Babysitting Class - Thursday, June 15, 2023
SGCMH Secure Payment Form
Donation Information:
Date:
06/10/23
Class Registration: $
20.00
Customer IP:
44.192.92.49
Credit Card Information:
Card Type:
Visa
MasterCard
American Express
Discover
Name as on Card:
Card Billing Address:
Card Billing Zipcode:
Card Number:
Card Expiration Date:
MMYY
Card ID (CVV2/CID) Number:
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What is the Card ID?
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Additional Contact Information:
Phone Number:
Email Address:
Email Address (to confirm):
Additional Comments
Please provide child's name. Due to class size limitation of 20, an additional class may be added the following day.