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	100K Campaign - Chabad House Jewish Community Center
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text-align: center;
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          <tr>
            <td class="pagetitle">100K Campaign</td>
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<tr>
            <td>
              <p><strong><span class="textplain">Your donation to the Building Fund will support, celebrate and sustain our faith and culture in the MetroWest area. Please accept our sincere thanks in advance for your attention, your energy and your contribution.</span></strong> <span class="textplain"><br>
 <em>Please note: All donations above $180 will be recognized on the "donor wall" in the new Chabad House. See other dedication opportunities <a href="/1914204">here</a>.</em></span></p>
<div class="yes"><br>
 Yes! I would like to join and be</div>
<div class="divselect" onclick="highlightLink(this);"><label class="labelwid"><input id="radio" type="radio" name="x_amount" value="400"> One of <strong>50</strong> and donate <strong>$400</strong></label></div>
<div class="divselect" onclick="highlightLink(this);"><label class="labelwid"><input id="radio" type="radio" name="x_amount" value="500"> One of <strong>20</strong> and donate <strong>$500</strong></label></div>
<div class="divselect" onclick="highlightLink(this);"><label class="labelwid"><input id="radio" type="radio" name="x_amount" value="1000"> One of <strong>15</strong> and donate <strong>$1,000</strong></label></div>
<div class="divselect" onclick="highlightLink(this);"><label class="labelwid"><input id="radio" type="radio" name="x_amount" value="3000"> One of <strong>10</strong> and donate <strong>$3,000</strong></label></div>
<div class="divselect" onclick="highlightLink(this);"><label class="labelwid"><input id="radio" type="radio" name="x_amount" value="5000"> One of <strong>5</strong> and donate <strong>$5,000</strong></label></div>
<div class="divselect" onclick="highlightLink(this);"><label class="labelwid"><input id="radio" type="radio" name="x_amount" value="Other Amount"> Other Amount <input name="Other" type="text" class="formbox" id="Other" size="7"></label></div>
<div style="clear: both">
                <p class="textplain"> </p>
<table cellspacing="0" cellpadding="0" width="100%" border="0">
                  <tbody>
                    <tr>
                      <td class="sectionhead1" colspan="2">My Information</td>
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<tr>
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<tr>
                              <td><label class="formdescrip" for="x_last_name">Last Name</label></td>
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                              <td><label class="formdescrip" for="x_email">Email</label></td>
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<tr>
                              <td><label class="formdescrip" for="x_phone">Phone</label></td>
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<tr>
                              <td><label class="formdescrip" for="Comments">Comments</label></td>
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                            <tr>
                              <td><label class="formdescrip" for="Payment Type">Payment</label></td>
                              <td><select name="Payment Type" id="Payment Type" class="formbox" required="" onchange="changeMitzvahDetails(this);"><option value="" selected description="">-- Select --</option>
                                  <option description="" value="2229">Pay by Credit Card Online</option>
                                  <option description="Mail Payable Check to Chabad, 34 Cedar St, Milford, MA 01757" value="2230">Check is in the Mail</option></select></td>
                            </tr>
<tr>
                              <td width="39%"><label class="formdescrip" for="x_card_num">Card Number</label></td>
                              <td width="61%"><input id="x_card_num" class="formbox" name="x_card_num" type="text"></td>
                            </tr>
<tr>
                              <td><label class="formdescrip" for="x_exp_month">Expiration</label></td>
                              <td><select id="x_exp_month" class="formbox" name="x_exp_month"><option value="Month" selected>Month</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 id="x_exp_year" class="formbox" name="x_exp_year"><option value="Year" selected>Year</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>
                                  <option value="2021">2021</option>
                                  <option value="2022">2022</option>
                                  <option value="2023">2023</option>
                                  <option value="2024">2024</option>
                                  <option value="2025">2025</option>
                                  <option value="2026">2026</option>
                                  <option value="2027">2027</option>
                                  <option value="2028">2028</option>
                                  <option value="2029">2029</option></select></td>
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<tr>
                              <td><label class="formdescrip" for="x_card_code">CVV Code</label></td>
                              <td><input id="x_card_code" class="formbox" name="x_card_code" type="text"></td>
                            </tr>
<tr>
                              <td><label class="formdescrip" for="x_zip">Billing Zip</label></td>
                              <td><input id="x_zip" class="formbox" name="x_zip" type="text"></td>
                            </tr>
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<tr>
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                        <table width="746" border="0" align="center" cellpadding="8" cellspacing="0" style="padding-bottom: 10px;">
                          <tbody>
                            <tr>
                              <td class="pledgeops"> </td>
                              <td colspan="4" class="pledgeops"><strong>We plan on paying off our pledge:</strong>  
<br>
 <input id="Payment in Full" type="radio" name="Pledge" value="Payment in Full"> <label for="Payment in Full">Payment in Full</label>   <input id="Annually" type="radio" name="Pledge" value="Annually" class="trigger" data-rel="pledgedeets"> <label for="Annually">In Installments</label>   
<div class="pledgeinfo pledgedeets">Over the next <select id="x_exp_month2" class="formbox" name="x_exp_month2"><option value="Select" selected>Select</option>
                                    <option value="6 months">6 months</option>
                                    <option value="12 months">12 months</option>
                                    <option value="18 months">18 months</option>
                                    <option value="24 months">24 months</option></select></div>
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<p class="textplain" style="text-align: center"><input id="submit" class="rsvpb" type="submit" name="submit" value="Submit"></p>
<p class="textplain"> </p>
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	<div class="footer3"><b>CHABAD HOUSE JEWISH CENTER | 34 Cedar Street, Milford, MA 01757 | 508.473.1299 | 501c3 EIN 04-3537294</b></div>
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