WEF Logo
601 Wythe Street
Alexandria, VA 22314-1994
Federal Tax ID# 53-0225129
GST# 133689-117RT
www.wef.org

One Time Credit Card Payment Authorization Form

By completing and submitting this form, you authorize Water Environment Federation to charge your credit card for the amount listed below. This is permission for a single transaction only and does not provide authorization for any additional unrelated debits or credits to your account.

Please complete the information below:

  Company/Representative Name*

Category*:  

Authorizes Water Environment Federation to charge the amount listed below.

Order Number:
 
Invoice Number:
 
Company ID:
Product Description*:   Amount*: $  
Account Type*:  
Cardholder Name*:  
Card Number*:  
Expiration Date*:  
CVV*:  
Billing Address*:   Phone*:  
City*:   State*:   ZIP*:  
Email*:  
I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. Receipt of payment will be sent to the listed email address, unless otherwise specified.
I certify that my answers are true and complete to the best of my knowledge.  
If you have questions regarding your payment, please contact:

Accounts Receivable

703.684.2427 - Phone
703.684.2428 - Fax
payments@wef.org