$32
$33
$50
$100
$250
$500
$1,000
Other $
(U.S. Currency)
Payment Options
*
Required
Debit Card
or Credit Card
Checking/Savings
Account
Card Number
Expiration Date
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
Security Code (CVV2)
?
Account Type
(U.S. Banks Only)
Checking
Savings
Routing Number
?
Account Number
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First Name
*
Required
Required
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*
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Required
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*
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*
Required
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Required
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AA
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AP
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MD
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MS
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OR
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PR
RI
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VI
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WA
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WY
Zip
*
Required
U.S. Phone
(
)
-
Email
*
Required
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Scottish Rite Charities
comply with
U.S. laws and regulations.
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Scottish Rite Charities
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