LOTW Credit Card Donation

Light of the World Ministry

Credit Card Donation
Donation Designation *
Donation Type *

One time gift Recurring gift
Frequency *
Date *

Month Day Year
*Card will be charged on date of submission
Name *

First Name Last Name
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Donation Amount *

USD Donation

Credit Card Information
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number
E-mail *
COMMENT:
Should be Empty: