Please enable JavaScript in your browser to complete this form.
Cyber Advantage Plan Sign Up Form
After completion and submission of this form, your account will be activated the next business day (Mon - Fri , 9 am - 5 pm).
Please enable JavaScript in your browser to complete this form.
-
Step
1
of 2
Business Name (DBA)
*
"DBA" means "Doing Business As"; Your business name.
Contact Name
*
First
Last
Legal Name
*
The name under which your tax return is filed.
Contact Phone
*
Merchant ID
*
This is your credit card processing number.
Contact Email
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Company Phone
*
Type of Business
-
Retailer
Telecommunication
Grocery and Supermarkets
Petroleum
E-Commerce
Mail order/Telephone order (MOTO)
Other
Company Contact Email
*
Type of Industry
-
Critical Infrastructure
Service Providers
Financial Services
Coops
Telcos
Museums
Airlines
Travel Agency
Retail
Apparel
Auto Dealers
Auto Rentals
Furniture
Restaurants
Entertainment
Supermarkets
Laboratories
Hospitals
Health Insurance
General Insurance
Hospitality
Education
Government
Gas Station
Business Services
Consulting Services
Other
Company Website / URL
Are you a Chamber of Commerce Member?
*
Select
Yes
No
Chamber Code
*
Cyber Advantage Plan
*
Select
Monthly 24.97
Annual (only $19.93 a month) 239.16
Monthly plans are not supported by PayPal
Chamber Cyber Advantage Plan
Select
Monthly 24.97
Annual 239.16
Monthly plans are not supported by PayPal
Payment Type
*
PayPal
Credit Card
PayPal cannot be used for monthly plans
Your Price
Price:
$ 191.64
Your discount has been applied-Thanks for being a chamber member!
Your Price
Price:
$ 19.93
Your discount has been applied-Thanks for being a chamber member!
Your Price
Price:
$ 24.97
Sorry, the code you entered is not valid.
Your Price
Price:
$ 239.16
Sorry, the code you entered is not valid.
Your Price
Price:
$ 24.97
Your Price
Price:
$ 239.16
Total
$ 0.00
Cardholder Name
*
First
Last
Secure Payment
*
Card Number
MM
1
2
3
4
5
6
7
8
9
10
11
12
Expiration
/
YY
24
25
26
27
28
29
30
31
32
33
34
Security Code
Agree and Subscribe
*
I understand and agree
I understand that by clicking here that I am agreeing to sign up for the Europay USA Cyber Advantage Plan billed to my credit card for $24.97 reccurring monthly payment. Payment will show up on your statement as Europay USA.
Agree and Subscribe
*
I understand and agree
I understand that by clicking here that I am agreeing to sign up for the Europay USA Cyber Advantage Plan billed to my credit card for $239.16 annually. Payment will show up on your statement as Europay USA.
Cancellation Policy
*
I understand and agree
The Europay USA Cyber Advantage plan may be canceled at any time by sending us an email to info@europayusa.com stating you wish to cancel. If you would be so kind to include a reason why we would appreciate it to better our product or service. All subscriptions will terminate at the end of the existing monthly period with no prorated return. Annual plans may be cancelled with a 10% cancelation fee.
Comments or Message
Next
Updating preview…
This is a preview of your submission. It has not been submitted yet!
Please take a moment to verify your information. You can also go back to make changes.
Previous
Submit
