[ { "type": "header", "subtype": "h3", "label": "Your Contact Info", "className": "no-top-margin" }, { "type": "text", "required": true, "label": "Full Name", "className": "form-control", "name": "full-name", "onList": "1", "listHeader": "Name", "subtype": "text" }, { "type": "text", "subtype": "email", "required": true, "label": "Email", "className": "form-control", "name": "email", "onList": "0" }, { "type": "text", "subtype": "tel", "required": true, "label": "Phone Number", "className": "form-control", "name": "phone-number", "onList": "0" }, { "type": "header", "subtype": "h3", "label": "Your Mailing Address" }, { "type": "text", "required": true, "label": "Street Address", "className": "form-control", "name": "street-address", "maxlength": "120", "onList": "0", "subtype": "text" }, { "type": "text", "label": "Street Address Line 2", "className": "form-control", "name": "street-address-line-2", "maxlength": "120", "onList": "0", "subtype": "text" }, { "type": "text", "required": true, "label": "City", "className": "form-control", "name": "city", "maxlength": "60", "onList": "0", "subtype": "text" }, { "type": "text", "required": true, "label": "Sate", "className": "form-control", "name": "state", "maxlength": "20", "onList": "0", "subtype": "text" }, { "type": "text", "required": true, "label": "Zip", "className": "form-control", "name": "zip-code", "maxlength": "10", "onList": "0", "subtype": "text" }, { "type": "header", "subtype": "h3", "label": "Membership Options" }, { "type": "radio-group", "label": "Membership Option", "name": "radio-group-1515452521666", "onList": "0", "values": [ { "label": "None", "value": "none", "selected": true }, { "label": "$25/Annual", "value": "annual-25" }, { "label": "$250/Life", "value": "life-250" } ] }, { "type": "header", "subtype": "h3", "label": "Capital Campaign Donation" }, { "type": "text", "label": "I would like to make a one-time gift of:", "className": "form-control", "name": "one-time-gift", "onList": "0", "subtype": "text" }, { "type": "text", "label": "I would like to make a recurring gift of:", "className": "form-control", "name": "recurring-gift", "onList": "0", "subtype": "text" }, { "type": "number", "label": "Number of Recurring Payments:", "className": "form-control", "name": "number-of-recurring-payments", "onList": "0" }, { "type": "text", "label": "Interval of Recurring Payments: (Monthly/Annual/Other)", "className": "form-control", "name": "interval-of-recurring-payments", "onList": "0", "subtype": "text" }, { "type": "text", "label": "Total of Pledge/Gift:", "className": "form-control", "name": "total-of-pledge", "onList": "0", "subtype": "text" }, { "type": "select", "label": "Do you wish to receive a letter of donation for your taxes?", "className": "form-control", "name": "letter-of-donation-for-taxes", "onList": "0", "values": [ { "label": "No", "value": "no", "selected": true }, { "label": "Yes", "value": "yes" } ] }, { "type": "header", "subtype": "h4", "label": "Make checks payable to:" }, { "type": "paragraph", "subtype": "p", "label": "Camp Anderson Corporation" }, { "type": "header", "subtype": "h4", "label": "Mail checks to:" }, { "type": "paragraph", "subtype": "span", "label": "Camp Anderson Corporation" }, { "type": "paragraph", "subtype": "span", "label": "Capital Campaign" }, { "type": "paragraph", "subtype": "span", "label": "PO Box 221" }, { "type": "paragraph", "subtype": "p", "label": "Tyrone, PA 16686" } ]