Donation Form

* Required Fields

Purchase an Engage Course
Please Select:

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

Payment Information
Payment Options

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

Privacy Policy
We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through our site. We use this information to process your payment.

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. You may contact us at [email protected] or 303-442-3333 if you wish to discontinue your pledge.

All gifts submitted through this form fall under the full discretion and control of Horizons international, and will be used for Horizons' tax-exempt purposes.