Debit Authorization: Student Information
Debit Authorization: Student Information
STUDENT INFORMATION
CARD INFORMATION
ADDRESS
MONTHLY PAYMENTS: ☐USD $277.68 (BACHELOR) ☐ USD $364.50 (MASTER) ☐ USD $424.50 (Ph.D.) ☐ USD $454.50 (Post-Doc)
ENROLLMENT OTHER
USD USD
REGULATIONS
THIS CREDIT AUTHORIZATION FORM IS USED FOR THE PAYMENT OF TUITION, ENROLLMENT, AND OUR INTERSEMINARS.
IF YOU DESIRE TO CANCEL YOUR AUTOMATIC MONTHLY PAYMENTS, PLEASE CONTACT OUR UNIVERSITY FOR FURTHER INFORMATION.
IT IS THE STUDENT’S OBLIGATION TO INFORM THE UNIVERSITY OF ANY CHANGES MADE TO THIS AUTHORIZATION, SUCH AS A NEW CREDIT
CARD NUMBER, IF YOUR CREDIT CARD EXPIRED, OR ANY ISSUES THAT YOU MAY ENCOUNTER.
I AUTHORIZE THE AUTOMATIC MONTHLY PAYMENT OF TUITION IN MY CREDIT CARD WITH THE VALUE ESTABLISHED ABOVE.
NOTE
SIGANTURE DATE
INTERNATIONAL HEADQUARTERS 5950 LAKEHURST DRIVE STE. 101 ORLANDO, FLORIDA 32819-8343 USA TEL: 1-407-896-0101 FAX: 1-407-896-4477
E-MAIL: [email protected] WWW.FLORIDACHRISTIANUNIVERSITY.EDU