Please fill out this form to submit your payment information securely to Phoenix Geeks for yours services.

Amount charged each month will be:

$24.95 per month for up to 1 GB of Internet backup, each additional gig is $14.

$89.99 per month Phone Service/Tech Support is billed at 89.99 for up to 6 channels.

You will be billed according the schedule above. Filling out this form gives us permission to collect payment for your monthly invoice. Invoices will be sent out each month prior to collection.

Client Email Address

Special Instructions

Cardholder Details

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Billing Address

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Expiration Date: MM/YY

Payment Confirmation

I hereby authorize Phoenix Geeks to charge my credit card monthly for services rendered or subscribed to. To cancel this authorization, I understand I just need to email ar@phoenixgeeks.us at least 5 days before the next monthly cycle on my account.

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