Danville

Use this form to make a payment on an Existing Order.
If you are placing a new order, use the Shop Catalog to create an order and checkout.

Student & Payment Information

School Name the Order Was Placed Under: *
Student First Name: *
Student Last Name: *
Order Number: optional
Student or Buyer Email: *
Graduation Year: *
This is a payment for: *
Class Ring

Graduation Supplies/Cap and Gown

Letterman Jacket

Championship Ring
Payment Amount: *ex(45.00)
Is this the final payment: *
Yes

No
Shipping and Handling: $12.00
Shipping and Handling: $12.00

Billing Information

Billing First Name: *
Billing Last Name: *
Billing Address 1
Billing Address 2
Billing City
Billing State & zip
Email Address: *
Phone: *

Shipping Information

Shipping Address matches Billing Address
Shipping First Name: *
Shipping Last Name: *
Shipping Address 1
Shipping Address 2
Shipping City
Shipping State & zip

Payment Method

Name on Card: *
Card Number: *
Card Type *
Expiration Date: *
Security Code: * (The Security Code can be found on the back of most major credit cards. The Security Code can be found on the front of the card above the number for American Express.)

Terms & Conditions

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