SECC Event – Donor Participant Form Payment option for events. Coordinators - please use paper or pdf reporting form for FULL event details 2024 SECC Event Form Event Date(Required) MM slash DD slash YYYY Your Name(Required) First Last Department/University(Required)Enter the General Govt Department or University that you work in (if non government, fill in "N/A" Division/Academic Unit(Required)Please enter the sub division, sub department, etc. that you work in (If non government, fill in "N/A") Email(Required) Enter Email Confirm Email Event Name(Required)Tell us the name or type of event (ex. Bake Sale, Pie Contest, etc.) Event Coordinator Name(Required)Please tell us the name of the person who ran/coordinated the event First Last Event Donation Amount(Required)Enter the amount it cost to participate in the event Total Credit Card Pledge PaymentPayPal CheckoutCredit Card American ExpressMasterCardVisaSupported Credit Cards: American Express, MasterCard, Visa Card Number 123456789 Expiration Date mm/yy Security Code Cardholder Name Δ