Trip Fee Payment

Use this form to pay your trip fees online through PayPal. You do not need a PayPal account to use a credit card. If you would rather pay by check, send it to JustHope, PO Box 4542, Tulsa OK 74159.

Trip Fee

Please enter the amount to apply to your PartnerTrip fee.

Clinic Rotation Fee

For medical residents participating in our clinic rotation program.

Cover Processor Fee

If you are paying using a credit card, please consider increasing your payment to cover the processing fee. This option adds a small percentage (3%) to your total. If you prefer not to pay extra for the fee, you can make JustHope's budget go further by mailing a check to JustHope, PO Box 4542, Tulsa OK 74159.

Total Amount

Email Address *

If you would like to create an account on this site, check the box below and enter a Username and a password. If you already have an account please login before completing this form.

Create an account?

Username

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Password

Confirm Password

Provide a password for the new account in both fields.

I am paying for another person

If you are paying a trip fee for another person, please include that person's information here so that we can properly credit it to their account. An email address is especially helpful.

On Behalf Of

Select an option to reveal honoree information fields.

First Name *

Last Name *

Email Address

Street Address (Primary)

City (Primary)

State (Primary)