Secure Donation Form

To process your donation using Visa, MasterCard, American Express, or Discover, please fill in the secure order form below with the requested information exactly as it appears on your monthly bankcard statement.
 

Billing Information - Exactly as it appears on your Credit Card

Donor Prefix:
Donor First Name:  *
Donor Middle Initial:
Donor Last Name:  *
Suffix (eg: Jr,Sr,II):
Billing Address:  *
Apartment or Suite:
Billing City:  *
Billing State or Province:  *
Billing Postal/Zip Code:  *
Billing Country:  *
Day Time Phone Number:
Mobile Phone Number:
Credit Card#:  *
Expiration Date:  *
Card Verification Value:  
E-Mail Address:  *
 

Donation Information

Choose an amount or pick Other to set your prefer 10 dollars - $10.00
25 dollars - $25.00
50 dollars - $50.00
5 Dollars - $5.00
Donation Player Lottery Entry - $75.00
Donation Secured Seat - $125.00
Tournament Corporate Sponsor - $500.00
CigarWhiskeyTicket1 Gold Package - $65.00
CigarWhiskeyTicket2 Silver Package - $50.00
CigarWhiskeyTicket3 Bronze A Cigar Only - $30.00
CigarWhiskeyTicket4 Bronze B Whiskey Only - $30.00
CigarWhiskeySponsor1 Diamond - $1,500.00
CigarWhiskeySponsor2 Ruby - $1,000.00
CigarWhiskeySponsor3 Sapphire - $500.00
 Other: 
Select your preferred Charity
Please Add a Comment for your Donation
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This transaction is being processed by KofC Arlington 2473 using Secure Socket Layer (SSL) Encryption.