria-labelledby=\"input_170_12_1_label gfield_label_170_12\"\/>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_170_12_2_container'>\n                                            <fieldset class='ginput_cardinfo_left gform-grid-col' id='input_170_12_2_cardinfo_left'>\n                                            <legend class='gform-field-label gform-field-label--type-sub '>Expiration Date<\/legend>\n                                                <span class='ginput_card_expiration_container ginput_card_field gform-grid-row'>\n                                                   <span class='ginput_card_expiration_month_container gform-grid-col'>\n                                                       <label for='input_170_12_2_month' class='gform-field-label gform-field-label--type-sub screen-reader-text'>\u041c\u0456\u0441\u044f\u0446\u044c<\/label>\n                                                       <select name='input_12.2[]' id='input_170_12_2_month'   class='ginput_card_expiration ginput_card_expiration_month' aria-required='false'  >\n                                                           <option value=''>\u041c\u0456\u0441\u044f\u0446\u044c<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                   <span class='ginput_card_expiration_year_container gform-grid-col'>\n                                                       <label for='input_170_12_2_year' class='gform-field-label gform-field-label--type-sub screen-reader-text'>\u0420\u0456\u043a<\/label>\n                                                       <select name='input_12.2[]' id='input_170_12_2_year'   class='ginput_card_expiration ginput_card_expiration_year' aria-required='false'  >\n                                                           <option value=''>\u0420\u0456\u043a<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' >2040<\/option><option value='2041' >2041<\/option><option value='2042' >2042<\/option><option value='2043' >2043<\/option><option value='2044' >2044<\/option><option value='2045' >2045<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                <\/span>\n                                            <\/fieldset><span class='ginput_cardinfo_right gform-grid-col' id='input_170_12_2_cardinfo_right'>\n                                                <label for='input_170_12_3' class='gform-field-label gform-field-label--type-sub '>Security Code<\/label>\n                                                <input type='text' name='input_12.3' id='input_170_12_3'   class='ginput_card_security_code' value='' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'  \/>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_170_12_5_container'>\n                                            <label for='input_170_12_5' id='input_170_12_5_label' class='gform-field-label gform-field-label--type-sub '>Cardholder Name<\/label>\n                                            <input type='text' name='input_12.5' id='input_170_12_5' value=''    aria-required='false'  \/>\n                                        <\/span> <\/div><\/fieldset><div id=\"field_170_29\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"555f3149\" data-field-span=\"12\"><strong>Financial information about this organization and a copy of its license are available from the State Solicitation Licensing Branch at 919-814-5400. The license is not an endorsement by the State.<\/strong><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <div class=\"gf-turnstile-container\"> <div id=\"cf-turnstile-gf-170\" class=\"cf-turnstile\" data-sitekey=\"0x4AAAAAAD2GVFzEN5GUCS3W\" data-theme=\"light\" data-language=\"auto\" data-size=\"normal\" data-retry=\"auto\" data-retry-interval=\"1000\" data-refresh-expired=\"auto\" data-refresh-timeout=\"auto\" data-action=\"gravity-form-170\" data-callback=\"turnstileGravityCallback\" data-appearance=\"always\"><\/div> <style>.gform_button { pointer-events: none; opacity: 0.5; }<\/style> <script data-jetpack-boost=\"ignore\" data-jetpack-boost=\"ignore\" data-cfasync=\"false\">(window.cfturnstileQueue=window.cfturnstileQueue||[]).push(\"-gf-170\");if(window.cfturnstileRender)window.cfturnstileRender();<\/script> <br class=\"cf-turnstile-br cf-turnstile-br-gf-170\"> <style>#cf-turnstile-gf-170 { margin-left: -15px; }<\/style> <\/div> <style> .gf-turnstile-container { width: 100%; } .gform_footer.top_label { display: flex; flex-wrap: wrap; } <\/style> <script data-jetpack-boost=\"ignore\" data-jetpack-boost=\"ignore\">document.addEventListener(\"DOMContentLoaded\", function() {document.addEventListener('gform\/post_render', function handlePostRender(event) {if (event.detail.formId !== 170) {return;}gform.utils.addAsyncFilter('gform\/submission\/pre_submission', async function handlePreSubmission(data) {document.addEventListener('gform\/post_render', function rerenderTurnstile(event) {if (event.detail.formId !== 170) {return;}const turnstileElement = document.getElementById('cf-turnstile-gf-170');if (turnstileElement) {turnstile.remove('#cf-turnstile-gf-170');turnstile.render('#cf-turnstile-gf-170', (typeof window.cfturnstileOpts === \"function\" ? window.cfturnstileOpts(turnstileElement) : {}));}document.removeEventListener('gform\/post_render', rerenderTurnstile);});gform.utils.removeFilter('gform\/submission\/pre_submission', handlePreSubmission);return data;});document.removeEventListener('gform\/post_render', handlePostRender);});});<\/script><button type='submit' id='gform_submit_button_170' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >\u0412\u0456\u0434\u043f\u0440\u0430\u0432\u0438\u0442\u0438<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_170' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_170' id='gform_theme_170' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_170' id='gform_style_settings_170' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_170' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='170' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='KBR1JgjY+e3LEIAdg7mKgUgBfQbbvwXBm5\/Cm+8jbB8d2EPou0307Vl4pUYLGUXwZmgrZQ26XFAM7SHYm4ki9xEqLxNIp6oNe7Y33hUinY8KHlE=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_170' value='WyJ7XCIzMFwiOltcImQ0MzM0ZGI4NGM2NTJlMGVhNTAwNDM1YWM5MWRhYWFhXCIsXCIyZjNhMjIzM2NhZWYxZGY1ZTBmYWE4MTVjMmMzYWI0N1wiXSxcIjMxLjFcIjpcImMwNmM5MDIxMGRjYmQzMjE5MTc5MzRjNzQwMmUzZDU0XCIsXCIzMy4xXCI6XCIzY2RiOGY0ZDdiMThhOGE2NjA2MGM0OTFkMjFiMzAzY1wiLFwiMzMuMlwiOlwiZmM0M2MzNjFkNjg2YTM5MmFjNWYxNzU1ZTg4YmI4OWZcIixcImdmb3JtX3N1Ym1pc3Npb25fbWV0aG9kXCI6W1wiYzE4N2UxYmMzNjZiZDhhYjQ3YjBlNmNjNWM0MzhkNzlcIixcIjZmZGFiODRmNzdkZDNiNGU1MWEwNzY2MGZkZjg3NmE2XCJdLFwiZ2Zvcm1fdGhlbWVcIjpcImE3OWM4OGJkYWFlNGY4MDg2MzQ5ZTQ1YTZjMDIzMmRmXCIsXCJnZm9ybV9zdHlsZV9zZXR0aW5nc1wiOlwiYjA4ZTIwNDc0ZTA5NWQxYWNhNTAzYjNkNTk5YmNiYWRcIixcImZvcm1faWRcIjpcImI5NmJlNWIxODE0NDFmNzkzZmRmOTBlZjU3YjgzYjdhXCIsXCJ1cmxcIjpcImYzMDEzMTE2M2I1OGMzOThkOWUyYzY3ZWUxNmQ1YTUxXCIsXCJzdGF0ZV90aW1lc3RhbXBcIjpcIjEyMGYzOTYwZmQ3NmJmNDIxYWY3NWM2NjFmNmJkYWIzXCJ9IiwiOTRiNDU4MjMwNTEzZWI0NzY1OTgxYTlkMDFmMWM4ZjMiLDE3OTQxMzU2NTNd' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_170' id='gform_target_page_number_170' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_170' id='gform_source_page_number_170' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_5&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Support NCHE with a Monthly Donation[NCHE is a member and donor-supported 501(c)(3) non profit. Donations are tax-deductible to the extent allowed by law.]\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_170' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; \u043f\u043e\u0437\u043d\u0430\u0447\u0430\u0454 \u043e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u0456 \u043f\u043e\u043b\u044f<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_170'  action='\/uk\/wp-json\/wp\/v2\/pages\/17913' data-formid='170' novalidate>\t\t\t\t\t<div style=\"display: none !important;\" class=\"akismet-fields-container gf_invisible\" data-prefix=\"ak_\">\n\t\t\t\t\t\t<label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"ak_js_2\" name=\"ak_js\" value=\"205\" \/>\n\t\t\t\t\t\t<script data-jetpack-boost=\"ignore\">\ndocument.getElementById( \"ak_js_2\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n\n\t\t\t\t\t<\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_170' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_170_35\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_170_35' class='gfield_label gform-field-label' for='input_170_35'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='gfield_description' id='gfield_description_170_35'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_35' id='input_170_35' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_170_24\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"b143a585\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_24' id='input_170_24' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_170_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c080931d\" data-field-span=\"12\"><legend id='gfield_label_170_1' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_170_1'>\n                            \n                            <span id='input_170_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_170_1_3' id='input_170_1_3_label' class='gform-field-label gform-field-label--type-sub '>\u041f\u0435\u0440\u043d\u0438\u0439<\/label>\n                                                    <input type='text' name='input_1.3' id='input_170_1_3' value=''   aria-required='true'     aria-labelledby=\"input_170_1_3_label gfield_label_170_1\"\/>\n                                                <\/span>\n                            \n                            <span id='input_170_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_170_1_6' id='input_170_1_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_1.6' id='input_170_1_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_170_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4b12d39c\" data-field-span=\"12\"><label id='gfield_label_170_3' class='gfield_label gform-field-label' for='input_170_3'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_170_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_170_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7933943f\" data-field-span=\"12\"><label id='gfield_label_170_7' class='gfield_label gform-field-label' for='input_170_7'><span class='gform-field-label__text'>Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_170_7' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_170_2\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"00e16848\" data-field-span=\"12\"><legend id='gfield_label_170_2' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_170_2' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_170_2_1_container' >\n                                        <label for='input_170_2_1' id='input_170_2_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_2.1' id='input_170_2_1' value=''    aria-required='true'    aria-labelledby=\"input_170_2_1_label gfield_label_170_2\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_170_2_2_container' >\n                                        <label for='input_170_2_2' id='input_170_2_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_2.2' id='input_170_2_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_170_2_3_container' >\n                                    <label for='input_170_2_3' id='input_170_2_3_label' class='gform-field-label gform-field-label--type-sub '>\u041c\u0456\u0441\u0442\u043e<\/label>\n                                    <input type='text' name='input_2.3' id='input_170_2_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_170_2_4_container' >\n                                        <label for='input_170_2_4' id='input_170_2_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_2.4' id='input_170_2_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430' >\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='\u0413\u0440\u0443\u0437\u0456\u044f' >\u0413\u0440\u0443\u0437\u0456\u044f<\/option><option value='\u0413\u0443\u0430\u043c' >\u0413\u0443\u0430\u043c<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='\u0406\u043d\u0434\u0456\u0430\u043d\u0430' >\u0406\u043d\u0434\u0456\u0430\u043d\u0430<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456' >\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='\u041d\u044c\u044e-\u0419\u043e\u0440\u043a' >\u041d\u044c\u044e-\u0419\u043e\u0440\u043a<\/option><option value='North Carolina' selected='selected'>North Carolina<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e' >\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432' >\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_170_2_5_container' >\n                                    <label for='input_170_2_5' id='input_170_2_5_label' class='gform-field-label gform-field-label--type-sub '>Zip\/ Postal Code<\/label>\n                                    <input type='text' name='input_2.5' id='input_170_2_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_2.6' id='input_170_2_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_170_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"bcaee607\" data-field-span=\"12\"><legend id='gfield_label_170_30' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How would you like your donation to be publicized?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_170_30'>\n\t\t\t<div class='gchoice gchoice_170_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Please publicize this donation as anonymous.'  id='choice_170_30_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_170_30_0 gfield_label_170_30\"   \/>\n\t\t\t\t\t<label for='choice_170_30_0' id='label_170_30_0' class='gform-field-label gform-field-label--type-inline'>Please publicize this donation as anonymous.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_170_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='You may use my name when publicizing this donation.'  id='choice_170_30_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_170_30_1' id='label_170_30_1' class='gform-field-label gform-field-label--type-inline'>You may use my name when publicizing this donation.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_170_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"ba77fa8b\" data-field-span=\"12\"><legend id='gfield_label_170_28' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>GREENHOUSE Magazine<\/span><\/legend><div class='gfield_description' id='gfield_description_170_28'>NCHE offers donors the opportunity to receive the GREENHOUSE magazine. It brings words of encouragement, methods of homeschooling, stories of student success and news to keep homeschoolers informed. NCHE prints three issues annually (spring and fall plus an annual graduate issue)<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_170_28'>\n\t\t\t<div class='gchoice gchoice_170_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes, I would like to have the GREENHOUSE mailed to my address for a year.'  id='choice_170_28_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_170_28\" aria-labelledby=\"label_170_28_0 gfield_label_170_28\"   \/>\n\t\t\t\t\t<label for='choice_170_28_0' id='label_170_28_0' class='gform-field-label gform-field-label--type-inline'>Yes, I would like to have the GREENHOUSE mailed to my address for a year.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_170_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No, I don&#039;t want to have the GREENHOUSE mailed to my address for a year.'  id='choice_170_28_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_170_28_1' id='label_170_28_1' class='gform-field-label gform-field-label--type-inline'>No, I don't want to have the GREENHOUSE mailed to my address for a year.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_170_26\" class=\"gfield gfield--type-product gfield--input-type-price gfield_price gfield_price_170_26 gfield_product_170_26 gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"3d58e843\" data-field-span=\"12\"><label id='gfield_label_170_26' class='gfield_label gform-field-label' for='input_170_26'><span class='gform-field-label__text'>Monthly Donation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_170_26'>Enter the amount you would like to donate every month. Your card will be charged this amount every 30 days.<\/div><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_26' id='input_170_26' type='text' value='' class='small ginput_amount'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_170_26\" \/>\n\t\t\t\t<\/div><\/div><fieldset id=\"field_170_31\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"1141aae5\" data-field-span=\"12\"><legend id='gfield_label_170_31' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>3% Fee<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_170_31'><div class='gchoice gchoice_170_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='I&#039;d like to donate an additional 3% to cover the processing fee.'  id='choice_170_31_1'    aria-labelledby=\"label_170_31_1 gfield_label_170_31\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_170_31_1' id='label_170_31_1' class='gform-field-label gform-field-label--type-inline'>I'd like to donate an additional 3% to cover the processing fee.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_170_33\" class=\"gfield gfield--type-tax gfield--input-type-tax gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1df82e77\" data-field-span=\"12\"><label id='gfield_label_170_33' class='gfield_label gform-field-label' for='input_170_33'><span class='gform-field-label__text'>Processing Fee<\/span><\/label>\n            <div class='ginput_container'>\n                <span class='ginput_tax ginput_product_price ginput_tax_170_33'\n                \tstyle=''>$0.00<\/span>\n                <input type='hidden' name='input_33' id='input_170_33' class='gform_hidden ginput_tax_input' \n                    onchange='jQuery( this ).prev( \"span\" ).text( gformFormatMoney( this.value, true ) );' \n                    data-amount='3' data-amounttype='percent'\n                    data-productstype='all' data-products='[]' \/>\n            <\/div><\/div><div id=\"field_170_34\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full gfield_price gfield_price_170_ gfield_total gfield_total_170_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"b05551da\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_170_34' class='gfield_label gform-field-label' for='input_170_34'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_34' id='input_170_34' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_170'  \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_170_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"38e80b53\" data-field-span=\"12\">Send an email to nche@nche.com when you want to stop your monthly contribution.<\/div><div id=\"field_170_23\" class=\"gfield gfield--type-total gfield--input-type-total gfield_price gfield_price_170_ gfield_total gfield_total_170_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"07ff1f6c\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_170_23' class='gfield_label gform-field-label' for='input_170_23'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_23' id='input_170_23' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_170'  \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_170_13\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1e784b22\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_13' id='input_170_13' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_170_14\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1f2f0490\" data-field-span=\"12\"><legend id='gfield_label_170_14' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Billing Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    <div id='input_170_14_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_170_14_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='2' data-source-field-label='Address' data-destination-field-label='Billing Address' name='input_14_copy_values_activated'   checked='checked'\/>\n                                        <label for='input_170_14_copy_values_activated' id='input_170_14_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Billing address is same as above<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_170_14' style='display:none;'>\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_170_14_1_container' >\n                                        <label for='input_170_14_1' id='input_170_14_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_14.1' id='input_170_14_1' value=''    aria-required='true'    aria-labelledby=\"input_170_14_1_label gfield_label_170_14\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_170_14_2_container' >\n                                        <label for='input_170_14_2' id='input_170_14_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_14.2' id='input_170_14_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_170_14_3_container' >\n                                    <label for='input_170_14_3' id='input_170_14_3_label' class='gform-field-label gform-field-label--type-sub '>\u041c\u0456\u0441\u0442\u043e<\/label>\n                                    <input type='text' name='input_14.3' id='input_170_14_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_170_14_4_container' >\n                                        <label for='input_170_14_4' id='input_170_14_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_14.4' id='input_170_14_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430' >\u0410\u043c\u0435\u0440\u0438\u043a\u0430\u043d\u0441\u044c\u043a\u0435 \u0421\u0430\u043c\u043e\u0430<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='\u0413\u0440\u0443\u0437\u0456\u044f' >\u0413\u0440\u0443\u0437\u0456\u044f<\/option><option value='\u0413\u0443\u0430\u043c' >\u0413\u0443\u0430\u043c<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='\u0406\u043d\u0434\u0456\u0430\u043d\u0430' >\u0406\u043d\u0434\u0456\u0430\u043d\u0430<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456' >\u041a\u0435\u043d\u0442\u0443\u043a\u043a\u0456<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='\u041d\u044c\u044e-\u0419\u043e\u0440\u043a' >\u041d\u044c\u044e-\u0419\u043e\u0440\u043a<\/option><option value='North Carolina' selected='selected'>North Carolina<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0430 \u0414\u0430\u043a\u043e\u0442\u0430<\/option><option value='\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438' >\u041f\u0456\u0432\u043d\u0456\u0447\u043d\u0456 \u041c\u0430\u0440\u0456\u0430\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e' >\u041f\u043e\u0440\u0442 \u0420\u0456\u043a\u043e<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432' >\u0412\u0456\u0440\u0433\u0456\u043d\u0441\u044c\u043a\u0456 \u043e\u0441\u0442\u0440\u043e\u0432\u0438 \u0421\u043f\u043e\u043b\u0443\u0447\u0435\u043d\u0438\u0445 \u0428\u0442\u0430\u0442\u0456\u0432<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_170_14_5_container' >\n                                    <label for='input_170_14_5' id='input_170_14_5_label' class='gform-field-label gform-field-label--type-sub '>Zip\/ Postal Code<\/label>\n                                    <input type='text' name='input_14.5' id='input_170_14_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_14.6' id='input_170_14_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_170_12\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"16f17f99\" data-field-span=\"12\"><legend id='gfield_label_170_12' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Credit Card<\/span><\/legend><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_170_12'><span class='ginput_full gform-grid-col' id='input_170_12_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_170_12_supported_creditcards'>\u041f\u0456\u0434\u0442\u0440\u0438\u043c\u0443\u044e\u0442\u044c\u0441\u044f \u043a\u0440\u0435\u0434\u0438\u0442\u043d\u0456 \u043a\u0430\u0440\u0442\u043a\u0438: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <label for='input_170_12_1' id='input_170_12_1_label' class='gform-field-label gform-field-label--type-sub '>Card Number<\/label>\n                                    <input type='text' name='input_12.1' id='input_170_12_1' value=''   onchange='gformMatchCard(\"input_170_12_1\");' onkeyup='gformMatchCard(\"input_170_12_1\");' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'   aria-labelledby=\"input_170_12_1_label gfield_label_170_12\"\/>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_170_12_2_container'>\n                                            <fieldset class='ginput_cardinfo_left gform-grid-col' id='input_170_12_2_cardinfo_left'>\n                                            <legend class='gform-field-label gform-field-label--type-sub '>Expiration Date<\/legend>\n                                                <span class='ginput_card_expiration_container ginput_card_field gform-grid-row'>\n                                                   <span class='ginput_card_expiration_month_container gform-grid-col'>\n                                                       <label for='input_170_12_2_month' class='gform-field-label gform-field-label--type-sub screen-reader-text'>\u041c\u0456\u0441\u044f\u0446\u044c<\/label>\n                                                       <select name='input_12.2[]' id='input_170_12_2_month'   class='ginput_card_expiration ginput_card_expiration_month' aria-required='false'  >\n                                                           <option value=''>\u041c\u0456\u0441\u044f\u0446\u044c<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                   <span class='ginput_card_expiration_year_container gform-grid-col'>\n                                                       <label for='input_170_12_2_year' class='gform-field-label gform-field-label--type-sub screen-reader-text'>\u0420\u0456\u043a<\/label>\n                                                       <select name='input_12.2[]' id='input_170_12_2_year'   class='ginput_card_expiration ginput_card_expiration_year' aria-required='false'  >\n                                                           <option value=''>\u0420\u0456\u043a<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' >2040<\/option><option value='2041' >2041<\/option><option value='2042' >2042<\/option><option value='2043' >2043<\/option><option value='2044' >2044<\/option><option value='2045' >2045<\/option>\n                                                       <\/select>\n                                                   <\/span>\n                                                <\/span>\n                                            <\/fieldset><span class='ginput_cardinfo_right gform-grid-col' id='input_170_12_2_cardinfo_right'>\n                                                <label for='input_170_12_3' class='gform-field-label gform-field-label--type-sub '>Security Code<\/label>\n                                                <input type='text' name='input_12.3' id='input_170_12_3'   class='ginput_card_security_code' value='' autocomplete='off' pattern='[0-9]*' title='Only digits are allowed'  aria-required='false'  \/>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_170_12_5_container'>\n                                            <label for='input_170_12_5' id='input_170_12_5_label' class='gform-field-label gform-field-label--type-sub '>Cardholder Name<\/label>\n                                            <input type='text' name='input_12.5' id='input_170_12_5' value=''    aria-required='false'  \/>\n                                        <\/span> <\/div><\/fieldset><div id=\"field_170_29\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"555f3149\" data-field-span=\"12\"><strong>Financial information about this organization and a copy of its license are available from the State Solicitation Licensing Branch at 919-814-5400. 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