Example Payment Page

Example Payment Form

This is an example of how your website can have a payment form for one off payments or regular payments (ie. memberships/subscriptions/gifts)

Please note: as this is a test form, the only Credit Card number that will go through is 4444333322221111 with an expiry date of any month and year in the future. Any value can be used in the CCV/Security Code number

What do you want to do*
- One off Donation
- Membership / Subscription
Select Your Gift Amount*
- $200
- $365
- $1000
- Other Amount
Other Amount
Membership Type*
- Standard Member ($70)
- Concession ($30)
- Life ($300)
Total Paid Today
$ 0.00
Name*
First Last
Address*
Street Address Suburb State / Province / Region Postcode Country
Phone*
Email*
Credit Card

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Comment
Phone
This field is for validation purposes and should be left unchanged.

Example Payment Page

Example Payment Form

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Example Payment Form

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