Friends of Colina DeLuz
Secure Payment Form - Recurring Donation
Donation Summary:
Order Date:
04/26/24
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:
Recurring Donation Information:
You will be charged today and thereafter according to the schedule you create, below.
Schedule:
Monthly
Quarterly
Biannually
Annually
Next Bill Date (YYYYMMDD)(Leave blank to bill this date next cycle):
Number of payments (* for unlimited):
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: