Affiliated with TWU/ESLI CANADA TWU/ESLI Credit Card Processing Please complete this form and fax to (604) 513-2132 Credit Card Payment: PAYMENT OF TWU/ESLI FEES: I authorize Trinity Western University/ESLI to charge my credit card as follows: (Please print clearly) Name on Credit card: _______________________________________________________ ( ) MasterCard ( ) Visa ( ) American Express Amount - Tuition/Fees: C$_____________________ Amount - Homestay: C$ _____________________ Credit Card Number: __________________________________ Expiry Date: _____________ If daily limit is exceeded please charge my card in daily increments until the full amount has been paid. ________________________________ ____________________ Credit Card Holder’s Signature Date ____________________________ _____________________ Student Name TWU Student ID# (if known) TWU/ ESLI Payment Policy Effective Date: March 2004 All Tuition and fees are payable on or before the day of registration. Returning Students: A $100 late registration fee will be charged for students registering after the published registration deadline. If full payment is not received by 2:00 PM on the day after registration, a $50 late payment fee will also be charged. All Students: Results of Placement Test will not be given until $1000 deposit has been paid. If full payment is not received before 5% of the program is complete, the student will not be permitted to attend classes until the balance is paid. A $50 late payment fee will be charged. Absences will be considered “Unexcused.” The ESLI Student Accounts Committee will determine all actions taken in the collection of outstanding accounts.