CREDIT CARD PAYMENT FORM

 

We gladly accept Mastercard, Visa, Discover, and American Express.

 

Please print, fill out the form below, scan and email it to us at shop@greatgifts4u.com. Or, if you prefer, you may fax it to us at (678) 482-0771.  For added security, you may leave the credit card digits blank and call us at (678) 482-2910 with those.

 

 

Organization:________________________________________________


Bill to address on statement:________________________________________________


Person placing order:________________________________________________

 

Name on card:________________________________________________

 

Credit card number:_________ - ________ - _________ - __________

 

Expiration date:______ / ______

 

CVC/3 digit code on back of card:______

 

Signature:________________________________________________

 

 

 

Does your card have a per diem/transaction limit?  If so, what amount should we charge each day?  $________

 

 

If this is an official purchasing card with an individual code for it, please list it.  _________

 

 

 

 

Thank you for your order.

We appreciate the opportunity to serve you!