Secure Donation Form

To process your donation using Visa, MasterCard, American Express, or Discover, please fill in the secure order form below with the requested information exactly as it appears on your monthly bankcard statement.
 

Billing Information - Exactly as it appears on your Credit Card

Donor Prefix:
Donor First Name:  *
Donor Middle Initial:
Donor Last Name:  *
Suffix (eg: Jr,Sr,II):
Billing Address:  *
Apartment or Suite:
Billing City:  *
Billing State or Province:  *
Billing Postal/Zip Code:  *
Billing Country:  *
Day Time Phone Number:
Mobile Phone Number:
Credit Card#:  *
Expiration Date:  *
Card Verification Value:   *
E-Mail Address:  *
 

Donation Information

Ten Dollars - $10.00
Twenty Five Dollars - $25.00
Fifty Dollars - $50.00
One Hundred Dollars - $100.00
Two Hundred and Fifty Dollars - $250.00
Five Hundred Dollars - $500.00
Five Dollars - $5.00
Designate use of your Donation
Tribute Type:
 
* = Required Field

This transaction is being processed by Arizona Mayflower Society using Secure Socket Layer (SSL) Encryption.