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Secure Credit Cards By Fax Or Mail
Note: If your printer cannot print this form,
download our
order form in the text version.

If you're worried about a secure Internet connection to make a payment, just copy and fill out this form and fax it Toll Free to 1-800-669-0183 or mail it to:

Search Engine Guy
101-215 Parkdale Avenue.
Ottawa, ON. K1Y 4T8
Canada

Package Information - All Prices Are In USD Funds
Package Ordered: __Package0 URL Submission $5.00
One URL submitted (as is) to the engines.
Does NOT include Submission Report
__Package1 URL Submission $19.95
One URL submitted (as is) to the engines.
Includes Submission Report
__Package2 URL Submission $29.95*
One URL submitted with optimization.*
Includes Submission Report
__Package3 URL Submission $99.95
Your entire site submitted (as is), (Up to 10 pages)
Includes Submission Report
__Package4 URL Submission $199.95*
Your entire site submitted with optimization*, (Up to 10 pages)
Includes Submission Report
__Package5 URL Submission $129.95
One URL submitted (as is) monthly for 1 year (12 Submissions)
Includes Submission Report
__Package6 URL Submission $149.95*
One URL submitted monthly for 1 year with optimization* (12 Submissions)
Includes Submission Report
Billing Information
Please enter your billing information below. The address must be the current address recognized by your credit card company.
Your Name:
(First/Middle/Last)
___________________   __  ___________________
Address: ____________________
City: ____________________
State/Province/Region: ____________________
Zip/Postal Code: ____________________
Country: ____________________
Telephone Number:
(area code + telephone number)
____________________
Email Address:
**Avoid using free email accounts.
____________________
Credit Card Information
Card Type: __MasterCard
__Visa
__American Express
__Discover
__JCB
__Diner's Club International
__Carte Blanche
Credit Card Number: ____________________
Security Code:
**Required for all
MasterCard, Visa and American Express purchases.
______ The verification number is a 3-digit number (Visa/MasterCard) printed on the back of your card in the signature area. It appears after and to the right of your card number.

The American Express verification number is a small 4-digit number printed on the front of your card on the right hand side.

Expiry (MM/YY):
__January (01) __May (05) __September (09)
__February (02) __June (06) __October (10)
__March (03) __July (07) __November (11)
__April (04) __August (08) __December (12)

Year = 20___

URLS we are submitting
Enter all that apply: ________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Transaction Notes:
  1. A charge by "PaySystems.COM" will appear on your billing statement in USD.
  2. Card fraud is a felony punishable by heavy fines and jail time.
  3. PaySystems.com is the online retailer for Search Engine Guy. You are purchasing the product/service from PaySystems.com Inc.
  4. Your name and email address will be made available to all parties to the sale as required to complete this purchase. It will not be sold to any third party.
  5. If this is a recurring transaction. Your account will be charged every 30 days, the cost of monthly maintenance in USD.
  6. Review Search Engine Guy's Terms and Conditions.