Pay - GET WRITE PUBLISHING

PAYMENT AUTHORIZATION

--Payments are non-refundable-- You may reschedule a session once after initial cancellation.

* Indicates required field

Name (As it Appears on Card) *

First

Last

Credit/Debit Card Number (16 Digits) *

Expiration Date *

3 Digit Security Code *

Billing Zip Code (5 Digits) *

Service Type *

VIP Day - 4 Hours - $159.00 (Expires 4/21) Virtual VIP - 2 Hours - $79.00 (Expires 4/21) Publishing Payment (Specify Exact Amount Below)

Total Amount to be Charged (Enter the amount below) *

Electronic Signature (Please Type Name to Approve Processing) *

Email (Digital Receipt Will be Sent) *

Comments or Special Instructions: *

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