Museum of Vanning Adopt-A-Van Subscription

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First Name & Last Name

First Name *

Last Name *

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. If you wish to renew annually, be sure to click the "Annually" recurring payment button on the final payment page. 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)

Visa MasterCard American Express Discover

Expiration Date (Required)

Security Code (Required)

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

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.

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Account Holder

First Name

Last Name

Account Type

Checking
Savings

Account Number (Required)

Routing Number (Required)

Make this a recurring payment?

No, this is a one-time payment.
Monthly

Make this a recurring 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