Ready for some peace of mind? First, fill out the identification form. Then, decide if you want to pay securely online or by email/telephone.

As you proceed through this form, you will see items using red italics. These are required fields.

1. Complete the identification form.

	First Name:
	Last Name:
	E-mail:
	Telephone:
	Street Address:
	City:
	State/Province:	Choose a State Outside US / Canada Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory
	Zip/Postal Code:
	Wintergreen Property Address:
	House or Condo?	House Condo
	Property Manager?	Wintergreen Home Watch No Preference
	Do you have any special requests, needs, or comments?

2. Choose one of the following options:

A. Click on the Send Message button to send us your request.

B. Pay securely online bycompleting the form below. The first quarter amount will be charged to your account when you click on the "Charge My Account" button.

	Credit Card Number:	(No spaces or punctuation--just numbers)
	Expiration Date:	01 02 03 04 05 06 07 08 09 10 11 12 Month / 2012 2013 2014 2015 2016 2017 2018 2019 Year
	Card Verification Number:	(What is a card verification number?)
	First Quarter Payment: