Pay To the Rotary Club of Elizabethtown, PA

Name*

First Last

Telephone Number*

We will only call you if we have a question about your payment. We will never use any data provided here for marketing purposes.

Email*

We'll use this to send a confirmation of your payment

Billing Address*

Street Address Address Line 2 City State ZIP

Payment is for:*

Select one or more. Provide further explanation below, if needed. The more information you provide the easier it will be for us to apply your payment correctly with having to call you.

Further explanation, (names of participants, etc.) if needed:

Payment Amount*

Help Cover our Service Fees- optional

OPTIONAL ADDITIONAL PAYMENT -- This price box will display 3.5% of your Payment Amount, (above), which we ask you to add to your payment to help us cover the administrative costs of providing this credit card payment option for your convenience. It will only be added to the TOTAL, below, if you place a "1" in the quantity field, here.

Price: $0.00

Credit Card*

Card Details

Cardholder Name

Total Payment Amount

This is the total amount to be charged to your credit card and includes the optional payment only if you selected it.

$0.00

CAPTCHA

Email

This field is for validation purposes and should be left unchanged.

Pay to the Rotary Club of Elizabethtown, PA