Form

Billing Address *

Your Email: *
Payment Amount *
This Payment is for: *

Deposit Final Payment Other
Card Info
Notes:

0/250
Authorization/ Acknowledgement
Authorization: *

By submitting this form, I do hereby authorize Dan Pril and/or Blue Ridge Tree Services to charge the above card immediately in the amount indicated. Dan Pril and/or Blue Ridge Tree Services assume no responsibility for changes made to a proposal if the payment fails to process. I am also acknowledging that I am the cardholder held under penalty of law.
Enter the message as it's shown *
Should be Empty:

One Time Payment Authorization