Roman Catholic Diocese of Erie - Acceptiva

Thank you for registering for the NET Middle School Retreat with the Diocese of Erie. THIS IS NOT REGISTRATION - ONLY PAYMENT. If you have not registered yet, please do that first at: https://www.eriercd.org/youth/

This is the page to pay for your $10 fee. Registration and deposit are due by October 18th.

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Qty

Description

Amount

Total

Registration Fee

$10.00

---

Additional Donation

---

Total: $0.00

Participant/middle schooler's name: *

Please select the retreat you are attending: *

Payer Information

First Name: *

Last Name: *

Billing Address: *

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

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

Email: *

A receipt will be emailed to this address.

Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *