WAITTA 2015 Payment Billing Information Name: Billing Address: City: State: Zip / Postal Code: Email Address: Phone Number: Product Name Unit Price Quantity Sub-Total Standard Seat $198.00 01234567 Table of 8 $1584.00 01234567 Full-time Student Seat $132.00 012345678 Order Total Your credit card payment will be processed securely by DirectOne Payment Solutions. Please click the DirectOne logo below to find out more about payment security.