Selectable Fee Options Form

In this sample form, customers can choose the fee options they want. The amount users have to pay will depend on the selected options.

Membership Plan *

6 Months Membership(60$)

9 Months Membership(90$)

12 Months Membership(120$)

Print Member Card

Yes(+10$)

First Name *

Last Name *

Address *

City *

Zip *

Country *

State *

Email *

Total Amount

$

Payment method *

Paypal
Authorize.net
Offline Payment
SnapPay
Payrexx