{"_id":"65f8442395e055298d314f6e","type":"form","tags":[],"owner":"5f9acba5f1b659b9e06350e4","components":[{"label":"Top of Form","columns":[{"components":[{"label":"<font color=\"red\">authorizationToken</font>","key":"authorizationToken","type":"hidden","input":true,"tableView":false,"hideOnChildrenHidden":false,"width":12}],"width":2,"offset":0,"push":0,"pull":0,"size":"md","currentWidth":2},{"components":[{"label":"<font color=\"red\">agencyFormId</font>","key":"agencyFormId","type":"hidden","input":true,"tableView":false,"hideOnChildrenHidden":false,"width":12}],"width":2,"offset":0,"push":0,"pull":0,"size":"md","currentWidth":2},{"components":[{"label":"min/max","persistent":"client-only","calculateServer":true,"trigger":{"init":true,"server":true},"dataSrc":"url","fetch":{"url":"{{ config.PAYGOV_ENV }}/public/api/v1/minmaxamount/{{ data.agencyFormId }}","method":"get","headers":[{"key":"X-Paygov-Authorization-Token","value":"{{ data.authorizationToken }}"}],"forwardHeaders":true,"authenticate":false},"key":"minMax","type":"datasource","input":true,"tableView":false,"hideOnChildrenHidden":false,"width":12}],"size":"md","width":2,"offset":0,"push":0,"pull":0,"currentWidth":2},{"components":[{"label":"Company Profile","persistent":"client-only","calculateServer":true,"trigger":{"init":true,"server":true},"dataSrc":"url","fetch":{"url":"{{ config.PAYGOV_ENV }}/public/api/v1/companyprofile/{{ data.agencyFormId }}","method":"get","headers":[{"key":"X-Paygov-Authorization-Token","value":"{{ data.authorizationToken }}"}],"forwardHeaders":true,"authenticate":false},"key":"CompanyDataFromPaygov","type":"datasource","input":true,"tableView":false,"validate":{"multiple":true},"hideOnChildrenHidden":false,"keyModified":true,"multiple":true,"width":12}],"size":"md","width":2,"offset":0,"push":0,"pull":0,"currentWidth":2}],"key":"topOfForm","type":"columns","input":false,"tableView":false,"hideOnChildrenHidden":false,"lockKey":true,"source":"5eac84259b53ff041c170ee7","isNew":true},{"label":"HTML","tag":"img","attrs":[{"attr":"src","value":"{{ config.STATIC_ASSETS_ENV }}/VAVISN/images/visn7_logo.jpg"},{"attr":"alt","value":"VA Capital Health Care Network VISN 7"},{"attr":"title","value":"VA Capital Health Care Network VISN 7"},{"attr":"style","value":"max-width: 250px;"}],"refreshOnChange":false,"key":"html1","type":"htmlelement","input":false,"tableView":false},{"label":"HTML","tag":"h3","attrs":[{"attr":"","value":""}],"content":"VA SOUTHEAST NETWORK: VISN 7<br>\n&nbsp;","refreshOnChange":false,"key":"html","type":"htmlelement","input":false,"tableView":false},{"label":"HTML","attrs":[{"attr":"","value":""}],"content":"Welcome to the Department of Veterans Affairs Southeast Network donation page.  The VA Southeast Network serves Atlanta, Augusta, Birmingham, Charleston, Columbia, Dublin, Montgomery, and Tuscaloosa.  Please click on the facility to which you would like to donate.<br><br>\n\n<font color=\"red\">*</font> Required Field<br>&nbsp;","refreshOnChange":false,"key":"html2","type":"htmlelement","input":false,"tableView":false,"hideOnChildrenHidden":false},{"label":"Columns","columns":[{"components":[{"label":"Facility","widget":"html5","tableView":true,"dataSrc":"custom","data":{"custom":"list = [\r\n  {\r\n    \"label\": \"Atlanta VA Health Care System\",\r\n    \"locationCode\": \"508\",\r\n    \"name\": \"Atlanta VA Health Care System\",\r\n    \"title\": \"Atlanta VA Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Atlanta VA Medical Center.\",\r\n    \"image\": \"visn7_atlanta.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Charlie Norwood VA Medical Center\",\r\n    \"locationCode\": \"509\",\r\n    \"name\": \"Charlie Norwood VA Medical Center\",\r\n    \"title\": \"Charlie Norwood VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Augusta Charlie Norwood VA Medical Center.\",\r\n    \"image\": \"visn7_augusta.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Birmingham VA Health Care System\",\r\n    \"locationCode\": \"521\",\r\n    \"name\": \"Birmingham VA Health Care System\",\r\n    \"title\": \"Birmingham VA Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Birmingham VA Medical Center.\",\r\n    \"image\": \"visn7_birmingham.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Central Alabama Veterans Health Care System\",\r\n    \"locationCode\": \"619\",\r\n    \"name\": \"Central Alabama Veterans Health Care System\",\r\n    \"title\": \"Central Alabama Veterans Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Central Alabama Veterans Health Care System.\",\r\n    \"image\": \"visn7_alabama.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Ralph H. Johnson VA Medical Center\",\r\n    \"locationCode\": \"534\",\r\n    \"name\": \"Ralph H. Johnson VA Medical Center\",\r\n    \"title\": \"Ralph H. Johnson VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. Those funds are used to supplement VA programs for Lowcountry Veterans from Hinesville, GA to Myrtle Beach, SC where we support 6 community clinics as well as our Medical Center in Charleston, SC. The Assistance / General Support for Patient Needs Fund is our general-purpose account and is used to assist our Veteran patients with obtaining a variety of basic needs, including clothing, shelter and transportation.  For questions regarding e-donations, please contact Voluntary Service at 843-789-7230. Thank you for supporting our Nation's Heroes.\",\r\n    \"image\": \"visn7_charleston.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Columbia VA Health Care System\",\r\n    \"locationCode\": \"544\",\r\n    \"name\": \"Columbia VA Health Care System\",\r\n    \"title\": \"Columbia VA Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Columbia VA Health Care System.\",\r\n    \"image\": \"visn7_columbia.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Dublin - Carl Vinson VA Medical Center\",\r\n    \"locationCode\": \"557\",\r\n    \"name\": \"Dublin - Carl Vinson VA Medical Center\",\r\n    \"title\": \"Dublin - Carl Vinson VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Dublin - Carl Vinson VA Medical Center.\",\r\n    \"image\": \"visn7_dublin.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  },{\r\n    \"label\": \"Tuscaloosa VA Medical Center\",\r\n    \"locationCode\": \"679\",\r\n    \"name\": \"Tuscaloosa VA Medical Center\",\r\n    \"title\": \"Tuscaloosa VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Tuscaloosa VA Medical Center.\",\r\n    \"image\": \"visn7_tuscaloosa.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  }\r\n];\r\n\r\nvalues = _.sortBy(list, \"label\")"},"valueProperty":"locationCode","dataType":"string","validate":{"required":true},"key":"FacilityList","type":"select","input":true,"hideOnChildrenHidden":false,"searchThreshold":0.3}],"width":6,"offset":0,"push":0,"pull":0,"size":"md","currentWidth":6},{"components":[{"label":"Facility","calculateValue":"switch (data.FacilityList) {\r\n\tcase \"508\" :\r\n  value = {\r\n    \"label\": \"Atlanta VA Health Care System\",\r\n    \"locationCode\": \"508\",\r\n    \"name\": \"Atlanta VA Health Care System\",\r\n    \"title\": \"Atlanta VA Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Atlanta VA Medical Center.\",\r\n    \"image\": \"visn7_atlanta.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"509\" :\r\n  value = {\r\n    \"label\": \"Charlie Norwood VA Medical Center\",\r\n    \"locationCode\": \"509\",\r\n    \"name\": \"Charlie Norwood VA Medical Center\",\r\n    \"title\": \"Charlie Norwood VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Augusta Charlie Norwood VA Medical Center.\",\r\n    \"image\": \"visn7_augusta.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"521\" :\r\n  value = {\r\n    \"label\": \"Birmingham VA Health Care System\",\r\n    \"locationCode\": \"521\",\r\n    \"name\": \"Birmingham VA Health Care System\",\r\n    \"title\": \"Birmingham VA Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Birmingham VA Medical Center.\",\r\n    \"image\": \"visn7_birmingham.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"619\" :\r\n  value = {\r\n    \"label\": \"Central Alabama Veterans Health Care System\",\r\n    \"locationCode\": \"619\",\r\n    \"name\": \"Central Alabama Veterans Health Care System\",\r\n    \"title\": \"Central Alabama Veterans Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Central Alabama Veterans Health Care System.\",\r\n    \"image\": \"visn7_alabama.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"534\" :\r\n  value = {\r\n    \"label\": \"Ralph H. Johnson VA Medical Center\",\r\n    \"locationCode\": \"534\",\r\n    \"name\": \"Ralph H. Johnson VA Medical Center\",\r\n    \"title\": \"Ralph H. Johnson VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. Those funds are used to supplement VA programs for Lowcountry Veterans from Hinesville, GA to Myrtle Beach, SC where we support 6 community clinics as well as our Medical Center in Charleston, SC. The Assistance / General Support for Patient Needs Fund is our general-purpose account and is used to assist our Veteran patients with obtaining a variety of basic needs, including clothing, shelter and transportation.  For questions regarding e-donations, please contact Voluntary Service at 843-789-7230. Thank you for supporting our Nation's Heroes.\",\r\n    \"image\": \"visn7_charleston.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"544\" :\r\n  value = {\r\n    \"label\": \"Columbia VA Health Care System\",\r\n    \"locationCode\": \"544\",\r\n    \"name\": \"Columbia VA Health Care System\",\r\n    \"title\": \"Columbia VA Health Care System\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Columbia VA Health Care System.\",\r\n    \"image\": \"visn7_columbia.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"557\" :\r\n  value = {\r\n    \"label\": \"Dublin - Carl Vinson VA Medical Center\",\r\n    \"locationCode\": \"557\",\r\n    \"name\": \"Dublin - Carl Vinson VA Medical Center\",\r\n    \"title\": \"Dublin - Carl Vinson VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Dublin - Carl Vinson VA Medical Center.\",\r\n    \"image\": \"visn7_dublin.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  case \"679\" :\r\n  value = {\r\n    \"label\": \"Tuscaloosa VA Medical Center\",\r\n    \"locationCode\": \"679\",\r\n    \"name\": \"Tuscaloosa VA Medical Center\",\r\n    \"title\": \"Tuscaloosa VA Medical Center\",\r\n    \"desc\": \"Please use the drop-down menu to select the program in which you would like your donation to be used. If you do not have a specific use in mind, you may donate money for general use. Those funds are used to fund programs for Veterans throughout the Tuscaloosa VA Medical Center.\",\r\n    \"image\": \"visn7_tuscaloosa.jpg\",\r\n    \"maxWidth\" : \"250\"\r\n  };\r\n  break;\r\n  \r\n  default: \r\n  value = \"\"; \r\n  break;\r\n}","calculateServer":true,"key":"Facility","type":"hidden","input":true,"tableView":false,"hideOnChildrenHidden":false}],"width":2,"offset":0,"push":0,"pull":0,"size":"md","currentWidth":2},{"components":[],"size":"md","width":2,"offset":0,"push":0,"pull":0,"currentWidth":2}],"key":"columns","type":"columns","input":false,"tableView":false,"hideOnChildrenHidden":false},{"title":"Donation Information","collapsible":false,"key":"donationInformation","customConditional":"show = !_.isEmpty(data.Facility.locationCode);","type":"panel","label":"Donation Information","input":false,"tableView":false,"components":[{"label":"HTML","tag":"img","attrs":[{"attr":"src","value":"{{ config.STATIC_ASSETS_ENV }}/VAVISN/images/{{ data.Facility.image }}"},{"attr":"alt","value":"VISN Logo"},{"attr":"title","value":"VISN Logo"},{"attr":"style","value":"max-width: 250px;"}],"refreshOnChange":false,"key":"html1","logic":[{"name":"Hidden","trigger":{"type":"javascript","javascript":"result = (data.Facility.title === \"South East Louisiana - New Orleans, LA\");"},"actions":[{"name":"Hidden","type":"property","content":"<div class=\"well\">Content</div>","property":{"label":"Hidden","value":"hidden","type":"boolean"},"state":true}]}],"type":"htmlelement","input":false,"tableView":false,"refreshOn":"Facility"},{"label":"HTML","attrs":[{"attr":"","value":""}],"content":"<br><strong>Welcome to the {{ data.Facility.title }} donation page.</strong><br><br>\r\n{{ data.Facility.desc }}<br><br>&nbsp;\r\n\r\n","refreshOnChange":true,"key":"html4","type":"htmlelement","input":false,"tableView":false},{"label":"Columns","columns":[{"components":[{"label":"Name","tableView":true,"validate":{"required":true,"custom":"valid = pgFormioGlobal().validateText(input);","maxLength":100},"key":"Name_Field","type":"textfield","input":true,"lockKey":true,"source":"5eac84259b53ff041c170ee7","isNew":true,"hideOnChildrenHidden":false},{"label":"Street Address","tableView":true,"validate":{"required":true,"custom":"valid = pgFormioGlobal().validateText(input);","maxLength":100},"key":"partyAddress1","type":"textfield","input":true,"hideOnChildrenHidden":false},{"label":"City","tableView":true,"validate":{"required":true,"custom":"valid = pgFormioGlobal().validateText(input);","maxLength":50},"key":"partyCity","type":"textfield","input":true,"hideOnChildrenHidden":false,"lockKey":true,"source":"5eac84253f388e5b14ba3b29","isNew":true},{"label":"State","widget":"html5","tableView":true,"dataSrc":"url","data":{"url":"{{ config.PAYGOV_ENV }}/public/api/v1/getStates?country=USA","headers":[{"key":"","value":""}]},"valueProperty":"stateAbbreviation","template":"<span>{{ item.stateName }}</span>","calculateServer":true,"key":"partyState","type":"select","input":true,"lazyLoad":false,"disableLimit":false,"hideOnChildrenHidden":false,"lockKey":true,"source":"5eac84259b53ff041c170ee7","isNew":true,"validate":{"required":true},"searchThreshold":0.3},{"label":"Zip Code","tableView":true,"validate":{"custom":"if (input === \"\" || input === undefined || input === null) {\r\n  valid = true;\r\n} else {\r\n  var regEx = /^\\d{5}(-?\\d{4})?$/;\r\n  if (regEx.test(input)) {\r\n    var str = input.replace(/-/g, \"\");\r\n    str = str.length === 5 ? str : str.substr(0,5) + \"-\" + str.substr(5);\r\n    if (typeof instance != \"undefined\") {\r\n    \tinstance.setValue(str);\r\n    } else {\r\n    \tdata[component.key] = str;  \r\n    }\r\n    valid = true;\r\n  } else {\r\n    valid = \"Invalid Zip Code\";\r\n  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Donation","widget":"html5","tableView":true,"dataSrc":"custom","data":{"custom":"var temp = [\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"All (General) Purpose\",\r\n        \"value\" : \"8882\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Adaptive Sports Programs\",\r\n        \"value\" : \"8901\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Domiciliary Programs\",\r\n        \"value\" : \"8884\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Community Base Outreach Clinics\",\r\n        \"value\" : \"8890\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Community Living Center (CLC) - Nursing Homes\",\r\n        \"value\" : \"8887\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Homeless Programs\",\r\n        \"value\" : \"8812\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Mental Health Programs\",\r\n        \"value\" : \"8885\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Recreational Therapy\",\r\n        \"value\" : \"8883\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Social Work Programs\",\r\n        \"value\" : \"8902\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Transportation for Veterans\",\r\n        \"value\" : \"8884\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Vet Centers\",\r\n        \"value\" : \"8896\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"508\",\r\n        \"label\" : \"Women Veterans Programs\",\r\n        \"value\" : \"8892\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Community Living Center (CLC)\",\r\n        \"value\" : \"8001\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Fisher House\",\r\n        \"value\" : \"8004\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Chaplain Fund\",\r\n        \"value\" : \"8007\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"General Purpose\",\r\n        \"value\" : \"8010\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"OEF/OIF/OND\",\r\n        \"value\" : \"8011\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Homeless Veteran\",\r\n        \"value\" : \"8012\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Athens Community Based Outpatient Clinic \",\r\n        \"value\" : \"8013\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Spinal Cord Units\",\r\n        \"value\" : \"8121\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Recreation\",\r\n        \"value\" : \"8123\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Domiciliary\",\r\n        \"value\" : \"8126\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Voluntary Service VAVS Committee\",\r\n        \"value\" : \"8315\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Hospice\",\r\n        \"value\" : \"8322\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Blind Rehabilitation\",\r\n        \"value\" : \"8323\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"509\",\r\n        \"label\" : \"Social Work/ Indigent\",\r\n        \"value\" : \"8401\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"521\",\r\n        \"label\" : \"General Purpose\",\r\n        \"value\" : \"1006\"\r\n    },\r\n    {\r\n        \"locationCode\" : \"521\",\r\n        \"label\" : \"Blind & Low Vision Vet Support\",\r\n 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Micronesia\"},{stateAbbreviation:\"FL\",stateName:\"Florida\"},{stateAbbreviation:\"GA\",stateName:\"Georgia\"},{stateAbbreviation:\"GU\",stateName:\"Guam\"},{stateAbbreviation:\"HI\",stateName:\"Hawaii\"},{stateAbbreviation:\"ID\",stateName:\"Idaho\"},{stateAbbreviation:\"IL\",stateName:\"Illinois\"},{stateAbbreviation:\"IN\",stateName:\"Indiana\"},{stateAbbreviation:\"IA\",stateName:\"Iowa\"},{stateAbbreviation:\"KS\",stateName:\"Kansas\"},{stateAbbreviation:\"KY\",stateName:\"Kentucky\"},{stateAbbreviation:\"LA\",stateName:\"Louisiana\"},{stateAbbreviation:\"ME\",stateName:\"Maine\"},{stateAbbreviation:\"MH\",stateName:\"Marshall Islands\"},{stateAbbreviation:\"MD\",stateName:\"Maryland\"},{stateAbbreviation:\"MA\",stateName:\"Massachusetts\"},{stateAbbreviation:\"MI\",stateName:\"Michigan\"},{stateAbbreviation:\"AA\",stateName:\"Military Americas\"},{stateAbbreviation:\"AE\",stateName:\"Military East\"},{stateAbbreviation:\"AP\",stateName:\"Military 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characters.\":!!/^[-a-zA-Z0-9#\\$&'\\*\\+/=\\?\\^_`\\{\\|\\}~]+(?:\\.[-a-zA-Z0-9#\\$&'\\*\\+/=\\?\\^_`\\{\\|\\}~]+)*@(?:[a-zA-Z0-9](?:[a-zA-Z0-9-]*[a-zA-Z0-9])?\\.)+[a-zA-Z0-9](?:[a-zA-Z0-9-]*[a-zA-Z0-9])?$/.test(a)||\"Email must be valid.\")},validateMinMax:function(a,e,t){if(a){if(!(0<=a))return\"Input must be a valid dollar amount.\";e=e.minMax||t.config.minMax;if(a<parseFloat(e.minAmount))return\"Your payment is below the allowed amount. 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