Donations-One Time

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

Donation Amount

$250

$100

$75

$50

$25

Other

Custom Question

What efforts would you like your gift to support?

Is this gift in celebration or in memory of someone?

Who is this gift in celebration of?

Who would you like to send an acknowledgement to?

What is the email or mailing address for the acknowledgement?

Who is gift in memory of?

Who would you like to send an acknowledgement to?

What is the email or mailing address for the acknowledgement?

Would you like to receive a quarterly Newsletter from Beans and Rice? We promise not to be annoying.

Billing and Contact Information

First Name: *

Middle Initial:

Last Name: *

Email: *

Country: *

Address: *

City: *

State: *

Province:

Zip/PostalCode: *

Phone:*

Full Name

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: *

CardExpirationYear

Invoice Number:

Purchase Order Number:

Name: *

Reference Number:

Beans and Rice is a 501C3 Nonprofit Organization. Our tax exempt number is 54-1851247.

Because we value your contribution, you will receive an email confirmation when the transaction is complete. Please keep this written acknowledgemnt of your donation for tax purposes

Advanced Redirect

Your donation:

Honor/Memorial Gifts

You will be charged:

Your one time contribution can make a difference!

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