Museum of Vanning Adopt-A-Van Subscription

First Name & Last Name

First Name *

Last Name *

o61zm3gpbnhf

Street Address or PO Box (Required)

Apt., Unit No., or other Designation (if applicable)

City, Township or Area (Required)

Country (Required)

State, Province or Other Applicable Jurisdiction (Required)

Zip Code or Postal Code (Required)

Email Address (Required)

Phone Number (Required)

+ Country Code

Phone Number

ext Extension

Country Code is 1 for USA & Canada

Country Code Required - Enter Your Country's Code

Level of Support

Choose one of the following levels of support

Bronze Level = $50 Annual Fee (USD)
Silver Level = $100 Annual Fee (USD)
Gold Level = $250 Annual Fee (USD)
Platinum Level = $500 Annual Fee (USD)

Choose your adopted van or contribute to the general van maintenance fund.

Royal Coach
Notel Motel
Voodoo Lounge
Pearl
Flying Eagle II
Moto Cross Van
Slurpee
General Van Maintenance Fund

Before you click the "Send" Button below: We hope you will consider the convenience of automatically renewing your subscription each year using a credit card or bank draft.

For Automatic Renewal please read carefully: You can activate automatic annual renewal by choosing the recurring payment option in the final payment window. Do not be confused. The website provider has provided only one recurring button that is labeled "make this a monthly payment." Click it even if you want to automatically renew annually. We'll make the necessary changes and confirm your choice with you, but you must click the "make this a monthly payment" in order to make this happen.

(Recurring payments can be cancelled at any time by contacting the Museum at museumofvanning@gmail.com)

If you do not choose automatic renewal, we will send you a reminder each year.

Clicking on "Send" below will submit your subscription and direct you to the secure payment site.

Select a Payment Method

Credit Card
Bank Account

Cardholder Name (Required)

Credit Card # (Required)

Expiration Date (Required)

Security Code (Required)

cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

Billing Zip Code (Required)

Cover the fee associated with this online transaction?

Yes, I will pay an additional {transaction_fee} to cover the cost of this transaction.

Cover the fee associated with this online transaction?

Account Holder

First Name

Last Name

Account Type

Checking
Savings

Account Number (Required)

Routing Number (Required)

Make this a monthly payment?

Yes, charge me today and on the 19th of every following month.

Make this a monthly payment?

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

How to Help

Online Adopt-A-Van

Adopt-A-Van Subscription