Alpha Phi Alpha TIL Dues Payments -Square Gateway

Alpha Phi Alpha Fraternity, Inc. TIL Dues Payments To Chapter

Chapter Dues Payment Form (Square Gateway)
Current-Date

MonthDayYear
Date
National-Late-Date

MonthDayYear
Date
Chapter-Late-Date

MonthDayYear
Date
Local Chapter Dues
Local Chapter Dues-Late
National-Dues-Amount
National-Dues-Amount-Late
Chapter Dues ${Local-Chapter-Dues}.00 After December 31, ${Local-ChapterDues-Late}.00
National Dues ${National-Dues-Amount}.00 After November 15, ${National-Dues-Amount-Late}.00
Full Name*

First NameLast Name
E-mail*

Confirmation EmailEnter Your eMail Address
Phone Number*
Please check the Dues you are paying, the amount will automatically popuate. If you paying both then check both dues boxes.
Dues*

Chapter DuesNational Dues
Chapter Dues
Chapter Dues
National Dues
National Dues
Total Dues*
Total Dues
Dues + Processing Fees*
Credit Card Charge
The Processing fees are charged by the bank and the chapter does not benefit from these fees.

Amount Charged*

USDDescription

Alpha Phi Alpha Fraternity, Inc. TIL Dues Payments To Chapter