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Secure Donor Information Update Form Faytene.TV / TheCRY / V-Kol / Justice Wall
First
*
Last
*
E-mail Address
*
Phone:
*
Please indicate what you are seeking to do today.
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Update my credit card number or expiry date.
Update my mailing address.
Update my e-mail.
Update my phone number.
Update my donation amount.
Multiple updates - please add details at the bottom of this form
Please indicate the following (add details at the bottom of this form)
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I would like to increase my monthly donation.
I would like to keep my monthly donation the same.
I would like to decrease my monthly donation.
If any of my monthly donations were missed because my credit card number changed I would like the following to happen:
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Please run my missed donations.
Please do not run missed donation but pick up my monthly donations going forward.
Not applicable.
If you are wanting to update your credit card information please fill in the fields in the section immediately below.
Name on Card
Credit Card Type (Visa/Mastercard Debit Accepted)
Visa
MasterCard
AMEX
Credit Card Number
Security Code
Expiration Date (mm/yy)
If you are wanting to update your mailing address, phone or e-mail please fill in the fields in the section immediately below.
Street Address
City
Province or State
Postal Code or ZIP
E-mail Address
If you would like to send us a message or have special instructions please write in the text block below.