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

Other - Please add what this is for in memo Rotary Member Lunch 1 Week - $14.00
Birthday Fund - $25.00
Happy Dollar 5 - $5.00
Happy Dollar 10 - $10.00
Rotary Member Lunch 4 weeks - $56.00
Swimarathon 25 - $25.00
Swimarathon 50 - $50.00
Swimarathon 100 - $100.00
Swimarathon 10 - $10.00
 Other: 
Select donation category
Memo
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* = Required Field

This transaction is being processed by Rotary Club of Watertown using Secure Socket Layer (SSL) Encryption.