Birdies for Charity Donation Form Charitable GivingI would like to make a gift of(Required) Payment for(Required)— Select —Amber's WingsBermuda Cancer and HealthBermuda Diabetes AssociationBermuda High SchoolBermuda Optimist Dinghy Association (BODA)Bermuda Sailing AssociationBermuda Underwater Exploration Institute (BUEI)Compassionate Care PartnersFriends of St. Peters ChurchFriends of the Bermuda National LibraryHabitat for HumanityKaleidoscope Arts FoundationKnowledge QuestMount Saint Agnes (MSA) FoundationPathways BermudaSaltusSt George’s FoundationTomorrow's VoicesAdditional Giving (if any)Payment for— Select —Amber's WingsBermuda Cancer and HealthBermuda Diabetes AssociationBermuda High SchoolBermuda Optimist Dinghy Association (BODA)Bermuda Sailing AssociationBermuda Underwater Exploration Institute (BUEI)Compassionate Care PartnersFriends of St. Peters ChurchFriends of the Bermuda National LibraryHabitat for HumanityKaleidoscope Arts FoundationKnowledge QuestMount Saint Agnes (MSA) FoundationPathways BermudaSaltusSt George’s FoundationTomorrow's VoicesAmount 2 Payment for— Select —Amber's WingsBermuda Cancer and HealthBermuda Diabetes AssociationBermuda High SchoolBermuda Optimist Dinghy Association (BODA)Bermuda Sailing AssociationBermuda Underwater Exploration Institute (BUEI)Compassionate Care PartnersFriends of St. Peters ChurchFriends of the Bermuda National LibraryHabitat for HumanityKaleidoscope Arts FoundationKnowledge QuestMount Saint Agnes (MSA) FoundationPathways BermudaSaltusSt George’s FoundationTomorrow's VoicesAmount 3 Total Credit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name Donor DetailsFirst Name(Required)Last Name*(Required)Email(Required) Phone(Required)Address Street Address City State/Parish Zip Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands CAPTCHA
