EFF Secure Payment Form

Please use the secure form below to submit credit card payments to Eat From Farms. The information you submit is encrypted during transmission using Secure Socket Layer(SSL) technology so you can safely use your credit card.
VISA | Mastercard | AMEX | Discover

NOTE: If you are using this form to sign up for service, please make the "Amount" $36 to cover four months account fee. You will be contacted to confirm your order before your credit card is charged.


Customer First/Last Name:
Business Name:
Amount:
Credit Card Number:   Expiration:   (mm/yy)
Exact Name on Credit Card:
Customer E-mail:
Customer Phone Number:
Comments:
Card billing information: (Address where bill is mailed.)
Street address:
City:
State:
Zip Code:

 

Before submitting, please be sure your information is correct and complete, especially the credit card number and expiration date.

This form may take a minute or two to submit, so please be patient.  A "Thank You" page will appear when it's been successfully submitted.

If you have any problem submitting this form, or if have any questions,
please call us at 518-326-1638.

secure order form by Simple Online Solutions

 


© 1997 - 2018 By Simple Online Solutions
431 Old Best Road, West Sand Lake, NY 12196