CREDIT CARD ORDER FORM

This form may be filled out online. Then print, and fax or mail it to TeacherWeb.

Mailing Address: TeacherWeb, Inc. * P.O. Box 1099 * Ridgefield, CT 06877

FAX: 203-438-2266

Contact Name:

Contact Email:

School Name:

School Address:

School Phone #:

Credit Card Number:

3-digit Security Code (found on back of card, except on Amex it's 4-digits on front):

Credit Card Expiration Date:

Name on Credit Card:

Billing Street Address & Zip Code:

* Number Of Webs:
* If 1 web: what's the URL:

After we have received your billing information, the contact person will be issued an account code if this order is for multiple webs at a school. For individual webs, processing of this credit card ($39 US for one year service) will automatically result in your web being marked as "paid". If you have any questions, please email us at Billing@TeacherWeb.com

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