Across Nations
Secure Payment Form - Recurring Missionary Support
Donation Summary:
Order Date:
12/30/24
Donation Amount:
Fund Designation (Please list specifics in the comments box.):
Chuck & Cindy Harper
Bill & Laura Naas
Jenna Martinez
Keith & Denise Ancar
Milt & Rita Shirleson
Roger & Sara Everett
Terry Battiest
Rose Spring
Jim & Shelle English
Albert Race
Other (Please Designate in comments)
Comments:
Recurring Donation Information:
Schedule:
monthly
quarterly
biannually
annually
Next Bill Date (YYYYMMDD):
*NOTE*
First payment will be processed when the form is submitted.
Number of payments (* for unlimited):
Credit Card Information:
Card Type:
Visa
MasterCard
American Express
Discover
Name as on Card:
Card Number:
Card Expiration Date:
MMYY
Card ID (CVV2/CID) Number:
[
What is the Card ID?
]
Billing Information:
First Name:
Last Name:
Address:
Address Line 2:
City:
State:
Zip:
Country:
Phone Number:
Email Address: