
                Ŀ
                  The Source BBS Credit Card Authorization  
                

      Due to Federal regulations governing "mail order" credit card
  purchases as well as the possibility of credit card fraud the service that
  we use here at The Source requires us to have a signed authorization for
  each transaction if at all possible.  This is for your protection as well
  as ours.  Please print this form, fill it, and return it to us by mail.


  Callers name as used on The Source BBS:



  Name EXACTLY as it apears on credit card:


  Please enter your ZIP CODE: [     -      ]

  Please note the type of card used:   [  ] VISA    [  ] MasterCard

  Please enter the credit card number:


  Enter the expiration date of the card:


  Amount charged:                      Security Level Desired:



  I hereby authorize the charge noted above to The Source BBS.


 
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 Cardholder Signature                  Date:


    Please mail to: 
                          The Source BBS
                          P.O. Box 1459                              
                          Redondo Beach, CA 90278
