Friends of Colina de Luz
Secure Payment Form - Recurring Donation

 
Donation Summary:
Donation Date: 12/12/19
Donation Amount (For donations OVER $1,000 please contact us at jim.colinadeluz@gmail.com):
Fund Designation (Please list specifics in the comments box.):
Comments:
           
Recurring Payment Information:
You will be charged today and thereafter according to the schedule you create, below.
Schedule:
Recurring Amount (if different from initial donation amount):
Start date("next" for this charge to be the first payment on the selected schedule):
Number of payments(* for unlimited):
     
   
Credit Card Information:
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Name as on Card:
Card Billing Address:
Card Billing Zipcode:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
 
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Billing Information:
First Name:
Last Name:
Address:
Address Line 2:
City:
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