American Legion Auxiliary
Secure Payment Form
Order Summary
Date
Amount
Number of Registrations
<p>List Senior and Juniors</p>
Number of Book of Reports
<p>How many Book of Reports are you paying for and who should they be given too (If more than 1 person registering)?</p>
Pay By Check
Pay By Credit Card
Name as on Check
Bank Routing Number
Bank Account Number
Billing Information
Unit #
First Name
Last Name
Address
Address 2
City
State
Zip
Phone Number
Email Address
Submit