Prime Time - donation

Use this form to make a donation for Prime Time Get Away

Online Donation

Use this form to make an online donation.

Donor information

Gift Designation

Prime Time Get Away - donation

First Name*

Last Name*

Church

Address*

Address 2

City*

Postal Code*

Country*

Province*

Phone

Email*

Donation Information

Amount

$

$

Credit Card or PayPal

Paypal or Credit Card

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card type*

Card Holder Name*