publiccode.asia
/
donate.html

<!DOCTYPE html>
<html lang="en">

<head>
  <meta charset="UTF-8">
  <title>Stripe Donation Form</title>
  <link rel="stylesheet" type="text/css" href="style.css" media="all">
  <script type="text/javascript" src="https://js.stripe.com/v2"></script>
  <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.7.2/jquery.min.js"></script>
  <script type="text/javascript">
    //  Stripe.setPublishableKey('pk_live_TYUOty0alel95s5ZGMydBd8Q');
    Stripe.setPublishableKey('pk_test_6pRNASCoBOKtIshFeQd4XMUh');
  </script>
  <script type="text/javascript" src="script.js"></script>
</head>

<body>
  <div class="wrapper">
    <h1>
      Stripe Donation Form
    </h1>
    <p>
      <strong>This form has been pre-populated with test Credit Card data. No
            live transactions are taking place.</strong> Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris
      nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est
      laborum.
    </p>

    <div class="messages">
      <!-- Error messages go here go here -->
    </div>

    <form action="#" method="POST" class="donation-form">
      <fieldset>
        <legend>
          Contact Information
        </legend>
        <div class="form-row form-first-name">
          <label>First Name</label>
          <input type="text" name="first-name" class="first-name text">
        </div>
        <div class="form-row form-last-name">
          <label>Last Name</label>
          <input type="text" name="last-name" class="last-name text">
        </div>
        <div class="form-row form-email">
          <label>Email</label>
          <input type="text" name="email" class="email text">
        </div>
        <div class="form-row form-phone">
          <label>Phone</label>
          <input type="text" name="phone" class="phone text">
        </div>
        <div class="form-row form-address">
          <label>Address</label>
          <textarea name="address" cols="30" rows="2" class="address text"></textarea>
        </div>
        <div class="form-row form-city">
          <label>City</label>
          <input type="text" name="city" class="city text">
        </div>
        <div class="form-row form-zip">
          <label>Zip</label>
          <input type="text" name="zip" class="zip text">
        </div>
      </fieldset>

      <fieldset>
        <legend>
          Your Generous Donation
        </legend>
        <div class="form-row form-amount">
          <label><input type="radio" name="amount" class="set-amount" value="25"> $25</label>
          <label><input type="radio" name="amount" class="set-amount" value="500"> $500</label>
          <label><input type="radio" name="amount" class="set-amount" value="2500"> $2,500</label>
          <label><input type="radio" name="amount" class="set-amount" value="100"> $100</label>
          <label><input type="radio" name="amount" class="set-amount" value="1000"> $1,000</label>
          <label><input type="radio" name="amount" class="set-amount" value="5000"> $5,000</label>
          <label><input type="radio" name="amount" class="other-amount" value="0"> Other:</label> <input type="text" class="amount text" disabled>
        </div>
        <div class="form-row form-number">
          <label>Card Number</label>
          <input type="text" autocomplete="off" class="card-number text" value="4242424242424242">
        </div>
        <div class="form-row form-cvc">
          <label>CVC</label>
          <input type="text" autocomplete="off" class="card-cvc text" value="123">
        </div>
        <div class="form-row form-expiry">
          <label>Expiration Date</label>
          <select class="card-expiry-month text">
                        <option value="01" selected>January</option>
                        <option value="02">February</option>
                        <option value="03">March</option>
                        <option value="04">April</option>
                        <option value="05">May</option>
                        <option value="06">June</option>
                        <option value="07">July</option>
                        <option value="08">August</option>
                        <option value="09">September</option>
                        <option value="10">October</option>
                        <option value="11">November</option>
                        <option value="12">December</option>
                    </select>
          <select class="card-expiry-year text">
                        <option value="2015" selected>2015</option>
                        <option value="2016">2016</option>
                        <option value="2017">2017</option>
                        <option value="2018">2018</option>
                        <option value="2019">2019</option>
                        <option value="2020">2020</option>
                    </select>
        </div>
        <div class="form-row form-submit">
          <input type="submit" class="submit-button" value="Submit Donation">
        </div>
      </fieldset>
    </form>
  </div>

  <script>
    if (window.Stripe) $('.donation-form').show()
  </script>
  <noscript><p>JavaScript is required for the donation form.</p></noscript>

</body>

</html>