| * = Required Field |
| * NAME OF CARDHOLDER: ___________________________________________________________ |
| * BILLING ADDRESS: _________________________________________________________________ |
| * ZIP CODE: _________________________________________________________________________ |
| * CONTACT PHONE NUMBER: _________________________________________________________ |
| CONTACT EMAIL ADDRESS: _________________________________________________________ |
| MASTERCARD OR VISA ONLY |
| * ACCOUNT NUMBER: ________________________________________________________________ |
| * CVV (3-digit # on the back of the card): ____________________________________________________ |
| * EXPIRATION DATE: _________________________________________________________________ |
| * CARDHOLDER SIGNATURE: __________________________________________________________ I certify that the above information is accurate and I authorize Specialty Show Services to charge the above credit card for the total entry fees plus $4.00/entry FAX Entry charge. I understand that if this credit card is denied for any reason, Specialty Show Services may add an additional service charge to process my entries. A denied charge may prevent my entries from being accepted by closing time. |