Once you have filled out this form please call Joshua 203-483-6100 ext: 111 to provide your credit card information which will securely be entered in the merchant processor’s database.
We can also process payments via ACH with Quickbooks. Please inquire via email to email@example.com if you'd like to pay via this manner.
I further agree that all orders transmitted to Excelerate LLC verbally, in writing, or electronically will be fulfilled (and charged to the above card) unless officially canceled in writing prior to shipping. Order cancellations must be made in a timely manner, and be followed by a confirmation from Excelerate LLC. Unconfirmed cancellations will not interrupt order fulfillment or credit card charges. Fees may be incurred for any cancellation. I hereby accept full responsibility for all costs resulting from improper order cancellation and/or credit card charge backs, fraudulent or otherwise.