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Western Union
Applicant Name
Lois Lane
Account Number
0123456789
Payment Plan
Couple 1 Year
Amount to Send
$99
General Instructions
Western Union is an easy and safe way to send cash payments. There are tens of thousands of Western Union agents in almost every country around the world. To locate a Western Union agent in your area, go to www.payment-solutions.com/agent.asp.
You must use a Western Union location that is able to make "QuickPay / QuickCollect" transfers.
Take this form to the nearest Western Union location (please check http://www.payment-solutions.com/agent.asp to make sure that this location is able to make "QuickPay" payments before you go). Request a QuickPay / QuicikCollect form (see sample form below).
0123456789
Western Union Form Instructions
PAY TO section
In the COMPANY NAME, fill in: TBD
In the COMPANY CODE line, fill in: TBD
In the COUNTRY line fill in: USA
SENDER section
Fill in all your personal information
In the ACCOUNT NUMBER line fill in your registration number: 0123456789
Sign the form
ALMOST DONE...just two more steps
Be sure to receive a confirmation number (called a Money Transfer Control Number or "MTCN") for your payment from the Western Union agent. Enter this number below, and keep it in a safe place.
Money Transfer Control Number: ________________________________________
Email USA Greencard Lottery at [email protected] using the subject Western Union Payment. Make sure to include your Account Number (0123456789) and the Western Union Money Transfer Control Number (MTCN#) for your payment from the Western Union agent.
If the user selects a Province or State, then the options of the Country menu should dynamically udpate such that only Canada and the United States of America are options.
If the user first selects a country other than Canada and the United States, then the Province or State menu should be disabled.