Please use this form to submit your Fiscal Sponsorship Application fee ($65), or your Fiscal Sponsorship Annual fee ($45).

Fee Type

First Name

Middle Initial

if used on credit card

Last Name

Enter $65.00 for an Application Fee, or $45.00 for an Annual Fee

Fee

One TimeRecurring Monthly

Amount

Monthly Amount

NOTE: Recurring payments are not currently available. Please select "One Time".

Payment Information

Billing Information

Billing Street Address

Billing City

Billing State

Billing Zip Code

Billing Email

Card Number

Code

Processing Fees

Include processing fees in donation so that FilmNorth receives my full donation

YesNo

Pre-Fees

Transaction Fee

Total