CINAmp

CINAmp 2024
Name*

First NameLast Name
Email*
Cell Number
Address

Street Address

Street Address Line 2

CityState / Province

Zip / Postal Code
Membership Level*

Passion FlowerSunflowerRose
Name (Additional Member #1)

First NameLast Name
Email #1
Name (Additional Member #2)

First NameLast Name
Email #2
Name (Additional Member #3)

First NameLast Name
Email #3
Name (Additional Member #4)

First NameLast Name
Email #4
Amount Due
Payment Type:*

Pay by CheckCredit/Debit Card
Check Number
Make Check Payable and Send to:

Carmelite Institute of North America
Whitefriars Hall
1600 Webster St., N.E.
Washington, D.C. 20017
Credit/Debit Card payments will be redirected to Zeffy, a company that processes for non profits w/ $0 fees. You'll be asked to enter your donation amount and your Credit/Debit Card information.
Your transaction is not complete until pay via Zeffy.
Zeffy asks for a voluntary contribution to cover their costs.
Select Other to leave it blank or enter the amount you choose.
Should be Empty:

CINAmp 2024