Phi Gamma Delta

Payment on Chapter's Account

Amount:

Additional Information

School Name/Comments:

Billing Information

Title:

First name:

Last name:

Country:

Address lines:

City:

State:

ZIP:

Phone:

Email:

Payment Information

By completing this form, I represent that I am authorized to act on behalf of the chapter. I acknowledge the chapter’s obligation for these charges. If I am using a personal credit card, I have accepted responsibility to pay on behalf of the chapter and acknowledge that any entitlement to reimbursement is between me and the chapter, not the International Fraternity of Phi Gamma Delta.

Cardholder's Name:

Credit Card Number:

Card Type:

Card Expiration:

Card Security Code:

Additional Security

This is a security measure to help prevent fraud.

Credit Card Rejections

To avoid credit card rejects, please ensure the following:

1. Make sure you enter the correct billing address.

2. If the credit card is rejected the first time, try again, carefully checking the credit card number and expiration date. Call the number on the back of the credit card if it is rejected a second time.

3. The payment must not exceed the daily spending limit. To find out the daily spending limit, call the number on the back of your credit card.