testing form | Super Scooper

Name

First

Last

Email

Address

Address Line 1

City

State

Zip Code

Select Monthly Service Rate

1 Dog – $53.50 / month (tax included)
2 Dogs – $64.20 / month (tax included)
3 Dogs – $74.90 / month (tax included)
4 Dogs – $85.60 / month (tax included)

Address Rate Name

Authorization

I authorize Super Scooper to automatically charge my selected payment method each month on this same calendar date until I cancel my subscription.

PayPal Commerce

Card Number

Expiration Date

Security Code

Card Holder Name

You do not need a PayPal account. You can securely use any Debit or Credit Card below.

Note on AutoPay Billing: Submitting this form activates your subscription immediately and charges your first month's payment today. Future payments will automatically recur on this same calendar date each month. If you prefer your monthly billing date to fall on the 1st of the month, please complete this setup on the 1st.

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