| Section
2:
2009-2010 Tuition Fee(s)
To setup your
2009-2010 tuition payment(s), please read and fill in
the fields, then print, then click Send.
Southeast
Educational Associates, Inc. dba Southeast Academy
AUTHORIZATION
AGREEMENT FOR AUTOMATIC CREDIT CARD TRANSACTION
COMPANY:
Southeast Educational
Associates
(276)
496-7777 Ext.
221
SEA,
P.O.
Box MM,
Phone
Hours: 8am-4pm EST
Call
if you need help with this form!
Tuition is normally
billed to your credit/debit card on the 1st or 15th,
whichever is before your student start date. (e.g.
Student starting on Sept. 7th would be billed on Sept.
1st for tuition, but a student starting Aug. 29th would
be billed on Aug. 15th for tuition.) Monthly
payments will be billed on the same day each month for
nine months. Quarterly payments will be billed on
the 1st or 15th, whichever is closet before the
student's new quarter.
This
will authorize Southeast Educational Associates, Inc.,
hereinafter called SEA, to initiate credit
entries and Adjustments for any entries in error, if
necessary, to the credit card indicated below for a
monthly, quarterly, or annual payment to the designation
listed below. This authorization is to remain in force
for the 2009-2010 school year OR until SEA has received
written notice of its termination in such time and in
such manner as to afford SEA a reasonable opportunity to
act on it. Termination will automatically require that
payments be made by PayPpal or over the phone or all
services of SEA will be terminated immediately. This
authorization does not change the terms of your tuition
payments or obligation to pay for services already
rendered.
This
will authorize the credit card company indicated when
you call to credit and/or debit the same credit card to
the account. SEA reserves
the right to revoke this authorization in the event of
dispute of the charge without prior notification;
account closed without prior notification, and/or two or
more declined transactions in one six month period
Reinstatement of SEA services will require
quarterly payments be made and cleared prior to shipping
of any materials.
PLEASE
ENTER INFORMATION WHERE APPROPRIATE:
Which
payment structure do you wish for 2009-2010
tuition? Same as you entered on the
application.
(annual, quarterly, or monthly)
Student
name(s) that will have tuition billed to the card you
will call in:
STUDENT
Full Name:
Grade
STUDENT
Full Name:
Grade
STUDENT
Full Name:
Grade
STUDENT Full Name:
Grade
CARDHOLDER
NAME:
CARDHOLDER
BILLING ADDRESS:
CITY
STATE
ZIP:
CARDHOLDER
EMAIL ADDRESS:
Cardholder Phone:
By entering my name in the Signature
box, I understand and agree with this
authorization to bill the credit/debit card I call in
for 2009-2010 tuition payments. CARDHOLDER
SIGNATURE:
DATE:
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