Tuition Express Form

Tuition Express Form

We are excited to offer the safety, convenience and ease of Tuition Express a payment processing system that allows secure, on-time tuition and fee payments to be made from either your bank account or credit card.
Which location does your family attend?*
ELECTRONIC FUNDS TRANSFER AUTHORIZATION FOR BANK ACCOUNT and CREDIT CARD to initiate credit card charges to I (we) hereby authorize Special Beginings to initate credit card charges to the below-referenced credit card account (Section A) OR, initiate debit entries to my (our) checking or savings account, indicated below (Section B) To properly affect the cancellation of this agreement, I (we) are required to give 10 days written notice. Credit union members: please contact your credit union to verify account and routing numbers for automatic payments. Check with the center for accepted credit card types.
What payment method do you prefer?*
Card
Cardholder Name*
Phone*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number*
Exp Date*
Signature*

Clear
Date*

MonthDayYear
Date
Bank Account
Your Name*
Phone*
Address*

Address

Street Address Line 2

CityState

Zip
Bank or Credit Union Name*
Address*

Bank or Credit Union Address

Street Address Line 2

CityState

Zip
Routing Transit Number*
Account Number*
Account Type*

CheckingSavings
Authorized Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Bank Account