CREDIT CARD HOLDER – BILLING INFORMATION: To avoid delay in processing, all information must be provided.
Print clearly in black or blue ink. Complete and sign.

A credit card signature acknowledges that I agree not to dispute and will pay the amount applied to my credit card for membership dues payment and applicable fees. I understand WMA has the right to adjust membership dues and/or the membership dues structure; and if applicable that qualified distributor members must recertify their company annually, in accordance with the WMA Bylaws, by returning a WMA Distributor Membership Dues Recertification Form. Membership dues are billed annually and are due by January 1st of each year. All membership dues and applicable fees are non-refundable. I agree and provide my consent to process my dues payment on my credit card; should the dues amount, or processing fee entered be incorrect amount, I grant permission for WMA to adjust the dues payment and any fees and I will not dispute the credit card amount for processing. I further acknowledge that I am the company credit card holder, or an authorized user of the credit card information referenced below.