I would like to give:

Annually

Monthly

One-Time

Contribution Amount

$50	$100	$250
$1,000	$2,500	Other

Contribution Amount

$10 / month	$20 / month	$50 / month
$100 / month	$200 / month	Other

Contribution Amount

$100 / year	$250 / year	$500 / year
$1000 / year	$2500 / year	Other

Or enter an alternate annual amount (Min $10)

$

Or enter an alternate monthly amount (Min $10)

$

Or enter an alternate one-time amount (Min $10)

$

I would like to divide this donation into monthly or quarterly payments

Payment Frequency

I would like to divide my donation into

payment(s) of

Donor Information

First Name

Last Name

Birth Month

Email

Phone Number

Phone Type

Yes, I would like to receive SMS messages from the Council

Street

City

State

Zip Code

Country

Select Address

Birth Year

Yes, I would like to receive the Council's Global Insight and Weekly Update emails

How did you hear about the Council?

Please specify

I would like to add a secondary member to my account

Payment Details

Name on Credit Card

Credit Card Type

Credit Card Number

CVV Number:

Card Expiration

I would like to cover the 3% credit card transaction fee on my donation

Billing Zipcode

Donation Summary

Payment Frequency

Donation:

Credit Card Transaction Fee:

Total:

Today's Charge

Total Amount Charged To Your Credit Card today (in USD).

For questions or comments, including requesting any changes to monthly or annual giving, please contact the Council Development Team at membership@globalaffairs.org

Next Payment Date

Next Payment Date

Chargent Connector Fields

Chargent Order Object ID (One-Time Payment)	Chargent Order ID (One-Time Payment)	Chargent Transaction Object ID (One-Time Payment)	Chargent Order Object ID (Monthly)
Chargent Transaction Object ID (Monthly)	Chargent Order ID (Monthly)	Chargent Order ID (Quarterly)	Chargent Order Object ID (Quarterly)
Chargent Transaction Object ID (Quarterly)	Chargent Opportunity ID (One-Time Payment)	Chargent Opportunity ID (Monthly)	Chargent Quantity One-Time Payment
Chargent Case ID (Monthly) Chargent Case ID (One-Time Payment)	Chargent Case ID (Quarterly)	Chargent Opportunity ID (Quarterly)

Custom Calculations (Should Be Hidden As A Group)

Total (Numeric)

Donation (Numeric):

Today's Donation

Credit Card Transaction Fee (Numeric)

One-Time Count

Chargent Amount Annual Payment

Chargent Amount Monthly Payment

Chargent Amount One-Time Payment

Chargent Quantity One-Time Payment

Credit Card Expiration (Month)

Credit Card Expiration (Year)

Payment Frequency

Chargent Billing Street

Chargent Billing City

Chargent Billing State

Chargent Billing Zip Code

Chargent Billing Country

Chargent Billing First Name

Chargent Billing Last Name

Chargent Order Object ID (Monthly)

Chargent Order ID (Monthly)

Chargent Transaction Object ID (Monthly)

Chargent Case ID (Monthly)

Chargent Opportunity ID (Monthly)

Chargent Order Object ID (Quarterly)

Chargent Order ID (Quarterly)

Chargent Transaction Object ID (Quarterly)

Chargent Case ID (Quarterly)

Chargent Opportunity ID (Quarterly)

Chargent Order Object ID (One-Time)

Chargent Order ID (One-Time)

Chargent Transaction Object ID (One-Time)

Chargent Case ID (One-Time)

Chargent Opportunity ID (One-Time)

Chargent Order Object ID (Monthly)

Chargent Order ID (Monthly)

Chargent Transaction Object ID (Monthly)

Chargent Case ID (Monthly)

Chargent Opportunity ID (Monthly)

Chargent Order Object ID (Annually)

Chargent Order ID (Annually)

Chargent Transaction Object ID (Annually)

Chargent Case ID (Annually)

Chargent Opportunity ID (Annually)

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