TIOH Statement Payment

NOTE: This form may not be used for tuition payments.

* First Name

* Last Name

* Address

(as it appears on your statement)

* City, ZIP

* Contribution Amount

* What is this payment for?

If you have a new email address please enter here:

A 3.5% processing fee will be added to all credit card transactions. Alternatively, please choose to pay directly through your checking account.

I would like to pay my balance in installments with the first transaction processed today.

E-mail

Enter your name and e-mail address for your confirmation

First Name

Last Name

Account

Online Fee:

Comments

Total: