Secure donation form

* denotes required information

Make a personal donation:
Make a donation on behalf of an organization:

* Organization:


	Home Work


* Address:

* City/Town:
* Country:
* * * * Province/State:
* Postal/Zip Code:
Phone number:	( ) Ext.
Cell phone number:	( )
* Email address:
* Confirm email address:

I give Saint Mary's University permission to contact me by email.

* What is your relationship to Saint Mary's?

Alumni
Friend
Current Student
Faculty / Staff
Parent
Other

Donor Recognition

Please do not publish my name in any donor listings.
I would like my name to appear in donor listings as (if different from above)

* Please indicate where you would like your gift to be designated:

If you would like to make this gift in honour or memory of someone, please provide their name:

Pay using credit card
Card Security Number is not supported in data entry. To process a credit card payment, you need to disable Card Security from the Electronic Payment page in the Configuration tab.

* * Donation amount:	$50 $150 $500 $10 per month $25 per month $100 per month Other Other
* Processing date:
* Number of installments:
	installments
Pay using PayPal
* Credit card type:
* Credit card number:
* Card security number:	Where is my card security number?
* Cardholder's name:
* Credit Card Expiration:



* Bank name:
* Bank ID:
* Cheque number:
* Transit number:
* Account number: