SCOTTSDALE UNITED METHODIST PRESCHOOL Authorization for Automatic Payment

I, , hereby authorize SUMCP to automatically charge the credit card listed below on a monthly basis for the total amount owed.

Signature Date

Type of Card:  Visa  Mastercard Discover

Credit Card #

Name on Card

Address City/State/Zip

V-Code (3 digits on back) Expiration Date

I would like to add $ per month to the SUMCP Scholarship Fund.

SCOTTSDALE UNITED METHODIST PRESCHOOL Authorization for Automatic Payment

I, , hereby authorize SUMCP to automatically charge the credit card listed below on a monthly basis for the total amount owed.

Signature Date

Type of Card:  Visa  Mastercard Discover Credit Card #

Name on Card

Address City/State/Zip

V-Code (3 digits on back) Expiration Date

I would like to add $ per month to the SUMCP Scholarship Fund.