Security note about payment information:
Please note that Email is not a secure method for transmitting payment information. If you do not have access to a fax machine we recommend that you leave your credit card or checking account number blank when filling out the form. Please complete the rest of the form including your billing address for the payment method you wish to use, and your signature. We can then obtain your account number over the phone or in person. Our fax and email is on the form, and don’t hesitate to contact us with any questions.