On-line credit card payment to Douglass Associates

We accept four major credit/debit cards. You must provide all of the information below.

Our credit card processing service is very picky. You must enter all of the card information, including the address information, exactly as the credit card company has it in its records. Even minor discrepancies will cause our credit card processing service to reject a charge. For this reason we must have the name and contact information for someone we can contact if we have problems processing your card.

NOTE: Your credit card information is encrypted by our proprietary mathod before it is sent to our server.

 Person to contact in the event of problems in processing credit card.
 Person's name          

 Amount of payment      
 Name of competition and purpose of payment     

 Card type:  MasterCard   Visa   AMEX   Discover

  Name on card     Card number 
  Street           Expiration date (mm/yy) 
  City                      Card security code  
  State/Province  ZIP/Postal code  Country