Personal Information

NOTE: All fields required

Company Name or Invoice #:

First Name:

Last Name:


Email Address:


Credit Card Information

NOTE: All fields required

Card: Pay With VISA Pay With MasterCard Pay With American Express

First Name on Card:

Last Name on Card:

Card Number: 16 digit (Visa/MasterCard)or 15 digit (American Express) number, no spaces

Card Code: 3-digit (Visa/MasterCard) or 4-digit (American Express) number on back of credit card

Exp. Date: /

I confirm that I am authorized to use this credit card and I authorize Stratics Group to charge my credit card for the amount listed on this form.

We offer credit card billing as a extra convenience in the event you are unable to pay by wire transfer or certified check.

Please contact our billing department for technical assistance or any questions you may have.
Toll Free: 1.877.453.0604 x 104 or