FCN_EASYPAY_UPGRADE
Thank you for choosing EZ Pay. Please provide your debit or credit card information below and your account will be automatically drafted at your current rate and term. Drafts occur 5-7 days prior to your expiration date. Your card will continue to be drafted until you notify us otherwise.
SUBSCRIPTION INFORMATION:
(* = required field)
First Name*:
Last Name*:
Primary Phone*:
(enter in XXX-XXX-XXXX format)
Street Address*:
City*:
State*:
Zip Code*:
Email*:
* You will receive e-mail confirmation of this transaction
BILLING INFORMATION:
(Complete only if different from street address information)
Billing Name:
Billing Address:
Billing City:
Billing State:
Billing Zip:


PAYMENT INFORMATION:
Credit Card Type*:
Credit Card Number*:
Credit Card Expiration*:
(Enter as MM/YY)
Credit Card CID*:
(CID is a unique 3-digit code for Visa, Mastercard and Discover and 4-digit code for AMEX)
**By signing up for EZ Pay, I authorize Forsyth County News to charge my credit/debit card automatically when my payment is due.
I agree to the above conditions and the Forsyth County News Terms of Use and Privacy Policy.