Levy Church of Christ
Secure Payment Form - One-time Payment
Payment Summary:
Payment Date:
08/25/24
One-time Payment Amount:
Designation:
Payment
Description:
Credit Card Information:
Card Type:
Visa
MasterCard
American Express
Discover
Name as on Card:
Card Number:
Card Expiration Date:
MMYY
Card ID (CVV2/CID) Number:
[
What is the Card ID?
]
Billing Information:
First Name:
Last Name:
Address:
Address Line 2:
City:
State:
Zip:
Phone Number:
Email Address: