ORTOP Donation Form
Contact Information
First Name
Last Name
Email
Phone Number
Extension
Do you want to dedicate this gift?
No
Yes, in honor of
Yes, in memory of
Honoree Name
Donation Information
Donation Type
one-time
recurring
One-time Amount
$
How often?
Please select...
monthly
quarterly
yearly
Recurring Amount
$100
$60
$30
$15
$5
I authorize Oregon Robotics Tournament and Outreach Program (ORTOP) to take payments from my account in accordance with the terms of my agreement with you. My authorization shall remain in effect until I notify ORTOP that I wish to change or end it, and ORTOP has had reasonable time to act on my wishes. A record of each contribution will appear on my credit/debit card statement and will serve as my receipt.
You must agree to these terms to continue.
I Agree
Please read and agree before continuing.
Payment Information
Name on Card
Zipcode
Card Number
MM
YYYY
Code
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ORTOP Contact Information