Online Payment Form Name(Required) First Last Email Business Name(Required)Billing Information(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Invoice #Payment Amount(Required)This field is hidden when viewing the formConvenience Fee(Required)Total Payment(Required) Price: $0.00 There will be a 2.9% + $0.30 convenience fee automatically assessed on all credit card transactions. Vaudra International does not keep any part of the convenience fee. The fee is charged and collected by Stripe.com to provide the convenience of credit card processing services for our clients.Credit CardCard Details Cardholder Name CAPTCHANameThis field is for validation purposes and should be left unchanged. 109