We are now able to accept credit cards. Print out this form, fill it in and fax it to the number shown below for a secure transaction.
Name (as it appears on your credit card):
City:__________________________ State:_______ Zipcode:_________-______
VISA MASTERCARD AMERICAN EXPRESS (please circle one)
Credit Card #:__________________________________________
Purpose of this payment: __________________________________
Please print this page, fill it in and fax it to 505-986-6019.
If you have any questions, contact Robert Haspel at firstname.lastname@example.org or 505-820-0186
Sustainable Communities/ZERI-NM is a public 501(c)(3) non-profit organization.
This page was last updated on January 12, 2005
Copyright Sustainable Communities/ZERI-NM, Inc. © 2004. All Rights Reserved.
E-mail: email@example.com for permission to use contents of this web site.
Unless otherwise indicated, all photographs are © 2001-2004 Lynda Taylor.