Y.I.D.S. ANIYEI AMCHA
Secure Payment Form
Credit Card Information
Amount (to charge now)
Card Number
Card Expiration Date
CVV2/CID
Email Addresss
Save Payment Info? (If recurring, leave YES)
Yes
No
RECURRING SCHEDULE (for a one-time transection, skip to SUBMIT
Enable Recurring/Schedule
Yes
No
Schedule (how often)
Disabled
Daily
Weekly
Biweekly
Monthly
Bimonthly
Quarterly
Biannually
Annually
Amount to charge each time
How many times should we charge?
Payment Schedule should start on:
Would you like a Receipt each time?
Yes
No
Submit