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        fbRequire([\'jquery\'], function ($) {\
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fbRequireJSScript.addEventListener("load", conditionalSectionJs);var overridePaymentJS = function () {\
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fbRequireJSScript.addEventListener(\'load\', overridePaymentJS);var paymentJs = function () {\
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                        var e = $(\'#validateCardCvc\');\
                        e.val(\'\');\
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                    }\
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\
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                        $(\'#validateCardExpiration\').val(\'\');\
                        $(\'#validateCardExpiration\').trigger(\'change\');\
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                    if ($(container).hasClass(\'StripeElement--empty\')) {\
                        $(\'#validateCardCvc\').val(\'\');\
                        $(\'#validateCardCvc\').trigger(\'change\');\
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            };\
\
            var stripeElements = {};\
            var stripe = {};\
\
            $(function () {\
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                    stripe = Stripe(\'pk_live_nPPnJc9ZetGgfJPpoK6a11xm\');\
\
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                            \'lineHeight\': \'2\',\
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                            \'fontFamily\': \'"Roboto", "Helvetica Neue", Helvetica, Arial, sans-serif\'\
                        }\
                    };\
\
                    var elements = stripe.elements();\
\
                    var cardNumberElement = elements.create(\'cardNumber\', {\
                        \'style\': style\
                    });\
                    cardNumberElement.mount(\'#CardNumber\');\
                    stripeElements.cardNumberElement = cardNumberElement;\
                    cardNumberElement.on(\'change\', function (event) {\
                        processChange(event, \'cardnumber\');\
                    });\
                    cardNumberElement.on(\'blur\', function (event) {\
                        processBlur(event, \'#CardNumber\');\
                    });\
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                    var cardExpiryElement = elements.create(\'cardExpiry\', {\
                        \'style\': style\
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\
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            function getStripeToken(container, successCallBack, failureCallBack) {\
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\
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\
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\
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};\
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fbRequireJSScript.addEventListener("load", paymentJs);';

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fbRenderedCssContainer.id = "fbRenderedCssContainer";

fbConfigScript.type = "text/javascript";
fbRequireJSScript.type = "text/javascript";
fbInstaMedJSScript.type = "text/javascript";
fbGeoCaptchaCallback.type = "text/javascript";
fbGeoReCaptchaCallback.type = "text/javascript";
fbFormulateRenderer.type = "text/javascript";
fbRenderedIntegrations.type = "text/javascript";
fbRenderedScripts.type = "text/javascript";
fbAutoPopulateFromQueryString.type = "text/javascript";

fbRequireJSScript.src = "https://formulate.geonetric.com/Scripts/require.min.js";
fbInstaMedJSScript.src = "https://formulate.geonetric.com/Scripts/vendor/instamed/token.js";
fbInstaMedJSScript.id = "instamed-sdk";
fbGeoCaptchaCallback.src = "https://formulate.geonetric.com/Scripts/geo-captcha-callback.js";
fbGeoReCaptchaCallback.src = "https://www.google.com/recaptcha/api.js?onload=geoFbCaptchaCallback&render=6LdxkTEpAAAAAMKbkhz8-INpQis_mvSaIXnoyC2V";
fbFormulateRenderer.src = "https://formulate.geonetric.com/Scripts/require/formulate-renderer.js?embeddedCssType=0&isTestResponse=False&hasGoogleAnalytics=False";
fbFormulateRenderer.id = "formulateRendererScript";
fbAutoPopulateFromQueryString.src = "https://formulate.geonetric.com/Scripts/auto-populate-from-query-string.js";

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fbRequireJSScript.addEventListener("load", function() {
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fbFormulateRenderer.addEventListener("load", function () {
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<p>Required fields are marked with <span class=\'fb-required\'>*</span></p>\
<input type=\'hidden\' name=\'formId\' id=\'formId\' value=\'5d71fff1-dbbc-4910-aa10-fda381abb20f\' />\
<input type=\'hidden\' name=\'formName\' id=\'formName\' value=\'Donate\' />\
<input type=\'hidden\' name=\'formVersion\' value=\'37\' id=\'formVersion\' />\
<input type=\'hidden\' name=\'organizationId\' id=\'organizationId\' value=\'722139f0-4c9e-4f0a-8c1b-53184b85c8af\' />\
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<div class=\'form-group\'><label for=\'FormField6_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>Donation Amount<span class=\'fb-required\'>*</span></label><div class=\' \'><input type=\'text\' name=\'FormField6_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField6_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium\' value=\'0\' data-export-label=\'Donation_Amount\'  data-field-type=\'user defined cost\' /></div></div><div class=\'\'><div class=\'form-group\' style=\'display:none\'><label class=\'control-label\'><strong>Subtotal:</strong></label><span class=\'subtotalCostAmount\'></span></div><div class=\'form-group\' style=\'display:none\'><label class=\'control-label\'><strong>Discount:</strong></label><span class=\'promoCodeDiscount\'></span>&nbsp;&#40;<span class=\'appliedPromoCode\'></span>&#41;</div><div class=\'form-group\'><label class=\'control-label  \'><strong>Total Cost:</strong></label><span class=\'totalCostAmount\'></span></div></div><div class=\'form-group\'><label  class=\'control-label  hidden-label\'>Recurring Donation</label><div class=\'Chkbx\'><div><div class=\'flow\'><input type=\'radio\' value=\'Show my support by making this a recurring donation.\'  name=\'checkbox8\' id=\'FormField8_5d71fff1-dbbc-4910-aa10-fda381abb20f_1\' class=\'right\' data-export-label=\'Recurring_Donation\' ><label for=\'FormField8_5d71fff1-dbbc-4910-aa10-fda381abb20f_1\'>Show my support by making this a recurring donation.</label></div></div></div></div><div class=\'fb-section\' style=\'display: none;\' id=\'FormField12_5d71fff1-dbbc-4910-aa10-fda381abb20f\'><div class=\'form-group\'><label for=\'FormField13_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>Frequency<span class=\'fb-required\'>*</span></label><div><select  name=\'FormField13_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField13_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control \' style=\'width: auto\' required data-msg-required=\'Frequency is required.\' data-export-label=\'Frequency\' ><option value=\'\' selected>( Please Select )</option><option value=\'Weekly\'>Weekly</option><option value=\'Monthly\'>Monthly</option><option value=\'Quarterly\'>Quarterly</option><option value=\'Yearly\'>Yearly</option></select></div></div><div class=\'form-group\'><label for=\'FormField14_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>Start Date<span class=\'fb-required\'>*</span></label><div><div class=\'clearfix\'><input type=\'text\' name=\'FormField14_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField14_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium isDatePicker\' required data-msg-required=\'Start Date is required.\' data-format=\'mm/dd/yy\' data-export-label=\'Start_Date\'  data-rule-dateFormat=\'MM/DD/YYYY\' style=\'float: left;\' /></div></div></div></div><div class=\'form-group\'><label for=\'FormField15_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>My donation is for:<span class=\'fb-required\'>*</span></label><div><select  name=\'FormField15_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField15_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium\' style=\'width: 75% !important\' required data-msg-required=\'My donation is for: is required.\' data-export-label=\'My_donation_is_for\' ><option value=\'\' selected>( Please Select )</option><option value=\'Area of Greatest Need\'>Area of Greatest Need</option><option value=\'CardioVascular Institute Remodel Project\'>CardioVascular Institute Remodel Project</option><option value=\'Carson Cancer Center\'>Carson Cancer Center</option><option value=\'Hope Fund\'>Hope Fund</option><option value=\'Rehabilitation Therapies\'>Rehabilitation Therapies</option><option value=\'Surgical Services/Sterile Processing Expansion Project\'>Surgical Services/Sterile Processing Expansion Project</option><option value=\'Women&#39;s &amp; Children&#39;s\'>Women&#39;s &amp; Children&#39;s</option></select></div></div><div class=\'form-group\'><label  class=\'control-label  \'>Donate Anonymously?<span class=\'fb-required\'>*</span></label><div class=\'Chkbx\'><div><fieldset class=\'RadioGroup\'><div class=\'flow\'><input type=\'radio\' value=\'Yes\' required data-msg-required=\'Donate Anonymously? is required.\' name=\'checkbox16\' id=\'FormField16_5d71fff1-dbbc-4910-aa10-fda381abb20f_1\' class=\'right\' data-export-label=\'Donate_Anonymously\' ><label for=\'FormField16_5d71fff1-dbbc-4910-aa10-fda381abb20f_1\'>Yes</label></div><div class=\'flow\'><input type=\'radio\' value=\'No\' required data-msg-required=\'Donate Anonymously? is required.\' name=\'checkbox16\' id=\'FormField16_5d71fff1-dbbc-4910-aa10-fda381abb20f_2\' class=\'right\' data-export-label=\'Donate_Anonymously\' ><label for=\'FormField16_5d71fff1-dbbc-4910-aa10-fda381abb20f_2\'>No</label></div></fieldset></div></div></div>\
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</div></div><div class=\'fb-section\'><div class=\'form-group\'><label for=\'FormField34_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>Billing Address Line 1<span class=\'fb-required\'>*</span></label><div>\
<input type=\'text\' name=\'FormField34_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField34_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'Billing Address Line 1 is required.\' data-export-label=\'Billing_Address_Line_1\'  placeholder=\'\'  />\
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<input type=\'text\' name=\'FormField33_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField33_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium \' value=\'\'   data-export-label=\'Billing_Address_Line_2\'  placeholder=\'\'  />\
</div></div><div class=\'form-group\'><label for=\'FormField32_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>City<span class=\'fb-required\'>*</span></label><div>\
<input type=\'text\' name=\'FormField32_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField32_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'City is required.\' data-export-label=\'City\'  placeholder=\'\'  />\
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<input type=\'text\' name=\'FormField31_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField31_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'State is required.\' data-export-label=\'State\'  placeholder=\'\'  />\
</div></div><div class=\'form-group\'><label for=\'FormField30_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>Zip Code<span class=\'fb-required\'>*</span></label><div>\
<input type=\'text\' name=\'FormField30_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField30_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control input-medium \' value=\'\'  required data-msg-required=\'Zip Code is required.\' data-export-label=\'Zip_Code\'  placeholder=\'\'  />\
</div></div></div><div class=\'form-group\'><label for=\'FormField17_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'control-label  \'>Comments</label><div>\
<textarea rows=\'10\' name=\'FormField17_5d71fff1-dbbc-4910-aa10-fda381abb20f\' id=\'FormField17_5d71fff1-dbbc-4910-aa10-fda381abb20f\' class=\'form-control textarea-medium\'   data-export-label=\'Comments\'  placeholder=\'\'></textarea>\
</div></div><div class=\'overridePayment\'>\
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        <div class=\' stripe-element\'>\
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        <div class=\' stripe-element\'>\
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    </div>\
</div><div class=\'validationSummary\'><p><i class=\'fa fa-exclamation-triangle\'></i> The following fields are required or invalid.</p><ul></ul></div>\
\
<div id=\'form-errors\' class=\'alert alert-danger fade in\' role=\'alert\' style=\'display:none\'></div>\
<div class=\'form-group ignore\'><div class=\'form-group ButtonHolder\'><div class=\'col-sm-4 col-sm-offset-2\'><button id=\'fb-submitButton\' type=\'button\' class=\'btn btn-primary Button\' value=\'Donate\'>Donate</button></div></div></div>\
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