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class="form-line" id="id_30"><div class="form-label-left" id="label_30"><label for="input_30"> Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_30"> </label></div><div id="cid_30" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q30_phoneNumber[area]" id="input_30_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_30_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q30_phoneNumber[phone]" id="input_30_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_30_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_25"><div class="form-label-left" id="label_25"><label for="input_25"> I would like to donate: </label><label class="label-message" for="input_25"> </label></div><div id="cid_25" class="form-input"> <div class="form-multiple-column" data-columns="2"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_0" name="q25_iWant" value="1800" /><label for="input_25_0"><span>$1800 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_1" name="q25_iWant" value="1000" /><label for="input_25_1"><span>$1000 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_25_2" name="q25_iWant" value="770" /><label for="input_25_2"><span>$770 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_3" name="q25_iWant" value="540" /><label for="input_25_3"><span>$540 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_25_4" name="q25_iWant" value="360" /><label for="input_25_4"><span>$360 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_5" name="q25_iWant" value="180" /><label for="input_25_5"><span>$180 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_25_6" name="q25_iWant" value="100" /><label for="input_25_6"><span>$100 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_7" name="q25_iWant" value="72" /><label for="input_25_7"><span>$72 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_25_8" name="q25_iWant" value="54" /><label for="input_25_8"><span>$54 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_9" name="q25_iWant" value="36" /><label for="input_25_9"><span>$36 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_25_10" name="q25_iWant" value="18" /><label for="input_25_10"><span>$18 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_25_11" name="q25_iWant" value="5" /><label for="input_25_11"><span>$5 USD</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio" name="q25_iWant" id="other_25" value="" /><span><input type="number" min="1" class="form-radio-other-input form-textbox" onkeypress="validateNumber(event)" name="q25_iWant[other]" data-otherhint="Other" size="15" id="input_25" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_5"><div class="form-label-left" id="label_5"><label for="input_5"> Total Charge </label></div><div id="cid_5" class="form-input"> <div id="total_amount">$0.00 USD</div> </div></li><li class="form-line" id="id_1"><div class="form-label-left" id="label_1"><label for="input_1"> Payment Method<span class="form-required">*</span> </label><label class="label-message" for="input_1"> </label></div><div id="cid_1" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2" class="form-payment-methods form-multiple-column"><span class="form-radio-item"><input class="paymentMethod form-radio validate[required, paymentMethod] form-radio" type="radio" id="input_1_creditCard" name="q1_paymentMethod[payment_method]" value="creditCard" onclick="BuildSource.creditCard(this)" /><label 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