Donation in EUR Full Name* First Name Last Name E-mail* Amount €36 EUR€72 EUR€180 EUR€540 EUR€1800 EUR€3600 EUR€5400 EUR Purpose of Donation DonationShabatGaneinuClubhouse Comment Total €0.00 EUR Yes, I'd like to donate the cost of processing this transaction by adding 2.4% Invoice Name for Invoice If different than the name above NIF Payment Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration Year *** If you got here from another form, please don't forget to press submit on both forms Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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