Demo – Payment Form (Donation / Membership)

Demo – Payment Form (Donation / Membership)

Profiler FM

Example Form
(WordPress)

(Integrated with Stripe – use Stripe test cards)

What do you want to do*
- One off Donation
- Membership / Subscription
Select Your Gift Amount*
- $200
- $365
- $1000
- Other Amount
Other Amount
Membership Type*
- Standard Member ($70)
- Concession ($30)
- Life ($300)
Total Paid Today
$ 0.00
Name*
First Last
Address*
Street Address Suburb State / Province / Region Postcode Country
Phone*
Email*
Credit Card

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Comment
Comments
This field is for validation purposes and should be left unchanged.