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South Central Conference of the United Church of Christ

Secure Donation Form

       
Date
Amount
Comments
Can we add you to our customer database?
The database keeps a record of donors for charitable giving, records for IRS purposes and conference records
Enable recurring donations?
Schedule for recurring donations
Total number of recurring donations

Ex: Monthly for 1 yr = 12, 2 yrs = 24, etc

Date of next donation
Designation
First Name
Last Name
Address
City
State
Zip
Phone Number
Email Address
Name as on Card
Card Billing Address
Card Billing Zip
Card Number
Card Expiration Date
CVV2/CID