Credit Card or Debit Card
World Service Authority, World Office
5 Thomas Circle N.W.,
Washington, D.C. 20005, USA
Tel: (202) 638-2662 Fax: (202) 638-0638
CREDIT CARD PAYMENT FORM
You may make donations and pay service fees by credit card. Please complete the online payment form by CLICKING ON THE PAY NOW BUTTON below. Please note that there are NO REFUNDS or EXCHANGES.
If you prefer to make donations and pay service fees offline, you may by submit your credit card information by post or by fax to 202-638-0638. Do NOT send the following form by email. Please note that there are NO REFUNDS or EXCHANGES.
Type of Credit Card (Check One):
Credit Card Number:________________________________ Expiration Date (Month/Year): _________
Name as it appears on the card: ________________________________ 3-digit CV code: ________ (on back side of card)or ________ 4-digit CV code (on front of card)
Authorized Signature and Date: _________________________________
Telephone & email of card holder: _______________________________
including Postal (Zip) Code: ____________________________________