Ken Hood: Credit Card For Recurring Billing
Questions marked by * are required.
1.
Name *
2.
Email *
3.
Phone *
4.
Address *
5.
City *
6.
State *
7.
Zip *
8.
Type of Card *
VISA
Mastercard
Discover
Amex
9.
Name on card *
10.
Credit Card Number *
11.
Expiration Date *
12.
CVV Code *
13.
Monthly amount for recurring billing *
14.
Day of the month to charge *
15.
Message
16.
Terms *
I understand and agree that I am authorized to use this card for purchases, and my card will be charged for only the stated amount above each month for services provided. I may cancel this recurring agreement at any time by emailing Ken Hood at ken@kenhood.net.
Agree
Disagree