Knesseth Bais Avigdor
Secure Payment Form
Donation Summary
Donation Amount
*
-- Select --
$3,600
$1,800
$720
$360
$180
$54
$36
Other Amount
Donation Frequency
*
-- Select --
One Time Donation
Monthly Recurring Donation
Split Donation
Number of Months to charge FULL amount listed above
No End Date
Payment for:
*
-- Select Payment Allocation --
New Donation
Aliya
Matanos L'evyonim
Locker
Annual Campaign
Kimcha D'Pischa
Yomim Noraim Seats
Other
Card Information
Cardholder Name
Card number
*
Exp date MMYY
*
CVV
*
Billing Information
First Name
*
Last Name
*
Address
*
Address 2
City
*
State
*
Zip
*
Phone
Email address
*
*
Required Fields
Payments Processed by: Paytek Payment Solutions – www.paytek.net
© Copyright 2024 Paytek Payment Solutions
