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Make a Payment

 
Your Full Name:
(as it appears on your credit card)
*

Billing Address:
Street Address: *
City: *
State: *
Zipcode: *
Phone Number:
Fax Number:
E-Mail Address: *

Required fields for all payments are marked with an asterisk (*)


$10 $25 $50 $100
$250 $1000 $2500 $5000
Other $ . *
Please enter numbers only,
no decimal points or commas.
 
I want to process the above payment:
One-Time
Weekly (every 7 days)
Bi-Weekly (every 14 days)
Monthly (every 30 days)
Bi-Monthly (every 60 days)
Quarterly (every 90 days)
 

Credit Card Number:
(Please enter numbers only,
no dashes or other punctuation)
*
Credit Card Expiration Date: Month * Year *
Credit Card CVV Security Code:
(What's this?)
*

I have read and agree to the Payment Policies.

You will have the opportunity to review your payment details on
the next page before your credit card is charged.


Security, Privacy, Refund & Recurring Payment Policies

VISA MC AMEX DISC

To send a check, please complete and print this form,
and mail it with your payment to this address:

Freedom Donations
4850 Wright Road, Suite 168
Stafford, TX 77477

Phone: 1-800-364-2243