Cheshire Lutheran Church
One Time Donation Secure Payment Form
* marked fields are required
Donation Information
Donation Date
One Time Donation Amount ($) *
Service Fee (3%)
Total Donation Amount + Service Fee ($)
Envelope Offering Number (if applicable)
Fund Designation *
- select fund -
General Fund
Other Fund
Designation Comment
Payment Card Information
Card Type * (debit or credit)
- select type -
Visa
MasterCard
American Express
Discover
Name as on Card * (exactly as shown)
Card Billing Address *
Card Billing Zip *
Card Number *
Card Expiration Date *
CVV2/CID *
[
What is the Card ID?
]
Donor Information
First Name *
Last Name *
Address *
City *
State *
Zip Code *
Phone Number *
Email Address *
Submit Donation
