Donation by credit or debit card

Versión española🇪🇸

Please fill in the form to make a donation to Umamanita

We use STRIPE for credit/debit card payments to ensure complete security. Once you have sent the form you will receive a confirmation email and a receipt.

First Name and Surname (Only for communication purposes)

Nombre

Apellidos

Would you like a receipt for your donation? *

• Yes
• No

Address (to include on the receipt) *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrito de ColumbiaFloridaGeorgiaHawaiIdahoIllinoisIndianaIowaKansasKentuckyLuisianaMaineMarylandMassachusettsMíchiganMinnesotaMisisipíMisuriMontanaNebraskaNevadaNuevo HampshireNueva JerseyNuevo MéxicoNueva YorkCarolina del norteDakota del norteOhioOklahomaOregónPensilvaniaRhode IslandCarolina del SurDakota del SurTennesseeTexasUtahVermontVirginiaWashingtonVirginia OccidentalWisconsinWyomingState

Zip Code

Email address (to send a confirmation email) *

Correo electrónico

Confirmar el correo electrónico

Amount you wish to donate *

Would you like your name to be included on our donors page? There are various options depending on your preferences, you can put a) your first name and surname, b) only your first name, c) your name and that of your partner (if relevant), d) the name or names of you children (if relevant), or e) all of the above… whatever you wish.Choose...YesNo

Please write the name or names that you would like to appear on our donor page:

If you would like to leave a message, please use the following space (opcional):

Total payment amount

0,00 €

Payment by credit or debit card *

Card

Name on Card

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