AUTHORIZATION RECURRING CARD PAYMENT AUTHORIZATIONName(Required) First Last Email(Required) Enter Email Confirm Email Phone Number(Required)Student Name(Required) First Last Card Type(Required) Visa Card Master Card Please enter the last four digits of your credit card(Required) I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify DaVinci Code Art Academy One Month (30 Days) in writing of any changes in account information or withdrawal from lessons before the next invoice date. I acknowledge that the origination of Credit Card transactions to my account must comply with the Code of Conduct for the Credit and Debit Card Industry in Canada. I certify that I am an authorized user of this Credit Card and will not dispute these scheduled transactions; so long as the transactions correspond to the terms indicated in this authorization form.(Required)I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify DaVinci Code Art Academy One Month (30 Days) in writing of any changes in account information or withdrawal from lessons before the next invoice date. I acknowledge that the origination of Credit Card transactions to my account must comply with the Code of Conduct for the Credit and Debit Card Industry in Canada. I certify that I am an authorized user of this Credit Card and will not dispute these scheduled transactions; so long as the transactions correspond to the terms indicated in this authorization form. I authorize DaVinci Code Art Academy to charge Credit Card on the invoice due date of each month.(Required) I understand and agree to abide to DaVinci Code Art Academy privacy and policy.NameThis field is for validation purposes and should be left unchanged.
