I authorize E3 Preparatory and Leadership Academy to initiate variable data entries to my account identified below in payment for monthly payments for class tuition. I understand that the Academy will debit my account on the First (1st) of each month or the next business day if that day falls on a Saturday, Sunday, or National holiday. (If the amount changes, I will be notified via email in advance of the withdrawal). I authorize my financial institution (identified below) to debit my account each month on behalf of E3 Preparatory and Leadership Academy. I understand I am in full control of my payment, that I have a right to hold or stop this electronic payment simply by providing the Academy timely written notice. In addition, I will immediately notify the Academy in writing of any changes in the information provided on this authorization form. (MINIMUM of 30 DAYS) I indemnify and hold E3 Preparatory and Leadership Academy, the check processor, and the bank harmless from damage, loss, or claim, resulting from all authorized actions hereunder.
NOTICE: All items returned unpaid are subject to an automatic debit (re-presentment) from my account including a maximum returned check fee as permitted by law.