Credit Card Authorization Form

Please fill out the Credit Card Authorizaion form below.

Once done click the 'Submit' button and we will be in touch with you within 48 hours to confirm your authorization.

As it appears on the card.
(Visa, Mastercard, etc.)
Example: 23-Aug-2024
CVC2 / CVV2
Would you like this to be a monthly recurring donation? We will automatically charge at the end of every month.
By checking the Yes box, you are authorizing Build Belize Inc. to charge your credit card for the above amount agreed for donation. You understand that your information will be saved on file for future processing of your card.