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:  *
CHeck Here to be added to our Mailing List

Donation Information

Donation Amounts 25 Dollars - $25.00
50 Dollars - $50.00
100 Dollars - $100.00
250 Dollars - $250.00
500 Dollars - $500.00
1000 Dollars - $1,000.00
Recurring: Make this a one-time donation
Make this a recurring donation.
Please Select Where your Donation is to be Used
Please Add any Comments Here
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This transaction is being processed by San Mateo Rotary Foundation-Scholarship using Secure Socket Layer (SSL) Encryption.