Read more about holding your account here.
Students Name (First, Last): (required) Account Holder's Name. *Who is Paying* (First, Last): (required)
Your Email: (required)
**You will receive a confirmation email.**
Why are you holding your account?
Type of Account: Bank AccountVisaMaster CardDiscoverOther Name on Account: Last 4 Digits of Account/Card Number:
I UNDERSTAND (required):
1. This constitutes as my 31 days written notice for hold and my payments will change ($25 /mo.) AFTER the next billing cycle ([next-month], [this-year]) per the agreement I signed. I understand and agree that the account above will continue to be charged the hold amount for subsequent months per the signed agreement of 31 days written notice. The $25 per month will include the Online University and also hold the rate I pay and class schedule I take at CPAMMA when I am ready to return after the minimum 2 months for hold. If I want to come back before the minimum two months hold I will charged the remainder of my monthly rate for the 1st month on hold and the remainder for the 2nd month I was supposed to be on hold.
**HOLDS MUST BE FOR A MINIMUM OF TWO FULL MONTHS**
2. I need to keep a copy of the confirmation email sent after I submit this form. If I don't receive a confirmation email I will resubmit this form until I have received the confirmation. However, if I am still having trouble I will need to email info@payment-company.com to notify The Payment Company to receive additional instructions on submitting the online form. The confirmation email is my proof of my hold request and I understand that until I have submitted it successfully, I have not put my account on hold. Putting my account on hold is not completed until the HOLDING STUDENT has a copy of the cancellation. Secure copies are kept on the server and time/date stamped.
3. I understand that even if I didn't use my membership that I am not eligible for any type of refund, per the agreement I signed. I also understand that if I cancel while I am on "hold" I will still be charged the $25 for the minimum two months. If I choose I can reinstate my membership during the first month I will have a $25 hold credit to go towards my monthly payment. If I choose to reinstate my membership during the second hold month I will still be charged the $25 hold fee.
4. By checking the following box I understand and agree to the Membership Policies and have read the FAQ regarding our rules, payments, cancellations, holds, etc.
5. I agree and confirm that I am 18 years or older and if I am not the student who this notice is concerning, I confirm that I am the parent or legal guardian of the above student.
I UNDERSTAND AND AGREE TO ALL OF THE ABOVE:
If you are holding due to injury, please submit your doctor's note. **Note must include how long you are not allowed to do (insert program here) to be valid.**:
Please type in the letters below:
Then click "Send" below: