Donation Purchaser Information First Name: * Last Name: * Country: * Afghanistan - AF Albania - AL Algeria - DZ American Samoa - AS Andorra - AD Angola - AO Anguilla - AI Antarctica - AQ Antigua and Barbuda - AG Argentina - AR Armenia - AM Aruba - AW Australia - AU Austria - AT Azerbaijan - AZ Bahamas - BS Bahrain - BH Bangladesh - BD Barbados - BB Belarus - BY Belgium - BE Belize - BZ Benin - BJ Bermuda - BM Bhutan - BT Bolivia - BO Bosnia and Herzegovina - BA Botswana - BW Bouvet Island - BV Brazil - BR British Indian Ocean Territory - IO Brunei Darussalam - BN Bulgaria - BG Burkina Faso - BF Burundi - BI Cambodia - KH Cameroon - CM Canada - CA Cape Verde - CV Caribbean Netherlands - BQ Cayman Islands - KY Central African Republic - CF Chad - TD Chile - CL China - CN Christmas Island - CX Cocos (Keeling) Islands - CC Colombia - CO Comoros - KM Congo - CG Congo, Democratic Republic of - CD Cook Islands - CK Costa Rica - CR Croatia - HR Cuba - CU Cyprus - CY Czech Republic - CZ Denmark - DK Djibouti - DJ Dominica - DM Dominican Republic - DO Ecuador - EC Egypt - EG El Salvador - SV Equatorial Guinea - GQ Eritrea - ER Estonia - EE Ethiopia - ET Falkland Islands - FK Faroe Islands - FO Fiji - FJ Finland - FI France - FR French Guiana - GF French Polynesia - PF French Southern Territories - TF Gabon - GA Gambia - GM Georgia - GE Germany - DE Ghana - GH Gibraltar - GI Greece - GR Greenland - GL Grenada - GD Guadeloupe - GP Guam - GU Guatemala - GT Guernsey - GG Guinea - GN Guinea-Bissau - GW Guyana - GY Haiti - HT Heard and McDonald Islands - HM Honduras - HN Hong Kong - HK Hungary - HU Iceland - IS India - IN Indonesia - ID Iran - IR Iraq - IQ Ireland - IE Isle of Man - IM Israel - IL Italy - IT Jamaica - JM Japan - JP Jersey - JE Jordan - JO Kazakhstan - KZ Kenya - KE Kiribati - KI Kuwait - KW Kyrgyzstan - KG Lao People's Democratic Republic - LA Latvia - LV Lebanon - LB Lesotho - LS Liberia - LR Libya - LY Liechtenstein - LI Lithuania - LT Luxembourg - LU Macau - MO Macedonia - MK Madagascar - MG Malawi - MW Malaysia - MY Maldives - MV Mali - ML Malta - MT Marshall Islands - MH Martinique - MQ Mauritania - MR Mauritius - MU Mayotte - YT Mexico - MX Micronesia, Federated States of - FM Moldova - MD Monaco - MC Mongolia - MN Montenegro - ME Montserrat - MS Morocco - MA Mozambique - MZ Myanmar - MM Namibia - NA Nauru - NR Nepal - NP New Caledonia - NC New Zealand - NZ Nicaragua - NI Niger - NE Nigeria - NG Niue - NU Norfolk Island - NF North Korea - KP Northern Mariana Islands - MP Norway - NO Oman - OM Pakistan - PK Palau - PW Palestine, State of - PS Panama - PA Papua New Guinea - PG Paraguay - PY Peru - PE Philippines - PH Pitcairn - PN Poland - PL Portugal - PT Puerto Rico - PR Qatar - QA Romania - RO Russian Federation - RU Rwanda - RW Saint Helena - SH Saint Kitts and Nevis - KN Saint Lucia - LC Saint Vincent and the Grenadines - VC Saint-Martin (France) - MF Samoa - WS San Marino - SM Sao Tome and Principe - ST Saudi Arabia - SA Senegal - SN Serbia - RS Seychelles - SC Sierra Leone - SL Singapore - SG Sint Maarten (Dutch part) - SX Slovakia - SK Slovenia - SI Solomon Islands - SB Somalia - SO South Africa - ZA South Georgia and the South Sandwich Islands - GS South Korea - KR South Sudan - SS Spain - ES Sri Lanka - LK St. Pierre and Miquelon - PM Sudan - SD Suriname - SR Svalbard and Jan Mayen Islands - SJ Swaziland - SZ Sweden - SE Switzerland - CH Syria - SY Taiwan - TW Tajikistan - TJ Tanzania - TZ Thailand - TH The Netherlands - NL Timor-Leste - TL Togo - TG Tokelau - TK Tonga - TO Trinidad and Tobago - TT Tunisia - TN Turkey - TR Turkmenistan - TM Turks and Caicos Islands - TC Tuvalu - TV Uganda - UG Ukraine - UA United Arab Emirates - AE United Kingdom - GB United States - US United States Minor Outlying Islands - UM Uruguay - UY Uzbekistan - UZ Vanuatu - VU Vatican - VA Venezuela - VE Vietnam - VN Virgin Islands (British) - VG Virgin Islands (U.S.) - VI Wallis and Futuna Islands - WF Western Sahara - EH Yemen - YE Zambia - ZM Zimbabwe - ZW Zip / Postal Code: * Address 1: * Address 2: City: * State / Province: * Phone: * Email: * Package: Donation 1 Donation Do you want your donation applied to a specific area, project or team, enter it here: Donation Amount: * Payment Type: * Online Credit Card Number: CVV: Exp Month: January February March April May June July August September October November December Exp Year: 19 20 21 22 23 24 25 26 27 28
