DO NOT USE THIS PAYMENT FORM FOR SETTING UP YOUR BUILDER ACCOUNT.

ONLY USE THIS FORM IF YOU HAVE AN ADD ON OR ARE ALREADY A MEMBER.

Full Name

Business Name

Phone *

Email *

Website

PAYMENT DATE:

Your Message

Collect Payment *

$ 35

$ 75

$ 120

$ 175

Other amount

ESTABLISHED MEMBERS ONLY/ USE FOR MONTHLY PAYMENT

Billing Frequency

I agree to terms & conditions provided by ONE CITY. Upon form submission I authorize the payment made by me on this form. By providing my phone number, I agree to receive text messages from the business.

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