HAMPA Payment Form
Processed through Square.
Business Name
*
Contact Person
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Comments
Type of Sponsorship
Whole Note ($500)
Half Note ($250)
Quarter Note ($100)
Other
Sponsorship Amount
*
An additional 3.5% processing fee will automatically be added.
Calculation
Total Charge
*
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( X )
USD
Credit Card
Submit
Should be Empty: