NC Hunter Jumper Association
Secure Payment Form

 
You will be emailed a tracking number when your award is shipped.
Award Information:
Order Date: 03/29/24
Award Mailing Type/Amount:
Horse/Rider Name:
Division:
Show Rating:
Additional Award Request:
Multiple awards can be included in one shipment. Please indicate in the 'Additional Request' column pertinent information regarding additional awards. I will follow up by email prior to shipping if necessary.
           
Credit Card Information:
Card Type:

Name as on Card:
Card Billing Address:
Card Billing Zipcode:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
 
[What is the Card ID?]
   
Shipping Information:
First Name:
Last Name:
Address:
Address Line 2:
City:
State:
Zip:
Phone Number:
Contact Email Address: