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            "text": "Amount: $_____",
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            "text": "Payment options:",
            "level": 3
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                    "id": "p1.18.1",
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                    "text": "Check (payable to Kentucky State University)"
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                {
                    "id": "p1.18.3",
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                        "r": 409.282,
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                    "text": "Payroll Deduction"
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                {
                    "id": "p1.18.4",
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                    "type": "list_item",
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                    "text": "Credit Card: Visa",
                    "attrs": {
                        "bbox_estimated": true
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                    "children": [
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                                "l": 374.858,
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                                "r": 382.778,
                                "b": 316.387
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                            "text": "Off",
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                                "label": "q Master Card",
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                    "bbox": {
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                    "text": "Off",
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                        "field_kind": "radio",
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                },
                {
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                        "r": 314.582,
                        "b": 364.345
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                    "text": "Off",
                    "attrs": {
                        "field_kind": "radio",
                        "label": "q Check (payable to Kentucky State University)",
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                },
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                        "l": 306.222,
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                        "b": 348.065
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                    "text": "Off",
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            "text": "Master Card",
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                    "id": "p1.19.1",
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                    "bbox": {
                        "l": 374.419,
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                    "text": "Off",
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                        "field_kind": "radio",
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                {
                    "id": "p1.20.1",
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                    "text": "Off",
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                        "label": "q American Express",
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                    "id": "p1.21.1",
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            "id": "p1.22",
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                    "id": "p1.22.1",
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                        "l": 335.16,
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                        "text_offset": 7,
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            "text": "Exp. Date: ___",
            "children": [
                {
                    "id": "p1.23.1",
                    "order": 67,
                    "type": "form_field",
                    "bbox": {
                        "l": 350.16,
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                        "b": 218.28
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                    "text": "",
                    "attrs": {
                        "field_kind": "text",
                        "label": "Exp. Date: ___",
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                }
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        },
        {
            "id": "p1.24",
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            "type": "text",
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            "text": "Security Code: ___",
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                {
                    "id": "p1.24.1",
                    "order": 69,
                    "type": "form_field",
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            "id": "p1.25",
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            "text": "<div style=\"text-align: center;\"><img src=\"imgs/img_in_image_box_0_1_1123_85.jpg\" alt=\"Image\" width=\"99%\" /></div>"
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            "id": "p1.26",
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            "type": "text",
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            "text": "Designate my contribution to:\nWhere the need is the greatest"
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            "text": "Kentucky State University | 400 East Main Street Hume Hall Suite 202 | Frankfort, KY 40601"
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        {
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