"*" indicates required fields Choose AmountDonation Type* One-time Monthly Donation Amount* $10 $50 $100 Custom Amount Custom Amount* Donation Choice*- choose one -Area of Greatest NeedFeed the Need | KXXVToysIn Honor OfIn Memory OfBaylor Alumni Network Group (BANG)Business Name*Please send acknowledgement toNotes InformationName* First Last Email* Phone*Mailing List Yes, I would like to join the mailing list Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How did you hear about us?* Friend/Family Facebook Instagram YouTube Radio TV PaymentPayment Method* Credit Card (convenience fee added) ACH Payment ACH Payment* Account Number SelectSavingsChecking Account Type Routing Number Account Holder Name Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Convenience Fee Price: $0.00 Total Recurring Total This amount will be donated monthly.
