Double Your Donation with the Mahindrakar Family | Access Life America (Powered by Donorbox)

CARD PAYPAL BANK TRANSFER

Card Number

MM / YY

CVC Code

The 3-4 digits on the back of your credit card

Billing ZIP Code

Enter the Zip/Postal code for your credit card billing address

By clicking Donate, you authorise ACCESSLIFEAMERICA to debit the bank account that you connect to for any amount owed for charges arising from your use of ACCESSLIFEAMERICA’ services and/or purchase of products from ACCESSLIFEAMERICA, pursuant to ACCESSLIFEAMERICA’ website and terms, until this authorisation is revoked. You may amend or cancel this authorisation at any time by providing notice to ACCESSLIFEAMERICA with 30 (thirty) days notice.

If you use ACCESSLIFEAMERICA’ services or purchase additional products periodically pursuant to ACCESSLIFEAMERICA’ terms, you authorise ACCESSLIFEAMERICA to debit your bank account periodically. Payments that fall outside the regular debits authorised above will only be debited after your authorisation is obtained.

Bank Name

Account Type

Account Last 4

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