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Payment Form

This form can be used for both donations and program fees.

Name*
First Last
Company Name (if applicable)
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
What is this payment for?*
- Fundraising Event (Provide specific details below)
- Youth Ambassador Fees
- Sponsorship
- Fundraiser for a specific sister city (Provide details below)
- Other (Please elaborate below)
Payment Description:*
Can you tell us more about this payment? If this is for an event, please include event name and date and specifics of the event. (ie. 2 tickets for XXX event, individual donation, golf tournament foursome with names, event sponsorship, youth ambassador program fees, etc)

If this is for a specific fundraiser for a need of one of our sister cities, please give the city name and the purpose of the donation)
Payment Amount*
Hidden
Would you like to add 2.9% to cover our credit card fees for this payment?
Mesa Sister Cities is a 501(c)3 non-profit organization that operates on donations and volunteer support. Any help you can give in helping to cover our credit card costs is greatly appreciated.
- Yes
- No
Credit Card Fees
Price: $0.00
Total
$0.00
Credit Card
Card Details
Cardholder Name
Name
This field is for validation purposes and should be left unchanged.

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Payment Form

This form can be used for both donations and program fees.

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