Unable to Embed Widget

I have not been able to get the following instructions to successful reflect on my website.
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Option 2: Inline Widget

HTML Snippet to Embed Widget

<form name=”dForm” id=”dForm” method=”post” action=”#”><div id=”donorContainer”></div></form>
<script language=”JavaScript” id=”dScript” src=”//easytithe.com/inline/js.asp?uid=Cent514671&w=n”></script>
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I have tried to us both the RAW HTML and Raw JS elements to no luck. Does this code need modified to work with the Highend template?