2. Village Hall Use Payment

   Only use this payment option after contacting the Village's Constituent Services & Administrative Assistant at ccv@montgomerycountymd.gov to confirm the correct amount.

4. First Name*
5. Last Name*
7. Village Address*
9. Description *
11. Billing Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
19. Email Address*
21. Fee
    Please enter the fee as directed by Staff
22. Fee
23. Fee
24. Shipping Cost
26. Taxable
28. Non-Standard Payments
    Please enter the rental cost in the Quantity field.
29. Price
30. Quantity
31. Shipping Cost
33. Taxable
35. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
37. Electronic Signature*
Leave This Blank:


38. Calculate Totals Proceed to Checkout

* indicates a required field