BERDICHEV REVIVAL 501C3


Secure Payment Form

Donation Summary:
BERDICHEV REVIVAL
Donation Amount: $180
$360
$500
$1000
$1800

 Or enter a contribution amount below.

Payment Method: Single Payment Recurring Payment
Description:  
Credit Card Information:
Card Type:

Card Number:  *
Card Expiration Date:  *
Card ID (CVV2/CID) Number:
 
[What is the Card ID?]
 *
   
Billing Information:
First Name:  *
Last Name:  *
Address:  *
City:
State:
Zip:  *
Phone Number:
Email Address:  *
     
Total Charge:

This is a 501C3 organization. Donations are tax deductible under TAX ID: 464126250