1 UNKNOWN_TYPE | f1 | MATHCOUNTS Foundation Online Donation Form |
2 NAME_FIRST | dnrfirst | Name * |
3 NAME_LAST | dnrlast | Name * |
4 COMPANY_NAME | company | Company |
5 ADDRESS_HOME_LINE1 | dadd1 | Address 1 * |
6 ADDRESS_HOME_LINE2 | dadd2 | Address 2 |
7 ADDRESS_HOME_CITY | dcity | City / State / Zip * |
8 ADDRESS_HOME_STATE | dstate | Name * | AL
9 ADDRESS_HOME_ZIP | dzip | Name * |
10 ADDRESS_HOME_COUNTRY | CC_COUNTRY | Country | United States
11 PHONE_HOME_WHOLE_NUMBER | dphone | Telephone |
12 EMAIL_ADDRESS | demail | Email * |
13 UNKNOWN_TYPE | amt | $ |
14 UNKNOWN_TYPE | tributeSelect | Name * | on
15 UNKNOWN_TYPE | DonationType | Name * | OneTime
16 UNKNOWN_TYPE | DonationType | This is a one time donation | Recurs
17 UNKNOWN_TYPE | ccrecurring | I would like to make this a recurring donation deducted | Monthly
18 UNKNOWN_TYPE | remLen | ( You may enter up to 500 characters. ) | 500
19 UNKNOWN_TYPE | Comments | ( You may enter up to 500 characters. ) |
20 UNKNOWN_TYPE | tribute | | IHO
21 UNKNOWN_TYPE | tribute | In Honor Of | IMO
22 NAME_FULL | Tribute_Name | Name: |
23 UNKNOWN_TYPE | Tribute_occasion | Occasion: |
24 UNKNOWN_TYPE | Tribute_Disclosure | Occasion: | on
25 UNKNOWN_TYPE | Tribute_Notification | I wish to remain anonymous | on
26 UNKNOWN_TYPE | Tribute_IncludeAmount | | 1
27 UNKNOWN_TYPE | Tribute_IncludeAmount | Include the amount | 0
28 NAME_FULL | Tribute_NotifyName | Name: |
29 EMAIL_ADDRESS | Tribute_Email | Email: |
30 ADDRESS_HOME_LINE1 | Tribute_NotifyAddr | Street: |
31 ADDRESS_HOME_CITY | Tribute_NotifyCity | City / St. / Zip: |
32 ADDRESS_HOME_STATE | Tribute_NotifyState | City / St. / Zip: |
33 ADDRESS_HOME_ZIP | Tribute_NotifyZip | City / St. / Zip: |
34 CREDIT_CARD_TYPE | cctype | Credit Card Type * | Visa
35 CREDIT_CARD_NUMBER | ccard | Credit Card Number * |
36 CREDIT_CARD_VERIFICATION_CODE | csc | CSC Number * What Is This? |
37 CREDIT_CARD_EXP_MONTH | ExpMon | Month | 1
38 CREDIT_CARD_EXP_4_DIGIT_YEAR | ExpYear | Year | 11
39 UNKNOWN_TYPE | SameAddress | Billing Address - | checkbox
40 ADDRESS_HOME_LINE1 | CC_Addr | Address 1 * |
41 ADDRESS_HOME_LINE2 | CC_Addr2 | Address 2 |
42 ADDRESS_HOME_CITY | CC_City | City / State / Zip * |
43 ADDRESS_HOME_STATE | CC_State | Credit Card Information |
44 ADDRESS_HOME_ZIP | CC_Zip | Credit Card Information |