Advanced Worldweb Design (AWD)          Credit Card Authorization 

5415 Lake Howell Road, Suite 204 WinterPark Fl. 32792
Phone 407-673-9331 Fax 877-207-5458

Your Name  Company Name:

Website Name: Address:

City: State: Zip:

Phone Number Fax Number:

Cell Phone #:

E-Mail:

I authorize Advanced Worldweb Design to charge my:

Visa or Master Card:

Amount

Card # Exp. date

The 3 digit number in the back of the card, CVS#

Name (as it appears on card)

Address City StZip

Hosting fees will auto re-bill to your card on file quarterly, or yearly depending on your hosting plan. 
To cancel you must call 30 days prior to you re-bill date 407-673-9331 x5, or fax letter to 877-207-5458

The Terms and Conditions are meant to maximize the quality of our service and to protect our customers from unnecessary interruption of our services.

I agree with the Terms and Conditions  Signed: ___________________________________

Date: _______   I understand that fees are non-refundable. Thank you. We look forward to working with you.