The University of Tennessee requires a signature to be on this form before we can process any credit card payment.
NO CREDIT CARD INFORMATION WILL BE TRANSMITTED OVER THE INTERNET. |
Cardholder name
as it appears on the card. ________________________________________________________________________ |
please print
|
Cardholder signature. ___________________________________________________________________________
|
| Visa or Mastercard No. ______________________________ PIN/CVV __________________ Exp. ______________ |