Payment option:

• If you are paying by check: Mail this completed form with your check to Heidi Roane, LAAA, 1 Cascade Plaza, 17th Floor, Akron OH 44308-1192
• If you are paying by MasterCard or Visa: Print this form, write down your credit card information, and fax this completed form 330.434.1104.

I will pay at the door
Check enclosed
Charge my credit card:  __ Visa         __ Mastercard
       Will appear as "Leadership Akron Alumni Association"
         on your statement

Number _____________________________ Exp _________

Signature _______________________Security Code______