Credit Card Payment by Fax
FAX THIS PAGE TO (301) 868-7909
Instructions for using Yoga Alliance Payment Processing by Fax: 1. 2. 3. 4. 5. 6. We accept Visa, MasterCard, and Discover only. We DO NOT accept American Express. You MUST include your Yoga Alliance registry number. This can be found on your Member ID card if you are an RYT, or on your renewal letter if you are either or both an RYS or RYT. Payment processing will generally occur within 24 to 48 hours after we receive your payment. Exceptions are Federally observed holidays and emergency closings. Please allow up to 7 business days once your payment has been processed to receive your renewal package. You must sign and date this form below authorizing Yoga Alliance to charge your credit card. Please check the INFORMATION UPDATE box below if you are advising us of changes in address or telephone number.
I Authorize Yoga Alliance to charge my credit card for the renewal fees indicated below.
Signature: _______________________________________________________________ Date: _______________________________
IF YOU ARE UPDATING YOUR CONTACT INFORMATION, CHECK THIS BOX IF YOUR MEMBERSHIP HAS EXPIRED, CHECK THIS BOX TO REINSTATE
Credit to: RYT Renewal E-RYT Renewal RYS Renewal
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RYT & RYS Renewal
YA ID #: ______________
REGISTRANT NAME: _______________________________________________________
(as it appears on YA Card)
Registrant Address: ____________________________________________________________________________________
Street City ST Zip Country (non-US)
Name on CREDIT card: ________________________________________________________________________________ Master Card VISA Discover Card Exp. Date: ____/ ____ Credit Card Verification # (CCV): _________
(Located on back of card if applicable)
Card #: __________ __________ __________ __________
Billing Address: _______________________________________________________________________________________
Street City ST Zip Country (non-US)
$
Amt to Charge:
Notes:
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