PAYMENT INFO

We only accept electronic funds transfer (ACH) debits and credit card for payments due.

Electronic funds transfer debits from the account for payments due, or when applicable, apply electronic funds transfer credits to the same.
For accounting purposes, all electronic debits will be reflected on the monthly bank statement that corresponds with financial institution account identified below.
If any such electronic debit(s) should be returned by my financial institution as unpaid (Non- Sufficient or Uncollected Funds), VMAC is to collect a returned item fee of $15.00 (or the maximum amount allowed by state law) per item by electronic debit from the same account identified below.
All payments are non-refundable / non-negotiable.

Student's First Name

Payee's First Name

Student's Last Name

Payee's Last Name

Email Address

Expiration (month and year)

Card number (16 digits)

I understand and authorize all of the above.

Thank you!