Secure Form for Credit Card Payments

   

Secure Form for Credit Card Payments

 
Visa, MasterCard, Amex
 
 Submit Credit Card Information Here
Amount authorized in U.S.$   
(or) amount authorized in Japanese yen �   
(Click here for current exchange rates)  

Purpose of Charge   

Cards Accepted (check one) Visa   MasterCard   American Express  

Card Number   
Expiration Date (month/year)   
Name on Card   
Email   
Phone   
Billing Address   
City   
State/Province/Prefecture   
Zip/Postal Code   
Country   

Comments, questions, or messages for TMA staff?  
  

Credit card billing statements will show charges credited to  
"Transpacific America" or "Transpacific Marriage America"  


  

Yen charges will be converted to dollars using the  
exchange rate on the day the charge was processed