Greater Seaford Chamber of Commerce
Post Office Box 26 221 High Street
Seaford, Delaware, 19973
phone: 302.629.9690 fax:
302.629.0281
email: admin@seafordchamber.com
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Greater Seaford Chamber of Commerce |
I, _____________________________ of __________________________ give permission
to THE GREATER SEAFORD CHAMBER OF COMMERCE [COMPANY] to use the Credit Card
Number for payment of invoice from COMPANY.
All sales will require a receipt that will be provided by COMPANY to
Credit Card Holder.
I, _________________________________am releasing this information with the understanding that all sales with this Credit Card Number are final.
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Card Holder:__________________________________________________________ |
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Billing Address: _______________________________________________________ |
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______________________________________________________________________ |
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Card
Type
____ MC ____ VISA ___ DISCOVER Amount of Transaction $_________ |
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Authorization
No. ______________________________________________________ |
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Expiration Date: _______________________________________________________ |
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Signature: _____________________________________________________________ |
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Date: __________________________________________________________________ |
Please print above
form, fill it out completely, sign and fax to 302-629-0281, or mail to
Greater Seaford Chamber of Commerce [GSCC], P O Box 26, Seaford, DE 19973. If
you have any
questions, please call us at 302-629-9690 or 800-416-GSCC