Credit Card Payment

Please print this page, fill in the information and fax it to AMC

1.   Credit card type    Master Card________    OR      Visa__________

2.  Credit Card ________________    OR        Debit Card______________

3.  Credit Card Number ____________________________________________________________

4.  Name as it appears on the card __________________________________________________

5.  Expiration Date     Month_________     Year_____________   

6.  Three Digit Code on the back of the Card __________________

7.  Billing Address for the card

_________________________________________________________

_________________________________________________________

_________________________________________________________

_____________________________________Zip__________________

8.  Phone Number _________________________________________

9. Charges will be for engineering time plus expenses that may include administrative fees.  All Charges will be in US Dollars.  There are NO refunds for time spent, work in progress, or minimum charges.  If the client requests a stop work we will endeavor to reduce additional expenses.

Authorized to proceed not to exceed $_______________________________

Signature_______________________________________   Date_____________________________

__________________________________________________________________________________

__________________________________________________________________________________

FAX completed form to CompanyFAX


Contact Information: 

Telephone
407-880-4945 -------- (Consulting is only available for customers)
FAX
 
Postal address  
 
Electronic mail
General Information: bob@WeldingEngineer.com
Customer Support: bob@WeldingEngineer.com  
Webmaster:  
 

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Send mail to bob@WeldingEngineer.com with questions or comments about this web site.
Copyright 1999 Robert McCabe                    
Last modified: February 17, 2015