Credit Cards

You may make a credit card donation or registration two ways:

Call our office at the number below and process the credit transaction over the phone during regular business hours or
Complete the form below which will transmit your credit card information to our website for next day processing. (Tab to next field)

NOTE: If you are registering for the Couples Communication class and paying by credit card, you also need to complete the registration form.

NOTE: All fields are required to process!
Name
Billing Address
City
State
Zip
Card#
$ Amount
3 digit Card Code
Expiration date (mm/yy)
Your email (required)
Would you like this to be a MONTHLY CONTRIBUTION AMOUNT?

If you have problems on this page or other concerns, please contact us at the number below.

Phone 704.895.8976

Fax 704.892.5098

Email

Questions

Donations

Jerry Hancock
Executive Director
Men in Balance
20908 N Main
Cornelius, NC 28031

How you can help!

Make a contribution by Credit Card!

Address: 20908 N Main Cornelius, NC 28031