NIGEL'S DRIVING SPECIALIST CREDIT CARD AUTHORIZATION FORM
What Date Did You Pay The Consultation Fee? Put todays date in numeric form. The consultation is when NDS assistant Tiffany asked you a series of questions and you gave a series of answers then both of you decided on the package that suited you best *
PLEASE PUT TODAYS DATE FOR EXAMPLE 03 02 2022
Was your goods and services received today? *
Are you paying for this package in full which includes your consultation fee and driving lesson fees? Or are you paying in increments which means your only paying the consultation fee today and your going to wait and pay for your lessons when you get with your instructor in cash? *
MAKE SURE ONE OPTION IS CLICKED ONLY
Transaction Total *
PUT THE PRICE WE JUST DISCUSSED OVER THE PHONE/IN PERSON. PLEASE DONT INCLUDE ANY DECIMALS OR DOLLAR SIGNS
Would you like this card saved on file for any future consultation fees made to Nigels Driving for faster booking in the future? *
KEEP IN MIND THIS ONLY PERTAINS TO WHEN YOU AND TIFFANY CONSULT OVER THE PHONE ABOUT THE CLIENT NEEDING MORE DRIVING PRACTICE OR WANTING TO RESCHEDULE. YOU WILL BE ASKED IF NDS CAN CHARGE YOUR CARD THATS ON FILE AS LONG AS YOU CLICK YES ON THIS AUTHORIZATION FORM. IF YOU CLICK NO YOU WILL HAVE TO DO A AUTHORIZATION. FORM EVERY TIME YOU CALL IN TO BOOK A SERVICE WITH NDS.
Client Name *
PLEASE PUT THE CLIENTS FIRST AND LAST NAME THATS TAKING THE PERMIT/DRIVING LESSON
Cardholder Name *
THE WAY THE PERSONS NAME IS WRITTEN ON THE DEBIT/CREDIT CARD THAT YOUR USING PLEASE TYPE IT JUST LIKE THAT ON THE FORM
Please upload a picture of your ID. The name of your ID must match the name on your credit card *
PLEASE TAKE A CLEAR PICTURE OF YOUR ID. DO NOT BLOCK ANY PART OF YOUR ID.
Expiration Date (MM/YY) *
C V V *
THE THREE NUMBERS ON THE BACK OF YOUR CARD
Cardholder Zip Code *
PLEASE PUT YOUR ZIP CODE ONLY. DO NOT PUT YOUR FULL ADDRESS.
Does the client/authorize card holder have knowledge of this charge and gives full consent *
Please check which social media account the card holder has: *
ONCE YOU CLICK THE SOCIAL MEDIA ACCOUNT THAT PERTAINS TO THE PERSON THATS PAYING, WRITE THEIR @ NAME SO THIER SOCIAL MEDIA CAN BE FOUND. THAT WAY THE FORM WILL KNOW THAT THE CARD HOLDER IS REALLY WHO THEY SAY THEY ARE.
PLEASE STATE THE SOCIAL MEDIA @ NAME. PLEASE DONT FORGET UNDERSCORES IF THEIR IS ANY *
REMEMBER TO PUT THE PERSON WHOS PAYING SOCIAL MEDIA NOT THE CLIENTS SOCIAL MEDIA
Due to service and tax fees an additional $8 will be applied to all consultation fees, cancellation fees, rescheduling fees, and payments made in full. *
PLEASE SIGN YOUR SIGNATURE THE SAME WAY YOU SIGNED IT ON YOUR ID. THIS WAY YOU WONT HAVE TO KEEP REDOING THE FORM
Signing here confirms that you understand that your information will be saved on file for cancellation fee purposes only. *
PLEASE SIGN YOUR SIGNATURE THE SAME WAY YOU SIGNED IT ON YOUR ID. THIS WAY YOU WONT HAVE TO KEEP REDOING THE FORM
If you confirm that you'll be coming to your lesson the day before your appointment and you cancel the day of your appointment, your card will be charged half of the amount of the remaining balance that you owe. Your form will be charged periodically if your consultation fee does not go through the first time you are charged your cancellation fee, even if it is years later. *
PLEASE SIGN YOUR SIGNATURE THE SAME WAY YOU SIGNED IT ON YOUR ID. THIS WAY YOU WONT HAVE TO KEEP REDOING THE FORM
If you confirm that you'll be coming to your lesson the day before your appointment and you confirm again that you’ll be coming to your lesson the day of your appointment. If you cancel after confirming that you'll be coming twice to your driving lesson, your card will be charged the full amount of the remaining balance that you owe. Your form will be charged periodically if your cancellation fee does not go through the first time you are charged your cancellation fee, even if it is years later. *
PLEASE SIGN YOUR SIGNATURE THE SAME WAY YOU SIGNED IT ON YOUR ID. THIS WAY YOU WONT HAVE TO KEEP REDOING THE FORM
Your signature authorizes Nigel's Driving Specialist via Square Point Of Sale Payments to charge your credit card a NON REFUNDABLE CONSULTATION FEE OR FULL PAYMENT THAT'S STATED IN THE TRANSACTION TOTAL ABOVE. *
PLEASE SIGN YOUR SIGNATURE THE SAME WAY YOU SIGNED IT ON YOUR ID. THIS WAY YOU WONT HAVE TO KEEP REDOING THE FORM
Your signature authorizes Nigel's Driving Specialist via Square Point Of Sale Payments to charge your credit card a NON REFUNDABLE CONSULTATION FEE OR FULL PAYMENT THAT'S STATED IN THE TRANSACTION TOTAL ABOVE. *
PLEASE SIGN YOUR SIGNATURE THE SAME WAY YOU SIGNED IT ON YOUR ID. THIS WAY YOU WONT HAVE TO KEEP REDOING THE FORM
PLEASE SEND IF EVERYTHING IS CORRECTLY FILLED OUT
