STAFF USE ONLY – Manual Credit Card Transaction

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_2025 AAI STAFF Manual Credit Card Transaction Form

Only use this if you have no other options. Please follow the directions.

AAI Staff Member Email Address(Required)

Company or Person Making Purchase

Examples: Company - Cargill or Person - Sam Cogdill

Email of Purchasing Party

Check the box if you would like to send an email receipt to the purchaser.

Yes. Send an email receipt.

Address of Purchasing Party

This should match the credit card billing address. Otherwise, leave it blank.

Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code

Purpose of Transaction(Required)

BE DESCRIPTIVE! Examples: AAI Dues Payment or $21.66 for 20 x Asmark Safety Posters

Price(Required)

Click the checkbox below if this is an AAI Dues Payment.

This is an AAI Dues Payment

Credit Card Processing Fee

Price: $0.00

Shipping Cost (if applicable)

Total

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