Secure Payment Form
This Secure Payment Form will submit your credit card information securely to our Accounting department, who will apply your payment towards an open order or open quotation. Please reference your quotation number or your order number in the "Quotation / Order Number" field.

When finished, please click the Submit Payment button at the bottom of the page.

You may also fax your credit card information using our Credit Card Authorization Form
Please send Fax to Artisan Technology Group Sales: (888) 557-6872 or (217) 352-9330

  Required Required
Required First Name :   
Required Last Name :   
Company :   
Required Address Line 1:   
 Address Line 2:   
Required City, State, ZIP:       
Required Phone :   
Required E-mail :   
   
Quotation / Order Number :   
   
Required Card Holder Name :       (as it appears on card)
Required Card Type :      VISA MasterCard Discover American Express
Required Card Number :   
Required VCode :   
Required Expiration Date :     
Required Total Payment (US dollars) :   
Message :