Customer IP: 3.141.35.60 
DOOR (Discovering Opportunities for Outreach & Reflection)
Secure Payment Form

 
Donation/ Payment Summary:
Order Date: 04/27/24
Donation/ Payment Amount:
Donation Designation or Payment Description:  
           
Credit Card Information:
Card Type:

Name on Card:
Card Billing Address:
Card Billing Zip Code:
Card Number:
Card Expiration Date: MMYY (do not use '/')
Card ID (CVV2/CID) Number:
 
[What is the Card ID?]
Email Address: (REQUIRED for all transactions)
   
Additional Contact Information:
First Name:
Last Name:
Preferred Mailing Address:
Address Line 2:
City:
State:
Zip Code:
Country:
Phone Number: