Use this secure form to subscribe to
Neurotech Business Report

You are connected to a secure server using up to 128-bit encryption.

Neurotech Reports accepts the following forms of payment

Your E-mail Address:
Where we will send you account information, and receipt.
Contact Person for this order:
Your Domain Name:
Select Neurotech Business Report Subscription:

Select Desired Subscription:

IMPORTANT NOTES:

  1. Individual on-line subscriptions are for one person/email address only. No sharing of password allowed.
  2. For multiple readers at one location, a site license for up to 15 readers is available for $1,495 US per year. You will be entitled to multiple account ids/passwords.
  3. You may cancel your subscription anytime within the 30 days for a full refund or any time for a refund of the unused portion..
  4. Payment must be in US funds; checks must be written on a US bank instrument.
  5. Entire contents of print and on-line editions of Neurotech Business Report, Copyright © 2001, Neurotech Reports, all rights reserved. No portion of this site or the publication may be reproduced without written consent of Neurotech Reports

Billing/Payment Information
 
First Name (on credit card):
Last Name (on credit card):
Company Name (if applicable):
Phone number where you receive card statement:
Daytime Phone number (if different):
Billing Address (where you get your credit card statement):
Billing City:
Billing State:
Billing Zipcode (+4 if known):
Billing Country:
Select Credit Card Type:
Credit Card Number (with spaces or dashes as on your card):
Credit Card Expiration (00/00):
Security Code: for Visa and American Express you MUST include your security code. On Amex it is on the front as 4 printed digits above the last of your card number. On Visa, it is on the back, and is the final 3 numbers (see image, at right).

We will contact you for these numbers if not included here.


Visa secure
For all credit cards, please provide the card provider's phone number (usually a toll-free number on reverse of your card). Note: if this is a debit-card from your bank (which is not a credit card), please indicate bank name or phone:
CREDIT CARDS NOTE: We ask for this credit card security information because while you are protected from online fraudulent use of your credit card, we are not. If we provide services for a customer based on fraudulent credit card use, we have no recourse and will be charged by the credit card company for the full amount.
Comments or Special Instructions:

— THIS IS A SECURE, ENCRYPTED FORM —

All credit card information is verified to prevent fraud.

 

Please press the "submit" button only once. A confirmation screen will appear. All credit card payments are processed "offline" for additional security (this form does not use automated payment processing).

Thank you for choosing Neotrope Software.

NOTE: Your credit card statement will show billing by Micro Publishing Press, Inc., and not Neurotech Business Report.

site design by shalatdesign | shalat.com