Payments Test Page Pay Session Fee $125 $100 $75 $50 $30 Pay Another Amount Input Amount Here Total $0.00 Select Counselor* Kathie Donaldson Michael Gembola Kristen Hull Dale Kuiken Dreama Plybon Love Jason Luke Dan Martinson Todd O'Brien Nancy Olson David Peck Nick Perrine Kaifang Zheng Other Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Enter Email Confirm Email Credit CardCard Details Cardholder Name Session Date(s)* Memo / Comments
