GENESIS WATERS
Secure Payment Form
Donation Amount
Donation Amount
Date
Designation (if any)
<p>General Ministry, Missionary Support (Watkins)</p>
Donor Information
First Name
Last Name
Address
City
State
<p>Enter state as two letter ID, for example Michigan = MI</p>
Zip Code
Phone Number
<p>Do not include any special characters, just nine digit number with area code</p>
Email Address
Pay By Check
If paying by bank account withdrawal, please complete this section and check the box in the "Credit Card Information" box that says Pay by Check.
Pay By Credit Card
Name as on Check
Bank Routing Number
Bank Account Number
Credit Card Information
Pay By Check
Name as on Card
Card Billing Address
Card Billing Zip Code
Card Number
Card Expiration Date
<p>Enter date in format MM/YY</p>
CVV2/CID
<p>Enter three digit security code</p>
Submit
