mother's day slide credit card authorization form · credit card authorization card number...
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2018 Credit Card Authorization FormCardholder Name
Billing Address City State Zip
Contact Phone Email
Credit Card AuthorizationCard Number Expiration Date Security Code Billing Zip Code
Signature Date
What is this charge for? Subtotal Charge $
o Membership + 4% Processing Fee $
o Entry Fees Total to be Charged $
o Stalls
o Other:
FOR OFFICE USE ONLYDate Received Amount
$
Total Charge Rec’d by
Please note, all credit card transactions are subject to a 4% fee imposed on us by the card processor, and will be added to your total charge.
Return form via email or regular mailArizona Reining Horse Association
28150 N Alma School Parkway w Suite 103 - 644 w Scottsdale, AZ [email protected]