"I authorize the above-named business to charge the credite card indicated in this authorization form according to the terms outlined above. This payment autho rization is for the goods/services described above. for the amount indicated above plus a 3% convenience fee. and is valid for one time use only. certify that am an authorized user of this credit card and that will not dispute the payment with my credit card company, so long as the transaction corresponds to the terma indicated in this form.