Credit Card Payment Balance on Initiation Fee

Please fill out the form below to submit credit card information for your CPTC Equity Membership initiation fee.  This submission will be emailed directly to our Membership Director.

A 2.5% transaction fee will be applied.

Option 1

Balance owing $5000*

Option 2

Balance owing $2000*

Option 3

Balance owing $500*

Email Address*
Phone Number*
Set Date
Club Number*
Name on Credit Card*
Credit Card Number*
CVV (Three or Four Digit Code)*
Zip Code (Attached to Credit Card)*
Set Date
* Indicates a required field.
CAPTCHA ImageReload Image
Please enter secure code above:*