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.