East Washington Freedom Alliance
Secure Payment Form
Donation Summary
Date
Donation Amount for Today
Add to EWAFA data base
Yes
No
Enable Recurring Donations
Yes
No
Amount of Recurring Donation
Schedule for Recurring Donation
Disabled
Daily
Weekly
Biweekly
Monthly
Bimonthly
Quarterly
Biannually
Annually
How many Recurring Donations
Date of first Recurring Donation
Credit Card Information
Name as on Card
Card Billing Address
Card Billing Zip
Card Number
Card Expiration Date
CVV2/CID
Phone Number
Email Address
Submit
