PAYQUIQ ONLINE :: The Faster Smarter Way to Pay

Make a Payment Towards Your Annual & Other Commitments

* Name(s)

* Daytime Phone Number

Note: There will be an online fee charge of 3% added to the Amount as a credit card convenience fee.

* Amount to be paid $

* Purpose (click all that apply)

	Annual Commitment, Reserves and/or Security Fee
	Sisterhood / Brotherhood Supporting Member Fee
	Other

If other, please specify

Would you like to be put on an automated monthly payment plan? We will contact you to discuss the installments.

Yes

Please consult your statement or contact the Temple Office if you need more information on your current balance - (561) 833-8421 or [email protected]

*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

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