Total College Prep - Testive Account Registration Form

Testive Account Registration Form

Thank you for your interest in receiving an online Testive account. Please fill out information below and we will activate your account as soon as possible.

First Name

Last Name

Mobile Phone

Address

City

State

Zip

Payment Terms -- Testive I agree for Total College Prep to authorize $50 monthly charges to my checking/savings account or credit card for each month I choose to keep my Testive account active. I understand that if I choose to pay with a credit card a 3% processing fee will be charged. A receipt for each payment will be provided to me. I understand that no prior-notification will be provided unless the date or amount changes, in which case I will receive notice from TCP at least 10 days prior to the payment being collected. I understand that these charges will occur monthly and I agree to notify Total College Prep in writing of any changes in my account information or termination of this authorization at least 10 days prior to the next billing date. Billing for each cycle will happen in the 10th of each month. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that Total College Prep may at its discretion attempt to process the charge again within 30 days, and agree to an additional $35 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this bank account and will not dispute these scheduled transactions with my bank; so long as the transactions correspond to the terms indicated in this authorization form.

Credit Card/ACH- Your Billing Address, City, State, Zip

Credit Card Details

You may pay using a Credit Card or an ACH account. Please fill in the payment information below. Please note that a 3% service charge will be applied to all CC transactions.

By submitting your credit card, you consent the initiation of payments on your behalf for services we provide to you.

ACH - Bank Details

ACH - Name on the account

ACH Routing Number

ACH Account Number

Text Opt-In/Opt-Out By providing your phone number, you consent to receiving text messages to confirm your lesson time/date or to communicate schedule changes. You may opt-out at any time by texting “STOP” to 972-587-5005. Message and data rates may apply.

Student

First Name

Last Name

Mobile Phone

In what year will your student be graduating?

Is/was your student enrolled in Total College Prep's ACT/SAT group classes or private lessons?

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