EZ_Pay

Welcome to The Day's Secure EZ Pay Form

Please complete the information below and hit submit.
MEMBER INFORMATION:
(*= required field)
First Name*:
Middle Initial:
Last Name*:
Suffix (e.g. Jr, III, etc):
Primary Telephone*:
Delivery Address*:
City*:
State*:
Zip Code*:
Email Address*:
Note: Email is a required field to receive confirmation of this request.
BILLING INFORMATION:
(Complete only if different from above)
Billing Name:
Billing Address:
Billing City:
Billing State:
Billing ZIP Code:
EZ PAY ENROLLMENT:
I would like to:
EZ Pay Membership:
Carrier gratuity:
(optional)
NIE/Literacy donation:
(optional)
PAYMENT INFORMATION:
Credit Card Type*:
Credit Card Number*:
Credit Card Expiration*:
(enter in format: MM/YY)
By enrolling in EZ Pay, you authorize The Day Publishing Company to automatically deduct your membership including carrier gratuity and/or NIE donation if included above, from your credit card upon each renewal. Your first payment will be processed within 3-5 business days of receipt.