Donation21 test Donation Form (2021) Drop in the Bucket is a non-profit organization building wells and sanitation systems at schools in sub-Saharan Africa. 1 DONATION AMOUNT2 DONATION TYPE3 4 donation frequencyGIVE ONCEGIVE MONTHLYMAKE THIS A MONTHLY RECURRING DONATION MAKE THIS A MONTHLY RECURRING DONATION NOTICE: You pressed the donate button from a campaign page. Do you want to make a donation to that campaign or a general donation to Drop in the Bucket?No, I'd like to make a general donationYes, apply my donation to the campaignThis Campaign has multiple members. Would you like to make your donation under any specific member?General DonationDonation Amount*Donation Amount$25$50$100$200Other AmountOther Amount Total $0.00 MAKE THIS DONATION IN SOMEONE’S NAME MAKE THIS DONATION IN SOMEONE’S NAME Recipients Name First Last Recipients Email MAKE THIS DONATION ANONYMOUS MAKE THIS DONATION ANONYMOUS SELECT PAYMENT METHODSELECT PAYMENT METHOD*SELECT PAYMENT METHODCredit CardPaypalGIVE BY CHECK OR MONEY ORDERSPONSOR A WELL FOR A SCHOOL OR COMMUNITY IN AFRICA $6000 Select your cardTo (Receiver’s name)From (sender’s name)Message Card Preview HereDeliveryPrint CardEmail CardRecipient Email Enter Email Confirm Email A printable card will be open in a popup after the donation form is completed. Press continue to go to the next step.Your card will be emailed to the recipient after the donation form is completed. Press continue to go to the next step. Email address*Email address First name Last name Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Credit Card American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name Price NumberUntitled First Choice Second Choice Third Choice
