Credit Card Authorization
Transcription
Credit Card Authorization
International Language Schools of Canada Vancouver ~ Toronto ~ Montreal Website: www.ilsc.ca e-mail: [email protected] Credit Card Authorization Form Student Name: ________________________________________________ I, ____________________________________, hereby authorize Name International Language Schools of Canada to charge the following fees to my credit card: Visa Mastercard Amex Amount: CAD CAD CAD or or USD USD $ _______________________________________ Card Number: __________________________________ (16 numbers) Expiration Date: _____ / _____ Month Security Code: Year ________________________________ (3 digits on back of card) _________________________________________ ____________________ Card Holder’s Signature Date *Please note the credit card options for ILSC - by City If you wish to pay with a credit card or currency that is not available in the location the student is registered, please contact the school. Vancouver Toronto Montreal Visa & Mastercard Visa & Mastercard Amex Visa, Mastercard Amex Canadian and American Dollars Canadian and American Dollars Amex in Canadian Dollars only Canadian and American Dollars Canadian Dollars only **Please fax or email this form to ILSC after completion Montreal 1(514) 876-4053 ***Although ILSC Montreal does not charge additional fees for international transactions your bank or credit card company MAY charge an additional fee.