Make a Payment

Name: Parkinson’s Moving Day Winston-Salem
Start: 2020-04-18T10:00:00-04:00
End: 2020-04-18T13:00:00-04:00
Location: Davie Medical Center

Need to make a one-off or special payment for something other than Membership Dues or one of our events? You can use this form.

Name*
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Reason for Payment*
Please indicate the reason for this payment. If you are trying to pay HIPSS Membership Dues, please visit the Annual Dues page.
Details*
Please provide any details necessary to ensure your payment is credited and applied properly.

Enter Your One-Time Payment Amount*
Amount To Be Processed
$0.00
Credit Card*

Card Details

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