PAYMENT AGREEMENT FORM 20-HOUR CTEC

PAYMENT AGREEMENT FORM

20-HOUR CONTINUING EDUCATION COURSE
The 20-Hour CTEC Continuing Education class is $329 (Early-Bird Special) or up to $399-$599 (Regular Price if registering after the Early-Bird Special). A minimum deposit of $199 is required to reserve your seat in the class. Payment arrangements can be made on the remaining balance. Your card will be charged automatically for the amount and date you select on this form. All fees must be paid in full before the last week of class.
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Format: (000) 000-0000.
Email
example@example.com
Session 1: 20-Hour CTEC (9/23/25-10/30/25 Tue. & Thur. 10am-12:30pm)Session 2: 20-Hour CTEC (9/23/25-10/30/25 Tue. & Thur. 6pm-8:30pm)
Which Payment Plan?

Select the payment plan you want. If selecting to make multiple payments, type the amount and date in the boxes as shown.
Option 1
Option 1: After initial $199 Deposit, I want to pay the remaining balance on this date:
Enter date for the remaining balance to be paid
Option 2
Option 2: After paying initial deposit of $199, I will pay the remaining balance in two (2) installments as follows (type the payment amount and date in box below):

1st Payment Amount & Date2nd Payment Amount & Date
Payment Method
Debit/Credit Card Number

Enter your card number

Billing Zip Code

Expiration MonthExpiration Year

3-Digit Code
Authorization & Signature

I certify under penalty of perjury that information on this form is true and correct to the best of my knowledge. I authorize Guardian Tax School to auto debit my card for the amount listed and date for the chosen Payment Option. All payments are non-refundable and non-transferable. If I drop the course or if I am dropped by an instructor for missing more than 2 classes, any payments made prior to that date are non-refundable unless I drop the course before the end of the 1st week of the start of the course.
Student Signature

Clear
Date

MonthDayYear
Date
Should be Empty: