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Thank you for participating in our online activities! We are so happy to have you. Please use this form to pay for your virtual classes and programs, If you have problems or questions, please contact Ariel at arielb@phinneycenter.org.

Online class & program payments

Payment Amount:

Which class(es) /program(s) are you paying for?*

If you are pre-paying for more than one session, how many sessions are you paying for?

Contact Information

Company:

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*

Credit Card Information

Card Types Accepted:
Visa

Credit Card Number:*

Card Security Code:*

Expiration Date:*

Electronic Signature:*

I agree to pay above total amount according to card issuer agreement. Once the transaction has completed successfully, a confirmation receipt will be sent to the email address entered.

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Online class & program payments

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