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Women’s Business Development Council
13155 SW 134 Street, Ste. 205
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Application step 1 Her profiles directory of woman-owned businesses in Florida

  • 1. NOTICE In order to process your credit card payment, please complete the credit card information below and send it to our office at the address above. Date: Company Name Contact Name Phone Number PAYMENT INFORMATION CREDIT CARD CHARGE AUTHORIZATION WBDC will use this authorization to charge your credit card account. Please complete the information requested below: Please circle card type: AMERICAN EXPRESS MASTERCARD VISA CREDIT CARD ACCOUNT NUMBER EXPIRATION DATE 3-4 digit security code CARDHOLDER BILLING ADDRESS: CITY/STATE/ZIP CARDHOLDER NAME (PLEASE PRINT) CARDHOLDER’S SIGNATURE CREDIT CARD AUTHORIZATION FORM Women’s Business Development Council 13155 SW 134 Street, Ste. 205 Miami, FL 33186 (305) 971-9446 Contact: Gelcy Capote (305) 971-9489 Phone (305) 971-7061 Fax Certification q Corporate Sponsorship $_ q Other__________________ $__ _ Total Due: $ FILL OUT AND SEND TO GELCY CAPOTE AT gcapote@womensbusiness.info