Total College Prep - Total College Prep Workshop Registration

Total College Prep Workshop Registration - College Essay Writing (ACH)

Welcome to Total College Prep! We have several College Essay Workshops available.

First Name

Last Name

Mobile Phone

Address

City

State

Zip

Payment

ACH - Name on the account

Your Billing Address, City, State, Zip

ACH Account Number

ACH Routing Number

Payment Agreement - Summer Workshops I agree for Total College Prep to authorize regularly scheduled charges to my checking/savings account or credit card if I choose to pay my tuition in installments. 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 this authorization will remain in effect until I cancel it in writing, and I agree to notify Total College Prep in writing of any changes in my account information or termination of this authorization at least 30 days prior to the next billing date. 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debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates.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.

I would like to attend the workshop on the following dates (choose 3 day or 2 day). All extended packages are 6 hrs and essential packages are 4 hrs.

Student

First Name

Last Name

Mobile Phone

Birth Date

School

In what year will your student be graduating?

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