Ref: Agreement to Debit Credit Card Books Order Date* MM slash DD slash YYYY Grade* Name: Parent*for the authorization for CIA to debit Mr./Mrs. First Last Name: Student*This agreement is between Caribbean International Academy (CIA) and Mr./Mrs. First Last Master/Visa card no.* Card Exp Date:* Order Number #*Book order total amount USD* Parent Signature* I agree and give my permission to charge my card.
