Gift Membership

MEMBERSHIP LEVEL

RECIPIENT INFORMATION

Recipient Information

Recipient First Name *

Recipient Last Name *

Spouse/Partner First Name

Spouse/Partner Last Name

Recipient Street Address *

City *

State *

Zip Code *

Recipient Phone Type *

Recipient Phone Number *

Recipient Email Address

Send Membership Packet to: *

Donor (Me)Recipient

YOUR INFORMATION

First Name: *

Middle Initial:

Last Name: *

Email: *

Country: *

Address: *

City: *

State: *

Province:

Zip/PostalCode: *

Phone (Please indicate phone type):*

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

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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Thanks for supporting the Center for Puppetry Arts through the gift of Membership!

Your Gift Membership will be active within 30 business days of purchase. An email announcement will be sent to the recipient if an address is provided.

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Center for Puppetry Arts is a nonprofit 501(c)(3) organization and as such a portion of this Membership contribution may be tax-deductible to the full extent of the law. Any tax deduction is limited to the excess of the contribution over the fair market value of any items received in exchange for the donation.

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