AutopayTuition Autopay Enrollment How would you like to make your tuition payment(s)?*The first tuition due date for the 2020-2021 school year is June 1, 2020. Credit Card Checking Account Savings Account I have read and agree to these terms for tuition autopay in the amounts indicated on my child's Enrollment or Re-Enrollment Contract.*To properly affect the cancellation of these charges, I am required to give 10 days written notice. I hereby authorize White Rock Montessori to initiate credit card charges to the below-referenced credit card account on tuition plan due date(s).* I acknowledge and agree to pay the 2.65% processing fee associated with credit card charges.I hereby authorize White Rock Montessori to initiate debit entries to the below-referenced checking or savings account on tuition plan due date(s).*To properly affect the cancellation of these charges, I am required to give 10 days written notice. I have read and agree to these terms for tuition autopay in the amounts indicated on my child's Enrollment or Re-Enrollment Contract.Account Holder Name*For the account to be used for tuition autopay First Last Account Holder Phone Number*For the account to be used for tuition autopayAccount Holder Address*Debit/Credit card to be used for tuition autopay Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Debit/Credit Card Number*Debit/Credit card to be used for tuition autopayDebit/Credit Card Expiration Date*For the account to be used for tuition autopayBank or Credit Union Name*For the account to be used for tuition autopayRouting Number*For the account to be used for tuition autopayAccount Number*For the account to be used for tuition autopayElectronic Signature*Please type your first and last name to serve as your electronic signature.Your Email Address*(to receive confirmation of tuition autopay setup) Enter Email Confirm Email Additional Email Address (Optional)Where you would like a copy of your email confirmation sent.