Linked Learning Alliance Charitable Donation Form

Donation Type

One-TimeRecurring

How often would you like this charge to occur?

Monthly (12x a year)Annually (1x a year)

One-Time Donation Amount (please enter the amount in as ##.## without $)

Recurring Donation Amount (please enter the amount in as ##.## without $)

Your Information

First Name

Last Name

Email Address

Phone Number

Payment

Donation Amount

Payment Type

Credit CardBank Account

Credit Card Information

Name on Card

Card Number

CVV Code

Billing Email

Billing First Name

Billing Last Name

Billing Address

City

Country

State

Province

Zip Code

Bank Information

Name on Account

Bank Name

Bank Routing Number

Bank Account Number

Account Type

CheckingSavings