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Crystal Clear ESL Student Payment Placement Form
Fill in this form to register and direct each new client payment into your account.
* Indicates required question
Email
*
Your email
Today's date:
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MM
/
DD
/
YYYY
Teacher Name (full)
*
Your answer
If you are already registered for curricula at Crystal Clear ESL, please detail which bundles here:
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Your answer
ACH routing number for Teacher's bank
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Your answer
Account number for Teacher's bank
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Your answer
Account type
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checking
savings
Is this a Wise bank account?
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Yes
No
Teacher Address: country, city, number and street, zipcode
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Your answer
Student name (full, any language)
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Your answer
Student email address (associated with payment)
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Your answer
Value of client payment in RMB, # of classes and pricing option
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Your answer
Tick to verify you have read the Terms and Conditions and agree to the Limited Liability Waiver
*
Yes, I have read the T&C's and agree to the LLW
No, I have not read the T&C's and/or do not agree to the LLW - DO NOT PROCEED WITH PAYMENT
Required
A copy of your responses will be emailed to the address you provided.
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