21 Partners

Recurring Donations
Complete the form below to make a regularly scheduled donation. Charges will continue into 2022 and beyond until canceled.

* Required Fields

Recurring Gift

Amount

$21

Other

Frequency

Contact Information
* First Name
* Last Name
Company Name
* Address
Address 2
* City
* State/Province
* Zip/Postal Code
Home Phone
Cell Phone
Work Phone
* Email

Credit Card Information
Card Holder Name

Card Account Number
Expiration Date
* Security Code The 3 or 4 digit Security Code (CVV2) can be found on the back of your credit card. For American Express, the Security Code (CID) can be found on the front of the card.

Billing Address
Same As Above
* Address
City
State/Province
* Zip/Postal Code
Email

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Terms/Conditions
By submitting your payment, you authorize us to charge the account above for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.

21 Partners

Recurring DonationsComplete the form below to make a regularly scheduled donation. Charges will continue into 2022 and beyond until canceled.

Recurring Donations
Complete the form below to make a regularly scheduled donation. Charges will continue into 2022 and beyond until canceled.