Payments

School MCA Multi-Coach Registration (or other payment)

Payer Information
The info below is for MCA records only - to be filled out by the person submitting this payment. (if you are applying for school memberships, be sure to also include your info on the spreadsheet)
Name*
First Last
Email*
Address*
Mailing address City State ZIP Code
School*
Are you school paying for multiple memberships?*
Add total payment due from the Excel spreadsheet. (Email the spreadsheet to Marian- donomca@3rivers.net)*
Payment For*
Deadline for ordering plaques is July 1. Please do not order plaques after that date as orders have already been submitted. If you can't attend the Awards Ceremony, please have someone pick up your plaque...or last resort, add $20 for shipping.
- Assistant to the Coach of the Year Plaque ($20 each)
- Coach of the Year Nominee Plaque ($20 each)
- Ship my plaque ($20) If at all possible, please ask someone to pick up your plaque, saving MCA headache of shipping.
- Ralph Halverson Scholarship Donation
- MCA Card Replacement ($5)
- Other payment
What are you paying for? PLEASE DETAIL EXACTLY WHAT YOU ARE PAYING FOR!*
PLEASE detail exactly (for example: AA BB COY Nominee-$20 or B COY FB Assistant Plaque + shipping - $40)) THIS IS IMPORTANT!!
Payment Amount*
Please put the correct payment amount on this line.
Total
$0.00
Payment Method*
Please select PayPal (even if you do not have a PayPal account). On the first page you will see the option to pay with a credit or debit card.

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Payments

School MCA Multi-Coach Registration (or other payment)

Payer Information