Home  |  Contact Us   |   FAQ   |   Search  | Feedback

Intron Computers

 

Credit Card Billing Form

Fill out the following form to send an email with your credit card billing information. This information must match the credit card you wish to use. Do not include your credit card number we will invoice you with a link for your secure online payment.

Please enter your billing information. This information must match the address on your credit card statement.

Please note that the form may not submit correctly if using an older AOL browser. If you experience this problem, upgrade your AOL browser to the latest version or try using Netscape (version 4,5,7) or Internet Explorer or go to the Contact Info page for additional contact options.

Salutation:
 

Your First Name: (Required)

Your Last Name: (Required)
 

Email Address: (Required)

Phone Number: (Required, including Area Code)
   

Street Address: (Required)


City: (Required)


State: (Req)


Zip Code: (Req)

Select Product: (Required)

Quantity and shipping address if different from billing: (Required)

Please ensure you have filled in ALL
required fields before submitting.