ONLINE PAYMENT PROCESSING FORM
NOTE:
YOU WILL BE BILLED AS "J/R SPORTS PICK CO."
BUY 2003-2004 NBA SEASON PACKAGE FOR
$599.00
(
REFUNDABLE
)
WE ACCEPT VISA & MASTERECARD
CUSTOMER INFORMATION
NAME
ADDRESS
CITY
STATE
ZIP
COUNTRY
E-MAIL
IMPORTANT NOTICE:
PLEASE AVOID " # ", " . ", " - " IN YOUR FORM.
