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Give Monthly (Credit Card)

Credit Card payments are automatically processed by PayPal on/around the 15th of each month, unless you specify another day for each month.

Name

First Name

Last Name

Name of Spouse (Optional)

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Monthly Donation Amount

$10

$25

$50

$83.33

$100

$250

$500

Other (Fill in Blank Below)

Other (Fill In) Donation Amount

Date of Monthly Payment

Choose a day of the month (1-28) you want your payment to be automatically processed on/around. If no date is chosen, payments will be automatically processed on/around the 15th of each month.

Name on Card

First Name

Last Name

Card - Billing Address

Leave blank if Card Billing Address is same as Address listed above.

Card - Number

Put no spaces between numbers

Card - Expiration Date

Put no spaces or "/" between numbers: MMYY

Card - CVC (Security #)

Agreement

By checking this option, I agree to use my credit/debit card as a payment method & authorize this organization to debit my credit/debit card to fulfill my donation.

I Agree