DESIGNATED GIVING

DESIGNATED GIVING Secure Payment Form - One-time Donation

Donation Summary:

Donation Date:

11/13/24

One-time Donation Amount:

Comments:

Credit Card Information:

Card Type:

Name as on Card:

Card Number:

Card Expiration Date:

MM/YY

Card ID (CVV2/CID) Number:
[What is the Card ID?]

Billing Information:

First Name:

Last Name:

Address:

Address Line 2:

City:

State:

Zip:

Phone Number:

Email Address: