Authorization for Automatic Card Payments

Thank you for choosing Ivy Tutors. We look forward to helping your child achieve their highest admissions and academic aims. We process card payments on a per-session basis, at the end of each session, and receipts are sent to the address specified on this form. We value your confidence and do not share your information with any other parties without prior consent.

Student Name

First Name

Last Name

Cardholder Name

First Name

Last Name

Card Type

Expiration Month

Expiration Year

Billing Zip Code

Security Code

4-digit code for Amex cards

Preferred email for receipts

Card Authorization

I hereby authorize Ivy Tutors to process payment in accordance with the above policies and procedures

Authorization for Automatic Card Payments

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