Online Payment by

Credit Card or Debit Card

  World Service Authority, World Office
5 Thomas Circle N.W.,
Washington, D.C. 20005, USA
Email: info@worldcitizengov.org
Tel: (202) 638-2662    Fax: (202) 638-0638

CREDIT CARD PAYMENT FORM

You may make donations and pay service fees by credit card. Please complete the online payment form by CLICKING ON THE DONATE BUTTON below. Please note that there are NO REFUNDS or EXCHANGES.

If you prefer to make donations and pay service fees offline, you may by submit your credit card information by post or by fax to 202-638-0638. Do NOT send the following form by email. Please note that there are NO REFUNDS or EXCHANGES.


Type of Credit Card (Check One):

Credit Card Number:________________________________      Expiration Date (Month/Year): _________

Name as it appears on the card: ________________________________     3-digit CV code: ________                                                                                                            (on back side of card)

                                                                              or ________ 4-digit CV code (on front of card)

Authorized Signature and Date: _________________________________

Telephone & email of card holder: _______________________________

Billing Address
including Postal (Zip) Code: ____________________________________