Credit Card Authorization Form 19-20
Name *
Your answer
Type of credit card *
Name as it appears on credit card *
Your answer
Expiration Date *
Your answer
Credit Card Number *
Your answer
CCV *
Your answer
Reason for submitting form (ex. partial dues payment, transfer in dues payment) *
Your answer
Amount to be charged *
Your answer
I agree to the terms and conditions above and authorize The Junior League of Baltimore, Inc. to charge my payment to the credit card listed above. *
Required
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