Dues Payment Form

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MOWW Dues Payment Form

Please choose from the following three choices:

Regular: Annual Membership at $60.00/year
Perpetual: $500.00
- Installment: 4 Quarterly payments ($125.00 each)
  (Every 3 months)
- One-Time Payment: $500.00

Please enter the information below to match your payment to your account.

*Sponsors: To pay for another Companion, please enter their info here on page 2, and your info in the cardholder information. The system will associate the payment with the name on page 2, not the cardholder.

Include a submember in your membership registration

Regular

Installment

Perpetual

I would like to automatically renew my membership (Recurring Payment)

Secure Payment

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First Name *

Last Name *

Email *

A confirmation will be sent to this address.

Membership Number

New Members: Leave blank. Current Members: Please provide your membership number.

Secure Payment

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Include a submember

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Choose Existing Contact(s)

Membership Level *

I would like to automatically renew my membership (Recurring Payment)

First Name *

Last Name *

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

Add {{subMemberDisplayName}}

Secure Payment

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Membership auto-renews monthly for {{ formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipInstallment.cost) }} until {{ orderSummary.membershipOrderItem.membershipInstallment.endDate }}

Membership auto-renews on {{orderSummary.membershipOrderItem.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipAutoRenew.cost)}}

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Membership auto-renews monthly for {{ formatAutoRenewAmount(sm.membershipInstallment.cost) }} until {{ sm.membershipInstallment.endDate }}

Membership auto-renews on {{sm.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(sm.membershipAutoRenew.cost)}}

Frequency selected: {{recurringUnitText}}. Next add-on payment processes on {{orderSummary.recurringDonationNextDate}} for {{formatAmount(orderSummary.donationAmount)}}

Discount Code

Code:

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Order summary

Subtotal {{formatAmount(orderSummary.subtotal)}}

Discounts -{{formatAmount(orderSummary.discounts)}}

Total {{formatAmount(orderSummary.total)}}

Secure Payment

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Card

or enter your card details below

Cardholder First Name *

Cardholder Last Name *

Cardholder Email *

A receipt will be sent to this email.

Card *

Payment Form Unable to Load: Your payment form is blocked by a firewall. This is most commonly due to use of an anonymous, untrusted IP address. If you are using a VPN to anonymize your IP, we recommend connecting through your local IP to complete your payment.

Billing address is the same as mailing address

Address Line 1 *

*Please use the address associated with the card.

Address Line 2

City *

State/Province *

Zip *

Country

Amount:

{{formatAmount(totalAmount)}} USD

Secure Payment

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About MOWW

MOWW Convention

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	Contact Name	Membership Level
	{{item.contactName}}	{{item.membershipLevel==null?'-':item.membershipLevel}} {{item.startDate}} - {{item.endDate}}
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