Credit/debit Card Payment Form Payment Of Account By Visa And Mastercard Or Debit Card

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Credit/Debit Card Payment Form
Payment of Account by Visa and MasterCard or Debit Card
For your convenience, credit card payments can be accepted for any of our charges. There will be a handling charge of 2.5% on these
transactions except for application fees, enrollment deposits, and re-enrollment deposits.
U.K. Debit Card transactions do not incur handling charges.
*** We regret that we cannot accept AMEX or Diners Club Cards ***
PAYMENT AUTHORIZATION FORM. Please complete this section in BLOCK CAPITALS with black ink
Description of expense:
Invoice No. if appropriate
Quantity
Price
Handling Charge Total Due
Application Fee
0.00
Enrollment Deposit
0.00
Re-enrollment Deposit
0.00
Tuition Fees
Travel/Activities
Laundry
Extras (Please specify)
TOTAL PAYABLE
If you wish to pay by credit or debit card, please complete the details below and return the form to the Business Office by mail, e-mail,
or fax: +44 (0) 1932 570599.
Name of Student: ________________________________________________________________________________________
Type of Card (please circle):
Visa / MasterCard / Debit Card
Card No.:
(last 3 digits on back of card)
Expires: _____ /_____
Valid From: _____ /_____
Security No.:
Issue No. (if applicable):
Name: _________________________________________________________________________________________________
Address: _______________________________________________________________________________________________
______________________________________________________________________________________________________
Mobile /Contact Phone No.: _______________________________________________________________________________
Signature: ___________________________________________________ Date : _____________________________________
PLEASE NOTE:
To enable TASIS to complete the transaction, confirmation must be sent to the Business Office (Fax +44 (0) 1932 570599) from you,
showing the amount of the transaction, your full name (as shown on the card) and signature, the full address to where your card bills
are mailed, the Card Expiry Date, Security No., and a mobile telephone number where we can reach you, should we have a question.

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