Secure Donation Form

Credit Card Information:     
Card Type:

Name as on Card:
Billing Address:
Billing Zipcode:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
[What is the Card ID?]
Donation Summary:
Donation Amount:
Recurring Payment (optional):
Choose Your Schedule:
Number of Payments: * - means indefinite.
To make changes or cancel your payment just call the church.
Contact Information:
First Name:
Last Name:
Phone Number (optional):
Email Address: