Levy Church of Christ
Secure Payment Form - One-time Donation
Donation Summary:
Donation Date:
10/08/24
One-time Donation Amount:
Fund Designation:
Regular Contribution
Harvest
Abercrombie Mission Fund
Don Williams Mission Fund
Haiti Mission Fund
Memorials
Food Pantry
Other (please specify)
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: