In-Person Payment Submission
Your Name
The information below has been submitted by
Date Collected
*
/
Month
/
Day
Year
Please mark the date when the payment was collected.
Player's Name
*
First Name
Last Name
Amount Received
*
Include only numbers, no “$" is needed.
Payment Type
*
Cash
Check
Check Number
Please add the 4 digit check number.
Additional Notes / Comments
Add any additional actionable comments as needed. Include the Receipt Number. If applicable included the Check Number for the payment.
Take Photo
Please include a photo of the Payment Envelope and Receipt for additional background
Submit
Should be Empty: