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Museum of Discovery & Science General Donation

Please fill out the form below to make a donation online. All fields are required except for comments.
This is a secure form.
First Name:
Last Name:
Address:
City:
State: (ignore for non-US transactions)
Zip Code:
Country:
Email Address:
Confirm Email Address:
Preferred Phone:
Title (optional):
Organization (optional):
Credit Card Billing Address
 
 If the address where you receive the credit card bill is different than above, please enter it here.
Address:
City:
State:
Zip Code:
 

Are you donating in memory of someone?
If yes, please provide their name.
Charge Amount:
  $10.00
$20.00
$30.00
$50.00
$75.00
$100.00
$200.00
$300.00
$500.00
$1,000.00
  Other Amount --> $
  You can choose any amount you'd like by checking the box for the amount you'd like to give, or by checking the Other option and entering a custom amount in the blank field.
Make this a Recurring Transaction?  
By default your card will only be charged today, with no recurrence set up. However, you can use the fields below to specify a recurring payment on the schedule of your choosing. Change the recurrence to specify how often your transaction will be processed. Specify an end date to stop transactions after a certain point in time (if you are unsure, use the expiration of your credit card).
Recurrence:
End Date: (required) mm/dd/yyyy
Pay by Credit Card  
Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
C V V Value: