Payment Form

Please enter a value greater than or equal to 25.
Credit card minimum - $25.00

Contact Information


Address:


Please PRINT and MAIL this form along with your payment to:
L.C.C.D.
2120 Cornwall Road, Suite 5
Lebanon, PA 17042-9788

Credit Card

Secure Payment Placement

All data is transmitted through a secure gateway. You will receive a confirmation email upon successful payment submission.

Your e-mail address will not be shared with any third parties and will remain strictly with LCCD.

By clicking the Submit Payment button, you confirm that you have reviewed this form for correctness and agree to have your credit card billed as indicated.

Please click the Submit Payment button only once. If you receive an error or do not receive a confirmation e-mail, please contact the LCCD office at 717-277-5275.

 

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