Payment Consent

Automatic Payment Setup

All fields are optional unless denoted with *
You may add your credit card or banking information, leave the other blank.

Your Name*
First Last
Email*
Bank Name
Bank Phone # (optional)
Routing #
Account #
Credit Card #
Exp Date
CVC
Billing Zip
Cardholder Name
Payment Consent*
I Consent
All of the billing information is correct. I consent payment on my current balance and future automatic charges for monthly costs from Personable Media, LLC.

I consent to allow Personable Media, LLC to use the billing information I've provided for setup on 3rd party accounts they've created on my behalf; Google Ads, Calendly, Zapier, Twilio and others.

Page Name	Link to page

Page Name	Link to page