Credit Card Payment Authorization Form

Thank you for ordering a Web Site from 1800websites.com a dividion of A1 Promotions. We would like to proceed with your order. Please confirm your order with us by filling out the form below and faxing it to us as soon as possible. Once we have received the fax version, we will process your order and charge your credit card and contact you to begin the process of building your web site. We will upload the web site only once we have received the original signed authorization by mail.


I _____________________________________,authorize A1 Promotions to design a web site for me. I concent to pay the fees In the amount of $_______________ US Dollars. I agree to pay the 50% deposit in advance and the remaining 50% upon completion of the web site. Upon completion of the web site , it will be uploaded to the internet.

I am paying by credt card and have filled in the credit card authorization information below.


Credit Card Authorization Form:
I _____________________________________,(name exactly as it appears on the credit card) authorize A1 Promotions to debit my ______________________ Credit Card #____________________________ Expiration Date_________ Bank__________________________________ In the amount of $_______________ US Dollars.

The billing address where the bill for this credit card is mailed to, is as follows:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________



I am aware that my order will not be processed until payment is made.
I am aware of the no refund policy on all A1 Promotional products and Service Packages.

Signature: ____________________________________________

Date:______________________