Old West Credit Card Payment form

tip in $5 increments ( Not required of course!)

$5.00 Quantity 1 2 3 4 5 6 7 8 9 10 $5 $10 $15 $20

  

Deposits

deposit for sessions 1 or 2

$15.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

deposit session 3

$25.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

deposit session 4

$50.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

Session 5 deposit

$100.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

Full Payment

session 1

15 minutes

$100.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

session 2

30 minutes

$200.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

Session 3

30 minutes + USB

$220.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

Session 4

1 hour +usb

$400.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

Session 5 with approval only

$500.00 Quantity 1 2 3 4 5 6 7 8 9 10

  

Remainder amount payments

remainder balance session 1

already paid the deposit, this is the remainder

$85.00

  

Remainder balance session 2

already paid the $15 deposit, this is the remainder

$185.00

  

Remainder balance Session 3

already paid the deposit of  $25 for this session and now you need to pay the remainder

$195.00

  

Remainder balce Session 4

already paid the $50 deposit and this is the remainder

$350.00