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GENESIS WATERS

Secure Payment Form

     
Donation Amount
Date
Designation (if any)

General Ministry, Missionary Support (Watkins)

First Name
Last Name
Address
City
State

Enter state as two letter ID, for example Michigan = MI

Zip Code
Phone Number

Do not include any special characters, just nine digit number with area code

Email Address
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.
Name as on Check
Bank Routing Number
Bank Account Number
Name as on Card
Card Billing Address
Card Billing Zip Code
Card Number
Card Expiration Date
CVV2/CID