Donation via on-line secure credit card transaction

 

To make a donation to Women on Waves on-line using a credit card, please fill out the specific form below. All transactions are secure, your information will be encrypted and will be sent through our secure server.

https://secure.vuurwerk.nl/~womenb/transaction_e.html

Billing Information

I wish to make a contribution of
US Dollars
Euro

How would you like to pay for your donation?
American Express
VISA

Masterdcard



Credit Card Number

Expiration date /

Security code: last three figures of the number on the signature-strip at the back of the credit card

First Name


Last Name


Billing Address


Apartment/Suite

City


State


Zip Code

Country

E-mail Address


Optional