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Please change my payment method using the information I’m providing below.

Use the tab key on your keyboard to move to the next field.

The contents of this form will be submitted via a secure, encrypted connection.

Name, Email, and Phone

This is the name as it appears on your credit card or credit card statement.

Email associated with your ConnectNC account

Phone number associated with the credit card or where you may be reached if there are any questions.

Address

Card Information

Please type your credit card number here. With or without spaces. Whichever is easiest for you.

Please enter the date in MM/YYYY format. For example, if the card expires in July of 2024, please enter 07/2024.

This is the 3 or 4 digit code typically found on the back of your card.

Thanks for using the online form to update your credit card information. If there are any issues, we'll let you know!