Lonny’s Stripe Test Pages | Academy of Aid-in-Dying Medicine

Test of Stripe “Continuing Education Payment Form”

Continuing Education Payment Form

Please pay $20 for your continuing education credit and/or certificate using the form below. Your certificate will be emailed within 2 weeks. Thank you!

"*" indicates required fields

Continuing Education Payment and Certificate

Name of course taken*

Amount*

$20

Contact Information

Name*

First Last

Email*

Checkout Information

Payment Amount

Test of Stripe “Lonny Test using copy of Continuing Education Payment Form to make a Donations Form.”