Online Payment for Contractor Self Contributions

We use a secure, PCI compliant credit card processing system to ensure the safety of your credit card information. Simply fill out the form below and the provide the amount due. When your full payment is received, your eligibility will be updated at the Fund office within 1 business day.

Please understand the North Central States Carpenters’ Health Fund self-payment rates are calculated for cash payments, and that by paying by credit card you are agreeing to pay an additional 3% convenience fee. You should expect to see the adjusted amount appear on your credit card statement. Prior to checkout, the total payment charged to your credit card will be calculated without the 3% cash discount and the new amount due will be presented next to the "Submit" button on our payment form.

* Required fields

Contact Information

First Name *

Last Name *

6-Digit Member ID

Phone *

Email *

Date of Birth *

Contribution Information

Eligibility Month *

Payment for September 2024 must be submitted by 4:45 pm on August 25, 2024.
No late payments can be accepted.

Payment Amount *

Comments

Credit Card Information

Please enter the following information
exactly as it appears on your Visa, MasterCard, or Discover credit card.

Billing Address *

City *

State *

Zip *

Card Type *

Expiration Date *

Credit Card # *

CVV # *

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Confirmation Code *

Total Payment: $0.00

Submit

By paying with credit card, you are choosing to forgo the cash discount.