St. Patrick Church

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STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Retreat Payments

Please make payment here ONLY IF you have been selected to live the retreat.
If you have any questions please feel free to contact our office for assistance.

Qty

Description

Amount

Total

ACTS - Women's Retreat Payment (Spanish)

$160.00

---

Total: $0.00

Retreatant Name/ Nombre del participante:

Your Information

First Name: *

Last Name: *

Envelope Number:

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Home Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *