Recurring Payment Authorization Form
Student Information
First Name:
Last Name:
Date of Birth:
Phone:
Email:
Payment Information:
Housing - Monthly Payment Plan Authorization
I authorize Ramp Universityto automatically charge the card listed below for monthly housing charges in the amount of
$350/month
. The payment will be taken out on the
1st of each month
and will be recurring until the student's account is at a $0 balance.
The Monthly Payment Plan will begin on September 1st and go through April 1st.
Please Note: Students who participate in the installment plan are unable to pause or stop the installment plan for any reason throughout the school year. Any payments made through Populi and the "Sponsor a Student" Form will be taken off of the total balance due. All recurring payments will remain the same amount and on the same draft date regardless of additional payments being made until there is a zero balance.
Will you be paying via Credit Card or ACH?
Please select...
Credit Card
ACH
Credit Card Information
Your card will be charged $350/month beginning on September 1st to April 1st or until the student's account is at a $0 balance.
It is the student's responsibility to update the Ramp University Finance Office with current card information.
Card Type:
MasterCard
Visa
Discover
AMEX
Other
Name on Card
Card Number
MM
YY
Code
Billing Email
Bank Information
Your account will be charged $350/month beginning on September 15th to April 15th or until the student's account is at a $0 balance.
It is the student's responsibility to update Ramp University's Finance Office with current information.
Payment Information
Name on Account
Bank Name
Bank Routing Number
Bank Account Number
Account Type
Checking
Savings
Please click "submit" below to proceed to the secure signature page.
Authnet_Hidden_Fields
Contact Information