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        /* ======================== */
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        /* ===== CSS For "Common Cases" Ends Here ===== */        /* ============================== */
        /* ============================== */
        /* ============================== */        /* ===== CSS For "Top Banner" Starts Here ===== */
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        /* ===== CSS For "Top Banner" Ends Here ===== */

        /* ============================== */
        /* ============================== */
        /* ============================== */        /* ===== CSS For "Three Boxes" Starts Here ===== */
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        /* ===== CSS For "Three Boxes" Ends Here ===== */

        /* ============================== */
        /* ============================== */
        /* ============================== */        /* ===== CSS For "What Are HH" Starts Here ===== */
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        /* ============================== */
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        /* ===== CSS For "Upcoming Schedule" Ends Here ===== */

        /* ============================== */
        /* ============================== */
        /* ============================== */        /* ===== CSS For "Sukkot" Starts Here ===== */
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            background: rgba(0,0,0, 0.6);
            padding: 50px 0px;
            
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            font-family: 'DM Sans', sans-serif;
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        /* ===== CSS For "Sukkot" Ends Here ===== */

        /* ============================== */
        /* ============================== */
        /* ============================== */        /* ===== CSS For "HH Apeal" Starts Here ===== */
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            gap: 20px;
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            font-family: 'Merriweather', serif;
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            font-size: 18px;
            line-height: 1.5;
            margin-bottom: 0px; 
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        /* ===== CSS For "HH Apeal" Ends Here ===== */

        /* ============================== */
        /* ============================== */
        /* ============================== */        /* ===== CSS For "Learn More" Starts Here ===== */
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            gap: 15px;
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<h5>Holiday Date</h5>    
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October 1 - 11, 2027</div></div>
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			<h1 class="article-header__title js-article-title js-page-title">Reservations</h1>
		
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<form class="userform-form" action="" method="post" name="form_5626054" id="5626054" accept-charset="utf-8"><input type="hidden" name="formID" value="5626054" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_31"><div id="cid_31" class="form-input-wide"> <div style="text-align:center;"><img alt="" class="form-image" border="0" src="https://w2.chabad.org/media/images/1201/HJDU12019899.jpg" height="332.5" width="665" /></div> </div></li><li id="cid_60" class="form-input-wide"> <div class="form-header-group"><h2 id="header_60" class="form-header">Daytime Location: 2730 Boston Post Rd., Guilford CT</h2><div id="subHeader_60" class="form-subHeader">Our daytime and evening locations are DIFFERENT, so please RSVP for locations and directions so you don't show up to the wrong place!</div></div> </li><li class="form-line" id="id_57"><div id="cid_57" class="form-input-wide"> <img alt="" class="form-image" border="0" src="https://w2.chabad.org/media/images/1202/rcig12020616.png" height="39.9" width="665" /> </div></li><li class="form-line" id="id_5"><div class="form-label-left" id="label_5"><label for="input_5"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_5"> </label></div><div id="cid_5" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q5_fullName5[first]" id="first_5" autocomplete="given-name" />  <label class="form-sub-label" for="first_5" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q5_fullName5[last]" id="last_5" autocomplete="family-name" />  <label class="form-sub-label" for="last_5" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_8"><div class="form-label-left" id="label_8"><label for="input_8"> Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_8"> </label></div><div id="cid_8" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q8_phoneNumber8[area]" id="input_8_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_8_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q8_phoneNumber8[phone]" id="input_8_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_8_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_9"><div class="form-label-left" id="label_9"><label for="input_9"> E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_9"> </label></div><div id="cid_9" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_9" name="q9_email" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_58"><div id="cid_58" class="form-input-wide"> <img alt="" class="form-image" border="0" src="https://w2.chabad.org/media/images/1202/Laxg12020617.png" height="39.9" width="665" /> </div></li><li id="cid_11" class="form-input-wide"> <div class="form-header-group"><h2 id="header_11" class="form-header">High Holiday Services I plan to attend.</h2><div id="subHeader_11" class="form-subHeader">Please indicate number of  participants that will attend each segment.</div></div> </li><li class="form-line" id="id_36"><div id="cid_36" class="form-input-wide"> <div id="text_36" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">First night of  Rosh Hashanah,  Wednesday, October 2</span></span></p>
</div> </div></li><li class="form-line" id="id_13"><div class="form-label-left" id="label_13"><label for="input_13"> Mincha &amp; Evening Services </label><label class="label-message" for="input_13"> </label></div><div id="cid_13" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_13" name="q13_amountAdult"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_14"><div class="form-label-left" id="label_14"><label for="input_14"> Holiday Dinner </label><label class="label-message" for="input_14"> </label></div><div id="cid_14" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_14" name="q14_amountOf"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_40"><div id="cid_40" class="form-input-wide"> <div id="text_40" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">First day of  Rosh Hashanah, Thursday</span></span><span style="font-size: 20px;"><span style="font-family: Verdana;">, October 3</span></span></p>
</div> </div></li><li class="form-line" id="id_38"><div class="form-label-left" id="label_38"><label for="input_38"> Morning Services  </label><label class="label-message" for="input_38"> </label></div><div id="cid_38" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_38" name="q38_amountOf38"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_39"><div class="form-label-left" id="label_39"><label for="input_39"> Children's Program </label><label class="label-message" for="input_39"> </label></div><div id="cid_39" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_39" name="q39_amountOf39"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_48"><div class="form-label-left" id="label_48"><label for="input_48"> Kidddush Lunch </label><label class="label-message" for="input_48"> </label></div><div id="cid_48" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_48" name="q48_amountOf48"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_43"><div id="cid_43" class="form-input-wide"> <div id="text_43" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">Second night of  Rosh Hashanah,  Thursday October 3</span></span></p>
</div> </div></li><li class="form-line" id="id_37"><div class="form-label-left" id="label_37"><label for="input_37"> Evening Services </label><label class="label-message" for="input_37"> </label></div><div id="cid_37" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_37" name="q37_amountOf37"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_41"><div class="form-label-left" id="label_41"><label for="input_41"> Holiday Dinner </label><label class="label-message" for="input_41"> </label></div><div id="cid_41" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_41" name="q41_amountOf41"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_44"><div id="cid_44" class="form-input-wide"> <div id="text_44" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">Second day of  Rosh Hashanah, Friday, October 4</span></span></p>
</div> </div></li><li class="form-line" id="id_45"><div class="form-label-left" id="label_45"><label for="input_45"> Morning Services  </label><label class="label-message" for="input_45"> </label></div><div id="cid_45" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_45" name="q45_amountOf45"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_46"><div class="form-label-left" id="label_46"><label for="input_46"> Children's program </label><label class="label-message" for="input_46"> </label></div><div id="cid_46" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_46" name="q46_amountOf46"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_47"><div class="form-label-left" id="label_47"><label for="input_47"> Kiddush Lunch </label><label class="label-message" for="input_47"> </label></div><div id="cid_47" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_47" name="q47_amountOf47"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_42"><div class="form-label-left" id="label_42"><label for="input_42"> Afternoon &amp; Tashlich Ceremony </label><label class="label-message" for="input_42"> </label></div><div id="cid_42" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_42" name="q42_amountOf42"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_61"><div id="cid_61" class="form-input-wide"> <div id="text_61" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">Friday night Services &amp; Dinner, October 4</span></span></p>
</div> </div></li><li class="form-line" id="id_65"><div class="form-label-left" id="label_65"><label for="input_65"> Evening Services </label><label class="label-message" for="input_65"> </label></div><div id="cid_65" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_65" name="q65_amountOf65"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_62"><div class="form-label-left" id="label_62"><label for="input_62"> Shabbat Dinner </label><label class="label-message" for="input_62"> </label></div><div id="cid_62" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_62" name="q62_amountOf62"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_67"><div id="cid_67" class="form-input-wide"> <div id="text_67" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">Shabbat Services &amp; Lunch October 5</span></span></p>
</div> </div></li><li class="form-line" id="id_63"><div class="form-label-left" id="label_63"><label for="input_63"> Shabbat Services </label><label class="label-message" for="input_63"> </label></div><div id="cid_63" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_63" name="q63_amountOf63"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_66"><div id="cid_66" class="form-input-wide"> <div id="text_66" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">Fast of Gedalya &amp; commemoration of "Oct. 7"<br />
Sunday, October 6 </span></span></p>
</div> </div></li><li class="form-line" id="id_68"><div class="form-label-left" id="label_68"><label for="input_68"> Morning Services </label><label class="label-message" for="input_68"> </label></div><div id="cid_68" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_68" name="q68_amountOf68"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_69"><div class="form-label-left" id="label_69"><label for="input_69"> Memorial &amp; Commemoration </label><label class="label-message" for="input_69"> </label></div><div id="cid_69" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_69" name="q69_amountOf69"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_52"><div id="cid_52" class="form-input-wide"> <div id="text_52" class="form-html"><p><span style="font-size: 20px;"><span style="font-family: Verdana;">Eve of Yom Kippur,  Friday, October 11</span></span></p>
</div> </div></li><li class="form-line" id="id_50"><div class="form-label-left" id="label_50"><label for="input_50"> Kol Nidrei Services </label><label class="label-message" for="input_50"> </label></div><div id="cid_50" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_50" name="q50_amountOf50"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_49"><div id="cid_49" class="form-input-wide"> <div id="text_49" class="form-html"><p><span style="font-family: Verdana; font-size: 20px;">Yom Kippur day, Saturday, October 12</span></p>
</div> </div></li><li class="form-line" id="id_51"><div class="form-label-left" id="label_51"><label for="input_51"> Morning Services  </label><label class="label-message" for="input_51"> </label></div><div id="cid_51" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_51" name="q51_amountOf51"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_54"><div class="form-label-left" id="label_54"><label for="input_54"> Children's Program </label><label class="label-message" for="input_54"> </label></div><div id="cid_54" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_54" name="q54_amountOf54"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_53"><div class="form-label-left" id="label_53"><label for="input_53"> Afternoon &amp; Neilah Services </label><label class="label-message" for="input_53"> </label></div><div id="cid_53" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_53" name="q53_amountOf53"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li class="form-line" id="id_55"><div class="form-label-left" id="label_55"><label for="input_55"> Break-fast Meal </label><label class="label-message" for="input_55"> </label></div><div id="cid_55" class="form-input"> <select class="form-dropdown" style="width:150px" id="input_55" name="q55_amountOf55"><option value=""></option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option></select> </div></li><li id="cid_27" class="form-input-wide"> <div class="form-header-group"><h2 id="header_27" class="form-header">3. High Holiday Donation</h2></div> </li><li class="form-line" id="id_59"><div id="cid_59" class="form-input-wide"> <img alt="" class="form-image" border="0" src="https://w2.chabad.org/media/images/1202/hkOh12020618.png" height="39.9" width="665" /> </div></li><li class="form-line" id="id_34"><div id="cid_34" class="form-input-wide"> <div id="text_34" class="form-html"><p><span style="font-size: 18px;"><span style="font-family: Verdana;">Chabad of the Shoreline runs on donations from people like you. Please give generously so that we can continue our open-door, no-charge policy. Your donation helps fund our programs and services for the entire community.</span></span></p></div> </div></li><li class="form-line" id="id_28"><div class="form-label-left" id="label_28"><label for="input_28"> Donation amount </label><label class="label-message" for="input_28"> </label></div><div id="cid_28" class="form-input"> <div class="form-multiple-column" data-columns="2"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_28_0" name="q28_donationAmount28" value="180" /><label for="input_28_0"><span>$180</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_28_1" name="q28_donationAmount28" value="360" /><label for="input_28_1"><span>$360</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_28_2" name="q28_donationAmount28" value="540" /><label for="input_28_2"><span>$540</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_28_3" name="q28_donationAmount28" value="1000" /><label for="input_28_3"><span>$1000</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_28_4" name="q28_donationAmount28" value="1800" /><label for="input_28_4"><span>$1800</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_28_5" name="q28_donationAmount28" value="3600" /><label for="input_28_5"><span>$3600</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_28_6" name="q28_donationAmount28" value="5400" /><label for="input_28_6"><span>$5400</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio-other form-radio" name="q28_donationAmount28" id="other_28" value="" /><span><input type="number" min="1" class="form-radio-other-input form-textbox" onkeypress="validateNumber(event)" name="q28_donationAmount28[other]" data-otherhint="Other" size="15" id="input_28" disabled="disabled" /></span><br /></span></div> </div></li><li class="form-line" id="id_32"><div class="form-label-left" id="label_32"><label for="input_32"> Total </label></div><div id="cid_32" class="form-input"> <div id="total_amount">$0.00 </div> </div></li><li class="form-line" id="id_35"><div class="form-label-left" id="label_35"><label for="input_35"> Payment </label><label class="label-message" for="input_35"> </label></div><div id="cid_35" 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[paymentMethod] form-radio" type="radio" id="input_35_creditCard" name="q35_payment[payment_method]" value="creditCard" onclick="BuildSource.creditCard(this)" /><label for="input_35_creditCard">Credit Card</label> </span><span class="form-radio-item"><input class="paymentMethod form-radio validate[paymentMethod] form-radio" type="radio" id="input_35_paypal" name="q35_payment[payment_method]" value="paypal" onclick="BuildSource.paypal(this)" /><label for="input_35_paypal">Paypal</label> </span><span class="form-radio-item"><input class="paymentMethod form-radio validate[paymentMethod] form-radio" type="radio" id="input_35_other" name="q35_payment[payment_method]" value="other" onclick="BuildSource.other(this)" /><label for="input_35_other">Check</label> </span></td></tr><tr class="credit_card hide"><th colspan="2">Credit Card</th></tr><tr class="credit_card hide"><td colspan="2" style="padding:0"><table cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2"><span class="form-sub-label-container">  <label class="form-sub-label">We accept Visa, MasterCard, American Express, Discover</label></span><div class="cc-icons"><div class="cc-icon visa-icon"></div><div class="cc-icon mastercard-icon"></div><div class="cc-icon amex-icon"></div><div class="cc-icon discover-icon"></div></div><input type="hidden" name="q35_payment[cc_type]" id="input_35_cc_type" value="" /></td></tr><tr><td><div class="cc-field-wrapper"><span class="form-sub-label-container"><input class="form-textbox form-creditcard js-cc-number validate[visible, creditcard]" type="text" name="q35_payment[cc_number]" id="input_35_cc_number" autocomplete="cc-number" size="20" />  <label class="form-sub-label" for="input_35_cc_number" id="sublabel_cc_number">Credit Card Number</label></span></div></td><td class="cc_ccv "><span class="form-sub-label-container"><input class="form-textbox validate[visible]" type="text" name="q35_payment[cc_ccv]" id="input_35_cc_ccv" autocomplete="cc-csc" size="6" />  <label class="form-sub-label" for="input_35_cc_ccv" id="sublabel_cc_ccv">Security Code</label></span></td></tr><tr><td colspan="2" class="cc_name_on_card "><span class="form-sub-label-container"><input class="form-textbox validate[visible]" type="text" name="q35_payment[cc_nameOnCard]" id="input_35_cc_nameOnCard" autocomplete="cc-name" size="33" />  <label class="form-sub-label" for="input_35_cc_nameOnCard" id="sublabel_cc_nameOnCard">Name on Card</label></span></td></tr><tr class="credit_card hide"><td colspan=""><span class="form-sub-label-container"><select class="form-textbox validate[visible]" name="q35_payment[cc_exp_month]" id="input_35_cc_exp_month" autocomplete="cc-exp-month"><option></option><option value="1">1 - January</option><option value="2">2 - February</option><option value="3">3 - March</option><option value="4">4 - April</option><option value="5">5 - May</option><option value="6">6 - June</option><option value="7">7 - July</option><option value="8">8 - August</option><option value="9">9 - September</option><option value="10">10 - October</option><option value="11">11 - November</option><option value="12">12 - December</option></select>  <label class="form-sub-label" for="input_35_cc_exp_month" id="sublabel_cc_exp_month">Expiration Month</label></span></td><td><span class="form-sub-label-container"><select class="form-textbox validate[visible]" name="q35_payment[cc_exp_year]" id="input_35_cc_exp_year" autocomplete="cc-exp-year"><option></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><option value="2030">2030</option><option value="2031">2031</option><option value="2032">2032</option><option value="2033">2033</option></select>  <label class="form-sub-label" for="input_35_cc_exp_year" id="sublabel_cc_exp_year">Expiration Year</label></span></td></tr></tbody></table></td></tr><tr class="paypal hide"><td colspan="2">Paypal has been selected. Payment will take place on the next page.</td></tr><tr class="other hide"><td colspan="2"></td></tr><tr class="billing_address hide"><th colspan="2">Billing Address</th></tr><tr class="billing_address hide"><td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q35_payment[addr_line1]" id="input_35_addr_line1" autocomplete="billing address-line1" />  <label class="form-sub-label" for="input_35_addr_line1" id="sublabel_35_addr_line1">Street Address</label></span></td></tr><tr class="billing_address hide"><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-city" type="text" name="q35_payment[city]" id="input_35_city" autocomplete="billing address-level2" />  <label class="form-sub-label" for="input_35_city" id="sublabel_35_city">City</label></span></td><td><span class="form-sub-label-container"><input class="form-textbox form-address-state" type="text" name="q35_payment[state]" id="input_35_state" autocomplete="billing address-level1" />  <label class="form-sub-label" for="input_35_state" id="sublabel_35_state">State / Province</label></span></td></tr><tr class="billing_address hide"><td width="50%"><span class="form-sub-label-container"><input class="form-textbox form-address-postal" type="text" name="q35_payment[postal]" id="input_35_postal" size="10" autocomplete="billing postal-code" />  <label class="form-sub-label" for="input_35_postal" id="sublabel_35_postal">Postal / Zip Code</label></span></td><td><span class="form-sub-label-container"><select class="form-dropdown form-address-country" name="q35_payment[country]" id="input_35_country" autocomplete="billing country-name"><option value="" selected="selected">Please Select</option><option value="United States">United States</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="The Bahamas">The Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option 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