Credit Card Submission / Authorization Form
This form is used only for securely transmitting credit card information to ProHosting's Billing Department. Please note: Use of this form does not automatically charge your credit card. All submissions are reviewed and processed within 24 hours after submission.
Domain Information
Please enter your domain name and a phone number you can be reached in case of problems with this card.
Domain name:
Phone :
Note: If you have more than one account and would like to update all of your accounts, please list the other domain names or account numbers in the Special Instructions box below.
Card Holder Information
The CVV code is a 3 digit number on the back of VISA/Mastercard cards, or a 4 digit number on the front of AMEX cards.
Check this box if you already have an account with us and are just changing credit card information.
Renewal Pricing
Special Instructions
Please input instructions and any additional information you would like us to know when processing this card.
For example: "Please charge this card for 12 months of hosting." OR "Please use this card to bring my account up to date and set it up for automatic monthly payments."
If you wish to receive an email confirmation that your information has been received by our Billing Department, please indicate that here as well.
Contact Info
IMPORTANT: If it is possible that the email address we have on record for you is not correct, please complete the following section. If you do not need to supply us with a new email address, please leave the following section empty.
New Email Address :
You need to supply a validation code if you are updating the contact email address on your account. The validation code is either the last 4 digits of your previously used credit card, or the check number from your last payment made.
Validation code :