Please complete all sections of this form and upload a voided copy of a check below.
Payments will begin August 1st and will be drafted on the 1st of each month with the final payment on April 1st. Payments will be drafted on the next business day when the 1st falls on a weekend or holiday.
I hereby authorize Augusta USD 402 (hereinafter the District) to debit my account for the amount of monthly tuition fees due by initiating debit entries to my account at the financial institution (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to withdrawal and to debit any debit entrees indicated by the District to my account and remit to the District. The authorization is to remain in full force and effect until final payment is received by the District. I acknowledge that written notice must be provided to the District of any changes in financial institution in such manner as to afford the District and Bank reasonable opportunity to act on it. Any returned ACH debit will be considered non-payment of tuition due to the District.