Directions:  Please complete the form in its entirety.  It must be completed prior to making a payment.

First Name: 

Last Name:  

Who are you making a payment for?   

Member Number:     

When Joined (List Fall or Spring and then year):

Date: 

Address: 

City:      State:  

Zip Code:      Phone Number(s):

Are you making a Retreat Payment, an Offering Payment, a payment for Membership Dues or purchasing Apparel?
(Note:  Please know that these are "One Time" Payments, and you must make your own reoccurring monthly payments.)

Please check the payment type and include the amount in the corresponding box.

Retreat Payment:           General Offering:          Emeralds Offering:           Retreat Offering:    
Membership Dues:           Apparel:          Leadership Camp:   

Please list what meeting(s) you are making payment(s) for below:

Please press the "Submit" button when completed filling out this form, then press the "Back" button in your Internet to make a Payment below.