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TUITION PAYMENT AGREEMENTS
Please fill it out per household
* Indicates required question
Email
*
Record my email address with my response
Name of 1st student
*
Your answer
Name of 2nd student
Your answer
Name of 3rd student
Your answer
Name of 4th student
Your answer
Preferred
term
of payment
*
One time payment
Two Semester Payments
Ten Monthly Payments
Preferred
form
of payment
*
Cash
Check ( Payable to : Tucson Japanese Language School )
Debt/Credit Cards ( surcharge of 3% will apply)
Tuition Chart : See the chart below, sum up amount you pay
per term
. If paying with a card, 3% will be added at when you pay.
*
Your answer
Please read:
*
※ If you are paying cash, please bring the exact amount.
※If you choose to pay per semester or monthly, you don't need to submit this form after the first payment.
I understand that tuition is not refundable and I agree to pay any fees due to bounced checks or credit card transactions.
Signature ( Please type student's full name or responsible parent/guardian's full name if students are minors)
*
Your answer
Signed Date
*
MM
/
DD
/
YYYY
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