AGAPE PROJECT
HIV AND AIDS
Donation Form


If contributing by mail, please make check payable to The Epworth Foundation - Agape.  Complete/print this screen and send it along with your check to:  Epworth Foundation - Agape, 3401 High Street, Denver, CO 80205  Phone:  (303) 296-6287.

To contribute online with a credit card, please complete the form below and click 'Submit My Order'.

Your online order is secure.


Sponsor's Information:
 
Name:  
Church or Organization:
Street::
City:
State:
Zip:   Country:
Email:
Phone:

Contribution

 Amount
Please enter the amount you would like to contribute:

Credit Card Information:
 

Name on Card:

Card Type:

Card Number (no spaces or dashes):

 

Card Expiration Date:

   


"Yes, please charge my credit card for the items and amounts indicated above."
(Check in box required to process order)

Comments/Special Note: