Shambhala USA credit card donation

Donation Amount $ *

Total Amount

I want to contribute this amount every month

Email Address *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

User Consent Shambhala

Donor Comments

Consent to process your personal information(Contribution)

I give permission for the personal information in this form to be collected so my transaction can be processed. (In order to provide a tax receipt for your donation, Shambhala will securely store this personal information as required by the regulations governing charities.)

To make a restricted donation to a specific project or fund, please contact [email protected].