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CBU Credit Card Authorization Form-BLANK PDF

This credit card authorization form contains information for student Gurkamalpreet Kaur, including her name, date of birth, program of study, credit card number belonging to Lovepreet S Khokhar, card type as Mastercard, expiration date of 09/22, CVV code of 633, and authorizes Cape Breton University to charge $103 to the card for Gurkamalpreet Kaur.

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2K views

CBU Credit Card Authorization Form-BLANK PDF

This credit card authorization form contains information for student Gurkamalpreet Kaur, including her name, date of birth, program of study, credit card number belonging to Lovepreet S Khokhar, card type as Mastercard, expiration date of 09/22, CVV code of 633, and authorizes Cape Breton University to charge $103 to the card for Gurkamalpreet Kaur.

Uploaded by

dollar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Credit Card Authorization Form

Student Name _________________________________________


GURKAMALPREET KAUR

DOB _________________________________________
13 OCT 1992

Program _________________________________________
POST DEGREE DIPLOMA IN HEALTH SCIENCE(PUBLIC HEALTH)

5305 6204 0138 3407


Credit Card Number _________________________________________

Name on Card LOVEPREET S KHOKHAR


_________________________________________
MASTERCARD
Card Type _________________________________________

Expiry Date _________________________________________


09/22

CVV Code _________________________________________


633

I hereby authorize Cape Breton University to charge the following amount to my


credit card on behalf of myself or for the following students –

Student Name Amount

________________________________________
GURKAMALPREET KAUR ___________
$103

________________________________________ ___________

________________________________________ ___________

________________________________________ ___________

Signature _______________________ Date 15/05/2018


____________

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