BNI Chapter 59

Visitor Payment Form

Order Summary
Order Date
Order Amount
BNI Chapter 59 - Visitor Meeting Dues
Meeting You Will Attend
If you are a member and are paying for your guest's fee, please include your guest's email here so that we may notify them you paid on their behalf.
Credit Card Information
Name as on Card
Company Name
Email Address
Card Billing Address
Card Billing Zipcode
Card Number
Card Expiration Date
Card ID (CVV2/CID) Number
(3 digits for Visa/MC/Disc, 4 digits for AMEX)