National Fraternity of Kappa Delta Rho
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Brothers Only
Kappa Delta Rho Foundation Donation Form
Donation Information
Amount:
Supporting Brother
$ 50.00
Red Rose Society
$ 100.00
Kimball Society
$ 250.00
Old Painter Hall Society
$ 500.00
Founder's Society
$ 1,000.00
Other
$
*
Designation:
Annual Fund
Other
Other
*
Additional Information
Type of gift:
One-time gift
Recurring gift
Pledge (installments)
Frequency:
Weekly
Monthly
Quarterly
Annually
On:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Starting:
Ending:
Ending:
Corporate:
This donation is on behalf of a company
Anonymous:
I prefer to make this donation anonymously
Comments:
Billing Information
Title:
Mr.
Mrs.
First name:
*
Last name:
*
Country:
United States
Canada
United Kingdom
Australia
New Zealand
AE
ARGENTINA
AUSTRIA
BAHAMAS
BELGIUM
BERMUDA
BOLIVIA
BRAZIL
BRITISH COLUMBIA
BULGARIA
CHINA
COLUMBIA
COSTA RICA
CYPRUS
CZECH REPUBLIC
DENMARK
ECUADOR
ENGLAND
ETHIOPIA
FRANCE
GERMANY
GREECE
GUAM
HONDURAS
HONG KONG
ICELAND
INDIA
INDONESIA
IRAQ
IRELAND
ISRAEL
JAPAN
JORDAN
KENYA
KOREA
LUXEMBOURG
MEXICO
MOZAMBIQUE
NETHERLANDS ANTILLES
NORWAY
PAKISTAN
PARAGUAY
PERAK MALAYSIA
PHILIPINES
PUERTO RICO
SINGAPORE
SOUTH KOREA
SPAIN
SRI LANKA
SWEDEN
SWITZERLAND
TAIWAN
TAMPERE
THAILAND
TURKEY
U.S.A.
UGANDA
UNITED ARAB EMERITS
US VIRGIN ISLANDS
VENEZUELA
WEST INDIES
ZAMBIA
ZIMBABWE
UNITED STATES OF AMERICA
Honduras. CA.
POLAND
US
USA
EL SALVADOR
EQUADOR
HUNGARY
ITALY
QATAR
SOUTH AFRICA
PANAMA
SCOTLAND
FINLAND
GHANA
BAHRAIN
Lebanon
Korea, Republic Of
Philippines
*
Address lines:
*
City:
*
State:
<Please Select>
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
CZ
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NL
NH
NJ
NM
NS
NT
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
NU
MX
*
ZIP:
*
Phone:
*
Email:
*
Payment Information
Payment Method:
Credit Card
Bill me later
Cardholder's Name:
*
Credit Card Number:
*
Card Type:
Visa
American Express
Diners Club
Discover
JCB
Maestro
MasterCard
*
Valid From:
01
02
03
04
05
06
07
08
09
10
11
12
/
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
(Maestro/Switch/Solo only)
Card Expiration:
01
02
03
04
05
06
07
08
09
10
11
12
/
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
*
Issue Number:
(Maestro/Switch/Solo only)
Card Security Code:
*
Note: The Card Security Code is not required for Maestro, Switch and Solo cards.
Matching Gifts
My company will match my gift
Company:
*
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