Photo Payment Complete the form below to make a payment for Everlasting Memories Photography Photo Payment Name on booking * First Last * Last Customer Number * Email * Phone Number * Billing Address * City * State * AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Zip Code * I'm paying for the following * Initial Deposit Final Payment Other Payment Payment Amount * amount to be charged during this transaction Payment Type * Credit Card Debit Card Card Type * MasterCard Visa Discover American Express Card Number * Expiration Month * 010203040506070809101112 Expiration Year * 2019202020212022202320242025202620272028 CVV Security Code * Last 3 digits on signature strip (4 digits on front of AmEx) Name as it appears on credit card (electronic signature) * By submitting, you certify that you are the cardholder and are authorizing Everlasting Memories to charge the listed amount to the credit card. I authorize Everlasting Memories to charge my credit card and agree to the payment terms on my reservation. * Yes I authorize Everlasting Memories to use the above information to charge my credit card the stated amount. Completion of this form and checking this box signifies acceptance in lieu of my signature.
