Payment — Alexis College Expert

Name that appears on card:

First Name

Last Name

Credit Card Number:

Expiration Date:

Billing Street Address:

City:

State:

Zip Code:

AUTHORIZATION SIGNATURE:

I hereby authorize The College Expert (Div. of The A-List Tutoring Services, Inc.) to charge my credit card.

Date

YYYY

For credit card payments:

For ACH payment:

Name on account:

First Name

Last Name

Bank routing number:

Bank account number:

Address associated with account:

City:

State:

Zip Code:

AUTHORIZATION SIGNATURE:

I hereby authorize The College Expert (Div. of The A-List Tutoring Services, Inc.) to deduct my balance from my bank account via ACH for educational services.

Date

YYYY

Payment Authorization Form

Alexis Collegexpert is a division of A-List Tutoring Services, Inc.

All information will be kept strictly confidential. Payments will be processed by A-List Tutoring and will appear as such on invoices, credit card statements, etc.

Alexis College Expert

A division of “alisttutoring services Inc.”

13437 Ventura Blvd. Suite 207
Sherman Oaks, CA 91423

(800) 714-9331

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