STEP 1 (Required)
I, _____________________________________ authorize New Dream Network dba DreamHost to charge
my credit card with the amount of ______________________________. I understand this charge is for _______ months of service.
STEP 2 (Required)
I authorize automatic rebilling of my credit card.
I understand that I can disallow automatic rebilling any time at https://panel.dreamhost.com/?tree=billing.payment
_________________________________ Email Address
_________________________________ Domain
_________________________________ Signature Required
_________________________________ Today's Date
STEP 3 (Required)
Please place your credit card under this paper and make an imprint of the card below by rubbing a pencil or crayon along the surface of the paper. A photocopy is not acceptable. Please ensure that the card number and cardholder name are legible - multiple rubbings are OK!
