Cardholder Information
* Cardholder First Name
* Cardholder Last Name
* Cardholder Phone Number
* Cardholder Email
* Cardholder Billing Address
* Cardholder Billing Zip

Amount
* Select Amount:	$25
	$50
	$75
	$100
Other:	$

If you prefer, you may also donate by check. Please make it payable to The Power of One World Leadership Foundation and mail it to the following address:

3821 Long Beach Blvd.
Long Beach, CA 90804
USA