Fax Donation Form

Fax Transmittal
Understand The Times, International
 (714) 957-3899 Fax Number

Name On Credit Card: ___________________________

Credit Card Number: ________________________

Expiration Date: _____________________

Credit Card Billing Address: ___________________________

Type Of Credit Card: ___________________________

CVS Code: ___________________________ 

(CVS Code) American Express = 4 Digit Code on the front

Phone Number: ________________________

Email Address: ____________________________

One Time Donation Amount: ___________________________ 

Purpose of Donation: ___________________________

Regular Monthly amount: ___________________________ 

Purpose of Donation: ___________________________

Signature: ___________________________