Credit Card Authorization Form

Tuition can be paid in a single payment or in installments in the form of bi-monthly Pre-Authorized Debit or credit card payments. The deposit which you paid at the time of registration covers the last months'. (ie July & Aug 2023).

To pay by credit card please complete the form below. There will be a 3.5% processing fee applied to each credit card payment.
Parent's Name*
First NameLast Name
Sudent Name(s)*

Payment*

Credit Card

We accept Visa, MasterCard, American Express
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Terms*
I authorize Uptown Chabad to charge my credit card for Gan Chabad tuition. I will promptly notify Uptown Chabad when the expiration date changes or the credit card becomes invalid. I understand that tuition will continue to be billed to my credit card bi-monthy for the duration of my child's enrollment and that if at any time I wish to discontinue or make changes to this payment method, I must notify Uptown Chabad, by written notification. Gan Chabad Preschool withdrawal policy remains in effect.
*
I understand that a 3.5% processing fee will be applied to each payment made via credit card.
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