Note: If you plan to pay by check and not by credit card, please indicate
so in the Comments below. You can then skip the payment page after submitting
this form. Make your check payable to Misericordia Family Association and
send it to Misericordia, ATTN: MFA Treasurer - Benefit Book, 6300 N Ridge,
Chicago, IL 60660. Include your MFA# on the check.