Florida Sewing Sew-ciety
Sewing . . . making a difference in all our lives
FLORIDA SEWINGSEW-CIETY
Credit Card RegistrationForm
Name as it appears on card: _________________________
Address: ______________________
Email Address: __________
Phone#: ______
Credit Card Type/Account Number: NO DEBITCARDS
Visa _________________________________
MC __________________________________
Discover __________________________________
Amex __________________________________
EXPIRATION DATE _ PIN# _ (3 digit on back of card)(Amex card - 4 digit # on front of card)
Only our State Treasurer, Martha Mitchell, will see this information!!!!
I authorize Florida Sewing Sew-Ciety to charge my credit card for amount of services plus a handling fee of $10.00. Include with registration form.
__________________________________
Signature
__________________________________
Date
Mail to: Martha Mitchell, P O Box 125, Havana, Fl 32333