Advanced Redirect

The patron will be redirect to the following pages based on the authorized result.

Important Note:

The redirect pages have to be secure otherwise no redirect will occur.
If your server is offline for any reason the redirect will fail, resulting in error. If the patron experiences a page not found based on your server’s availability it may result to double charges

Use complete URL including https://

Success landing page * :

Declined landing page * :

The following URL parameters are included in the response and may be used on the landing page via custom programming:

Example Success URL:
https://yourpageurl.com/success-page?on=123456&result=success&response=authorized&t=totalamount&refid=referenceid&trk=tracker

on = OrderNumber
result = success
response = authorized
t = totalamount
refid = referenceid
trk = tracker

Example Decline URL:
https://yourpageurl.com/decline-page?on=123456&result=failure&response=dcl&t=totalamount

on = OrderNumber
result = failure
response = dcl
t = totalamount

Your Donation Total:

Donation Amount

Recurring Option

One time onlyMonthlyQuarterlyYearly

Billing and Contact Information

First Name: *

Middle Initial:

Last Name: *

Email: *

Country: *

Address: *

City: *

State: *

Province:

Zip/PostalCode: *

Phone:*

Make this donation anonymously

Display my Name as:

Your public posted comment:

Choose a Program to Apply Donation

List of Programs

Choose to apply for general use or a particular program *

For General Use (to be used where we need it most)Individual and Family Assistance (including Food Pantry, Holiday Gifts, Back to School)Senior Outreach (Including Activities, Classes, Lunches, Meals on Wheels)Highland Youth Recreation (HYR) Year-round Sports LeaguesChild Care Centers (Eastern Star, Douglass Blvd. Christian, St. Paul UMC)Acupuncture Clinic for Veterans & 1st RespondersEmpty Bowls Hunger Benefit during Week in The HighlandsTaste of The Highlands Fundraiser during Mardi Gras

Honor/Memorial Gifts

I want to dedicate my donation to someone:

In Honor Of In Memory Of Tribute To

In Memory Of:

Honoree Name:

Send Email acknowledgement to:

Send Postal Mail acknowledgement:

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip/Postal Code:

Country:

Dedication Message:

Payment Details

Credit Card eCheck

Routing Number: *

Account Number: *

Check Number: *

Account Type: *

Check Type: *

Name on Card: *

Credit Card Number: *

Card Verification (CVV): *

Expiration Date: *

Invoice Number:

Purchase Order Number:

Name: *
Reference Number:

You will be charged:

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Highlands Community Ministries | 1228 E. Breckinridge St. | Lou, KY 40204 | 502/451-3695