Bnos Menachem - Reaching Higher

DONATION TYPE

GENERAL TEAM

Donation Amount (USD$)

54
100
180
360
540
1,000
1,800
3,600
OTHER : $

Cover processing fees of 2.9% + 30 cents =

DONOR INFORMATION

*IF LEFT BLANK, FIRST AND LAST NAME WILL APPEAR ON THE SITE.

PAYMENT METHOD*

CREDIT CARD

SAME AS FIRST NAME & LAST NAME ABOVE

EXPIRATION*