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Secure Donation Form for the Gladewater Unit

 
Recurring Donations:
Order Date: 04/26/24
Customer IP: 18.216.233.58 
Kids Fund = $25 per month Lifechangers =$83.33 per month  
Recurring Donation Amount (FIRST DONATION PROCESSES TONIGHT):
           
Schedule:
Next/Regular Donation Date (enter date in YYYYMMDD format):
Number of payments (* for unlimited):
     
   
Credit Card Information:
Card Type:

Name as on Card:
Card Billing Address:
City:
State:
Card Billing Zipcode:
Phone Number:
Email Address:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
 [What is the Card ID?]