Friends of Colina DeLuz
Secure Payment Form - One-time Donation
Donation Summary:
Donation Date:
09/25/23
One-time Donation Amount (For donations OVER $1,000 please contact us at jim.colinadeluz@gmail.com):
Fund Designation (Please list specifics in the comments box.):
General Fund
Specific Project
Specific Missionary
Monthly Child Sponsor
Other
Comments:
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:
Phone Number:
Email Address: