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Credit Card Payment

Credit Card payment is accomplished via the First Virtual Internet service. Establishing an account with First Virtual takes only minutes of your time, and is completely secure (your credit card number will never be transmitted across the Internet or stored on any Internet server). Once your First Virtual Account is established you can purchase products and services from hundreds of Internet merchants (including US WebSites!). To establish a First Virtual account, click here.

If you already have an First Virtual account, you may authorize payment via the following form:

Name:
E-Mail address:
First Virtual ID:

I hereby authorize First Virtual Internet to charge my account for the item as selected below:

Select Item Amount
Email Alias - per ad $5
Autoresponder $10
Red Headline/Bold Text/URL Link $5
Red Headline/Bold Text/URL Link
Email Alias -per ad		 $10
Red Headline/Bold Text/URL Link
Autoresponder		 $15
Red Headline/Bold Text/URL Link/Graphic $10
Red Headline/Bold Text/URL Link/Graphic
Email Alias -per ad		 $15
Red Headline/Bold Text/URL Link/Graphic
Autoresponder 		$20
Web Page $150
Web Page and autoresponder package $250
Ad ID#:
If you selected an Email Alias or Autoresponder, please enter requested name, limited to 8 letters or numbers, below. If requested name is not available we will add a digit to your requested name.
Alias: @roch.com

I am aware that First Virtual will contact me via e-mail to authorize this payment.

WebSite - Link your ad to a WebSite. Create your own FREE business website using QwikWeb. Includes a guest book and comment form. We will set up your site to include an email alias and autoresponder for no additional charge. All this for only $49 a month. Build your site now!

Custom WebSites - Please visit US WebSites for complete details about our custom website,hosting, marketing and renovation services.

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