Individual - Invoice request

If you are signing up as an individual Earth Heal member, and are unable to use the PayFast buttons on our membership payment page, and require an invoice to make your annual membership payment, please reply to the questions below.

Q1 - Q6 require an answer, Q7 - Q10 are optional.

Send the completed form by clicking the 'Done' button at the bottom of the page when you have finished, or if you prefer to send it via e-mail, just copy and paste the completed form (without clicking the "Done" button) into the body of an e-mail and send it to earthhealadmin[at]gmail[dot]com

We will be in touch with you via e-mail as soon as possible.

* 1. Name

* 2. E-mail address

* 3. Which country do you live in?

* 4. Please let us know which category applies :

* 5. Did you try to use the applicable PayFast button on our membership payments page to make your payment?

* 6. Would you like us to send you an invoice with a link to make your payment from PayFast, our preferred payment gateway?

* 7. If no to Q7, would you like an invoice sent to you from Payoneer? (Our second choice)

* 8. If no to Q8, would you like us to send you a PayPal invoice?

* 9. If no to Q9, please indicate below which payment method you would like to use.  Where applicable, additional amounts in USD  are added in brackets, to cover commission, bank charges or other costs.

* 10. If you have any other queries regarding payment for individual annual membership, please write them in the box below.