Fusion Math Payment Authorization Form
Secure Payment Form

Form Information:
Order Date: 09/15/19
Order Amount: 0.01
Customer IP: 
Form Information: This form will charge your Credit Card or debit your Bank Account (if you choose Pay By Check below) $0.01 to allow us to securely save your payment information.

Your bank may alert you that your payment is "Recurring" or the charge may appear on your Credit Card Statement as recurring but that is a system setting due to how we process the payments. You will only ever be charged for sessions that were scheduled.

By completing this form and clicking the Process Payment button below you authorize Fusion Math to automatically charge your Credit Card or debit your Bank Account bi-monthly for Tutoring Services rendered. By submitting this form you agree to Fusion Math's rates and cancellation policy outlined below.

Current Tutoring Rates:
Minimum 1 hour sessions except for special arrangements. Appointments are charged as time booked plus any additional time.
General Math, Science: 104/hr, after 10/31: 108/hr
Calculus, Advanced, Honors, AP, IB: 114/hr, after 10/31: 118/hr
Test Prep such as SAT, ACT, ISEE, SSAT: 134/hr, after 10/31: 138/hr
Same Day Bookings: 20/hr extra helps ensure a tutorís availability.
Contact us to discuss tutoring more than one student simultaneously.
Mark's rates are not published - please call to inquire.

Cancellation and Change Policy:
Changes or Cancellations made for any reason after 5pm two days prior to appointment: $20 charge.
Changes or Cancellations made for any reason after 5pm the day prior to appointment: half-charge.
Changes or Cancellations made for any reason the day of appointment: full-charge.

Kindly fill in ALL fields Below and thank you for also filling in your Student's Name, School, and Grade.
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Card Expiration Date: MMYY
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STUDENT Grade 2019:20:
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