Alternate Payment Form for New Year’s Sale

 

    Please fill out the information below and click send. We will complete your purchase manually and email

    you when it is complete. Thank you!

    Your Name (required)

    Your Email (required)

    Credit Card Number

    Expiration Date: Month and Year

    3 digit code on back of card or 4 digit code on front of American Express card

    I authorize Brain Pages Inc to charge my account for $30.00 in purchase of the Mega Genius Package End of The Year Sale.