Form

i-DareU Academy Inc.
Organization Name
Full Name *

First Name Last Name
E-mail *
Phone Number *

- Area Code Phone Number

Total Financial Contribution

USD Description

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Select or enter the amount you want to donate *

$500 $1,000 $5,000 $10,000 Other option
Calculation *
Should be Empty: