ONLINE PAYMENT PROCESSING FORM

NOTE: YOU WILL BE BILLED AS "J/R SPORTS PICK CO."

BUY WEEKLY DGP FOR $56.00 (REFUNDABLE)

WE ACCEPT VISA & MASTERECARD


CUSTOMER INFORMATION

NAME

ADDRESS
CITY
STATE
ZIP
COUNTRY
E-MAIL

IMPORTANT NOTICE: PLEASE AVOID " # ", " . ", " - " IN YOUR FORM.