Gift & Payment Information

North Jersey Run/Walk Sponsorship Donation

Sponsorship Information

Company Name:

Contact First Name:

Contact Last Name:

Contact Street 1:

Contact Street 2:

Contact City:

Contact State/Province:

Contact ZIP/Postal code:

Contact Country:

Email Address:

Contact Phone Number:

If a Run/Walk is canceled due to an unforeseeable situation (weather, etc) the sponsorship is non-refundable and will remain applied to the event.

Policy Acknowledgement

I acknowledge that this sponsorship is non-refundable.

Billing Information

Payment details same as above

Billing First Name:

Billing Last Name:

Billing Street 1:

Billing Street 2:

Billing City:

State/Province:

Billing Country:

Billing ZIP/Postal Code:

ZERO will email you a donor's receipt and occasional news about the fight against prostate cancer. Don't worry, we will never sell your data, and you can opt out at any time.

Payment Method:

Credit CardChecking Account

Credit Card Information:

Credit Card Type:

Credit Card Number:

Select month of credit card Select Expiration Year

CVV: What is this?

Checking Account Information:

Bank Routing Number: What is this?

Bank Account Number:

Verify Bank Account Number:

Account Type:

Checking
Savings

By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.