Form to Set Up Monthly Payment Plan

READ THIS FIRST!

Use this form to set up your monthly payment plan.

Please write in the "Payment Amount" exactly as what Ruth Alcabes (AOP Administrator) or Lynda Simons (ALEPH Finance and Operations Manager) has provided you (you must first check BEFORE completing this form - thanks!).
IMPORTANT! MAKE SURE YOU DO THIS: Check the BOX next to "I want to contribute this amount every month." If the box is left unchecked, your payment plan will not go through and everything will have to be redone.
NO WORRIES! The plan's duration will be adjusted. Your credit card will not be charged every month forever. If an error occurs, we will issue a refund.
After you've entered all the billing information, click "Review your contribution." On the next page, verify your info and then confirm payment one more time by hitting the "Make Payment" button. Your card will then be charged and you will receive an email receipt.

Thank you and Shalom!

Payment Amount $ *

Total Amount

I want to contribute this amount every month

Name and email

First Name *

Last Name *

Email Address *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *