PAYQUIQ ONLINE :: The Faster Smarter Way to Pay

Youth Group Merchandise

NFTY Pyramid Short Sleeve:

URJ Youth Long Sleeve:

NFTY Sweatpants:

* Name (First and Last)

* Email Address

* Phone Number

URJ Youth Comfort Colors Long Sleeve - $20

NFTY Pyramid Short Sleeve - $10

NFTY Sweatpants - $30

How would you like to receive your merch?

	Shipping - add $5 to total
	Pick up at United Hebrew

If picking up at UH, we will email you to coordinate a pick up time

Paying Now Via Credit Card $

Add up your total and type it in the box to be prompted to pay by Credit Card now

Other Payment Options

Paying via Venmo

Add up your total and venmo @uhcstl

Address for shipping

If you chose ship to me, please provide the address to ship your merchandise to.

*E-mail

*First Name

*Last Name

Account

Online Fee:

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Comments

Increase the amount by 3% to cover credit card fees. Please select YES to increase your payment.

Total: