Telephone Authorizations for Credit Card Charges

I, _____________________________________, do hereby authorize Craven Community College to charge

(Please print name legibly)

my credit card in the amount of $________________for__________________________________________.

(Student’s Name)

for the following charges: (please check the one that applies, if Other, please explain.)

Tuition & Other Fees

Transcripts

Library fine

Parking fine

Other:

Type of credit card		MasterCard		Visa
Credit Card Number
Expiration Date
Name as it appears on the card
Student’s ID #
Phone Number	(Home)		(Work)

Please provide us with a person to contact in the event there is a problem with the credit card.

Name

Address

City, State, Zip Code

Phone Number

E-Mail Address

Date	Processing Cashier