SYDA Foundation

Please Complete All Information

I would like to practice dakshina by:

beginning a Monthly Dakshina Practice
updating a Monthly Dakshina Practice

Please enter offering amount, payment option, and contact information to begin or update a Monthly Dakshina Practice.

Monthly Offering Amount:

$ U.S. Currency

Please Choose One of These Payment Options

Credit Card & Check/Debit Card
Bank Account Transfer (ACH)

Expiration date

Credit card number

Security Code (CVV2)

Account type

Account number

Routing number

Your monthly offering will be charged or debited on or about the 20th of each month.

Please Enter Your Contact Information

All fields marked with an * are required.

First Name*

Spiritual Name

Last Name*

Company Name

(if offering through a company)

Title/Position

E-mail*

Confirm E-mail*

Street Address*

(line 2)

City / State / Zip*

U.S. Phone

( ) -

If you reside outside the United States, please complete the following section.

Country*

Province/Territory

International Phone

Yes, remember my contact information.

Checking this box allows your contact information to be automatically entered the next time you use this form.