Payment: Undoing Racism Sept 2014

First Name

Last Name

Country

Billing Address

City

Postal code

Email

Phone

Send email updates

Contributions are not tax deductible.

Amount

$25 $50 $100 $250 $300 Other $

Credit card number

I understand that my payment is being made to Democracy Engine, who accepts the responsibility of distributing the funds to my designated recipient(s). My card or bank statement will show a payment to “Democracy Engine” and if there are any issues or discrepancies with the payment or I wish to revoke the payment, I can contact Democracy Engine at [email protected].