State Of Insanity Credit Card Form

Hi!.. *smile*.. lets see... if you want to pay by credit card.. then.. simply fill out the form below. Keep in mind SOI does not provide refunds.

We accept Visa, Mastercard and Discover.

Note: Use of SOI constitutes agreement to the SOI Conditions of Use.

Thanks!.. *smile*.. love..seph

Enter the SOI handle (account) you are paying for:
Enter a password (if this is a new account):
Your E-Mail:
(E-Mail is only used if there is a problem setting up the account).

Enter Your Handle (if different from above or if moving to SOI, specify from the current account):

If you are on a visa, or, this is a new account, select one of the following:

Not Applicable:
Initial Citizenship plus 4 months ($30.00):
Initial Citizenship plus 6 months ($40.00):
Initial Citizenship plus 1 year ($65.00 - Pay for 11, 1 month free):

If you are an existing citizen and are paying again, select one of the following:

Not Applicable:
Four more Months ($20.00):
Six more Months ($30.00):
One more year ($55.00 - Pay for 11, 1 month free):
Move existing account to SOI ($10.00):

If you are moving from one of the sister SOI chat sites to SOI, select the following:

Moving from other chat site To SOI ($10.00):

Name on card:

Birthday (DD/MM/YY):

Address where card is billed:

Line 1:

Line 2:

City:

State/Province:

Zip Code:

Country:

Card Number:

Card Expiration Date:

...........

Name on card:
Birthday (DD/MM/YY):
Address where card is billed:
Line 1:
Line 2:
City:
State/Province:
Zip Code:
Country:
Card Number:
Card Expiration Date:

Thanks for supporting SOI!