WEBster Computing Services
Credit Card Payment Form
for a secure, encrypted version click here


Credit Card Type: VISAMASTERCARD DISCOVER 
AMERICAN EXPRESS
Expiration date:
Card number:
Card holder's name (on card):
Full billing address of credit card:
Your email address:
Comment/Description:
In the comment field please enter the service you are ordering, the domain or username this information should be applied to, or further information to help up speed and assist your order.

CHARGE AUTHORIZATION:

Do you authorize us to charge your credit card? By clicking "Yes" or signing below (type in your name if submitting online) you hereby authorize WEBster Computing Services to use the above credit card to bill you for products ordered or services rendered (which includes setup fees, normal monthly fees and any future services you request) until such time as you cancel such services, and you hereby state that you have the legal authority to use this credit card: 

Yes No    |  SIGNATURE: 

 
SECURITY CHECK ONE:
Support Phone Number on Back of Card:
Sponsoring Bank on Back of Card:
Instructions: On the back of your credit card there is a phone number to call your bank for assistance (usually a toll free number).  Please enter this phone number in the field above.  Also, on the back of your credit card will be the name of its sponsoring bank.  Some examples of this are: First USA, City Bank, MBNA, Chase.  Note that some American Express cards do not have a sponsoring bank.  In this case just enter American Express.

 
SECURITY CHECK TWO:
Best Hours to Contact You By Phone:
Instructions: For your security, a billing agent may contact you to verify your credit card information and address. Please enter the hours (for example 5-9pm  EST) when you will be available for confirmation.  Please give us a window of several hours if possible. If the phone number is different from one entered previously please let us know.  To speed up this process of random security verification, you may hand sign and fax this form to one of the numbers listed at the bottom of this page. 

Note well: credit card forgery is a crime and we do pursue every offense to the fullest extent of the law.

This form may be sent online securely by pressing the button above, or
may be faxed to our offices at 1-866-779-3227
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