{"id":2772,"date":"2023-02-10T10:51:46","date_gmt":"2023-02-10T16:51:46","guid":{"rendered":"https:\/\/chsstl.org\/?page_id=2772"},"modified":"2023-03-21T15:13:45","modified_gmt":"2023-03-21T20:13:45","slug":"bill-pay","status":"publish","type":"page","link":"https:\/\/chsstl.org\/bill-pay\/","title":{"rendered":"Bill Pay"},"content":{"rendered":"<script type=\"text\/javascript\">var 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0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_2' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_2' id='gform_2' class='bill-pay-form' action='\/wp-json\/wp\/v2\/pages\/2772\/#gf_2' data-formid='2' novalidate><div class=\"fuel-gf-alert\" role=\"alert\"><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_11\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_11\" ><label class='gfield_label gform-field-label' for='input_2_11'>Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_2_11' type='text' value='' class='medium'    placeholder='First &amp; Last Name' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_13\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_13\" ><label class='gfield_label gform-field-label' for='input_2_13'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_13' id='input_2_13' type='email' value='' class='medium'   placeholder='name@email.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_2_3\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_3\" ><label class='gfield_label gform-field-label' for='input_2_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_2_3' type='tel' value='' class='medium'  placeholder='(123) 123-4567' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_4\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_4\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_2_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_2_4_1_container' >\n                                        <label for='input_2_4_1' id='input_2_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_4.1' id='input_2_4_1' value=''   placeholder='123 First St.' aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_2_4_2_container' >\n                                        <label for='input_2_4_2' id='input_2_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_4.2' id='input_2_4_2' value=''   placeholder='Apt B'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_4_3_container' >\n                                    <label for='input_2_4_3' id='input_2_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_4.3' id='input_2_4_3' value=''   placeholder='St. Louis' aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_2_4_4_container' >\n                                        <label for='input_2_4_4' id='input_2_4_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_4.4' id='input_2_4_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' selected='selected'>Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_2_4_5_container' >\n                                    <label for='input_2_4_5' id='input_2_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_4.5' id='input_2_4_5' value=''   placeholder='63119' aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_2_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_2_5\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_5\" ><label class='gfield_label gform-field-label' for='input_2_5'>Invoice#<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_2_5' type='text' value='' class='medium'    placeholder='123456' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_2_6\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_2_6 gfield_product_2_6 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_6\" ><label class='gfield_label gform-field-label' for='input_2_6'>Payment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_6' id='input_2_6' type='text' value='' class='medium ginput_amount'  placeholder='0.00' aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><div id=\"field_2_16\" class=\"gfield gfield--type-product gfield--input-type-calculation gfield--width-full gfield_price gfield_price_2_16 gfield_product_2_16 gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_16\" ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_2_16_1'>Service Fee<\/label><div class='ginput_container ginput_container_product_calculation'>\n\t\t\t\t\t<input type='hidden' name='input_16.1' value='Service Fee' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_2_16' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<span class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/span>\n\t\t\t\t\t\t<span class='gform-field-label gform-field-label--type-sub-large ginput_product_price' id='input_2_16'>$0.00<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_16.2' id='ginput_base_price_2_16' class='gform_hidden' value='$0.00'\/>\n\t\t\t\t\t<input type='hidden' name='input_16.3' value='1' class='ginput_quantity_2_16 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_2_8\" class=\"gfield gfield--type-total gfield--width-full gfield_price gfield_price_2_ gfield_total gfield_total_2_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" data-js-reload=\"field_2_8\" ><label class='gfield_label gform-field-label' for='input_2_8'>Total<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_8' id='input_2_8' value='$0.00' class='gform-text-input-reset ginput_total ginput_total_2' \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_2_17\" class=\"gfield gfield--type-gravity_forms_tokenizer gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_2_17\" ><label class='gfield_label gform-field-label' for='input_2_17'>Credit Card Information<\/label><script src=\"https:\/\/cdn.jsdelivr.net\/gh\/fluidpay\/fluidpay-tokenizer@v1.9.0\/dist\/tokenizer.js\"><\/script>\n<script id=\"form_load\" src=\"https:\/\/chsstl.org\/wp-content\/plugins\/gravity-tokenizer\/frontend\/dist\/js\/form_load.js\" data-custom_amount=\"Custom Amount\" data-sub_items=''\ndata-url='https:\/\/app.gotnpgateway.com' data-public_key='pub_2L6ylpKXEarft8xlYcLIV9Ff6KB' data-amounts=\"\" data-selected_amounts_type=\"\"\ndata-show_card=\"1\" data-show_ach=\"\" data-enable_subscription=\"\" data-input_id=\"17\"\ndata-form_id=\"2\"><\/script>\n<link href=\"https:\/\/chsstl.org\/wp-content\/plugins\/gravity-tokenizer\/frontend\/dist\/style\/form_styles.css\" rel=\"stylesheet\" \/>\n<link href=\"https:\/\/cdn.jsdelivr.net\/npm\/select2@4.1.0-rc.0\/dist\/css\/select2.min.css\" rel=\"stylesheet\" \/>\n<div class=\"tokenizer_form\">\n    <script src=\"https:\/\/cdn.jsdelivr.net\/npm\/select2@4.1.0-rc.0\/dist\/js\/select2.min.js\"><\/script>\n    <input id=\"gf_tokenizer_2\" name=\"input_17\" hidden value=\"\">\n    <div id=\"gravity-forms-tokenizer\"><\/div>\n    <button type=\"button\" id=\"button_generate_token\" style=\"display:none\">Verify Payment Details<\/button>\n    <p id=\"generate_token_text\" hidden>Payment details have been verified.<\/p>\n    <p id=\"settings_error_text\" hidden class=\"error_text_color\">A payment configuration error has occurred. 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