JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
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Phishing - You agree that Company may terminate your JotForm Service immediately if a form is created or JotForm is found to be used to: Obtain credit cards sensitive information, get social security numbers, show content with child pornography. Or if a form was made to steal user login credentials. All these activities are considered as Phishing and any account along with the guilty forms will be suspended immediately.
Because of that we have scanned all of our database and replaced part of the CC numbers with # hash symbols. From now on data in credit card fields will be replaced with # hash symbols.
Card number, expiration date, security codes and card holder name are considered critical information and cannot be collected on plain text fields. The only services allowed to collect such data are those that are DSS/PCI certified.
I have removed credit card fields from your form.
Inside of this articles you can find out more about payment tools and how to set payment form:
If you want to charge your users manually at later date, I would suggest you to use on of payment tools that has built in credit card fields like PayPal Pro, Stripe, Authorize.net, Dwolla.
Feel free to contact us if you have any other questions.