Credit Card Authorization Form

Credit Card Authorization Form
Cardholder Name

First NameLast Name
I, the cardholder, hereby agree to pay Pressman Seminars $238 monthly via auto-pay to participate in the weekly Group held by Pressman Seminars.

I understand that to sign up for the Group, I must agree to monthly auto-pay. I understand that I can cancel auto-pay at any time by emailing admin@toddpressman.com, but that by doing so I may give up my spot in Group.

Upon departure from the Group, I will automatically be unenrolled in auto-pay.
Date

MonthDayYear
Date
Cardholder Signature

Clear

Group Payment*

Monthly GroupYou will be auto-billed monthly. Includes 3.5% service charge.

$238.00 for each month

Total

$0.00

Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which group are you in?

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