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EZ-EFT Authorization Enrollment Form

Advantages of Electronic Funds Transfer

1. You have one less thing to forget when it comes to paying bills

2. EZ-EFT saves you energy you can use for other things

3. It is very secure by using the Federal Reserves electronic payment network

4. As long as you use it you will never be charged a late fee due to a forgotten tuition payment

5. EZ-EFT is exact when making timed monthly payments

6. There is no additional fee for using EZ-EFT

7. Only the preauthorized amount is deducted everytime

8. You can start or stop using EZ-EFT at anytime

9. Your tuition payment is recorded on your bank statement

10. You have a choice to deduct directly from either checking or savings

Electronic Funds Transfer Template

EFT Enrollment Form

Parent's Name:


Parent's Signature:


Student's Name:


[__] Yes, please sign me up for EZ-EFT. Please fill out the authorization below.

[__] Continue my EZ-EFT, but please change the account information. Please fill out the authorization below.

[__] Continue my EZ- EFT with the same account information as last year.

[__] Cancel my EZ-EFT from the prior school year. I will be paying by personal check for this school year.

If you need to add or change account information, please fill out the authorization below and attach a voided check to the form and return it to the school office.

EZ-EFT Authorization

I hereby authorize __________________to make my

periodic payments on my behalf from the checking or savings account that is listed below and transfer it to [School Name].

My EZ-EFT payments will begin on the 5th day of __________, 20___.

Choose One:

[__] Checking Account Transfer: Account #__________________

[__] Savings Account Transfer: Account #___________________

I hereby understand that I am in complete control of my payment and if at anytime I decide to make any changes or discontinue this service, I will notify the [School Name] and the change of payment method will not affect the terms of my child's enrollment.

_______________________ Date_____



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