PAYMENT AUTHORIZATION FORMSTUDY MATERIAL
Study Materials Study Materials are mailed via express courier Total Study
Material express
courier Fee Ontario ($20.00)
Canada ($30.00)
USA ($45.00)
International ($75.00)
Specimen Materials $50.00
Insight into IELTS $80.00
IELTS Express (Intermediate) $45.00
Top Tips for IELTS (Academic) $55.00
Top Tips for IELTS (General Training)
$55.00
IELTS 8 $90.00
IELTS 9 $90.00
Express Courier Fee
# Additional Material
# ADDITIONAL MATERIAL FEE INFORMATION: If you are purchasing more than one book, the express courier charge for any additional books will be charged $5.00 each
Total Fees TOTAL $
Complete all information below. NOTE: Declined credit card transactions will be assessed a Handling Fee of $20.00
==============================================================================CREDIT CARD AUTHORIZATION
Name: ________________________________________________________________________________
Address: ______________________________________________________________________________
Phone: __________________________________E-mail: ________________________________________
□ – VISA □ – MASTERCARD Expiry Date: _____ / _____ (Month / Year )
- - -Card Number:
I authorize CONESTOGA COLLEGE to charge $ ___________ Cdn. to my credit card.
Signature of Card Holder: _______________________________________ Date: ___________________
Receipt #: ______________________________________For Office Use Only – 30-June-16
