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Tutor Doctor Indy

Secure Payment Form

* indicates a required field.
Payment Date
Quantity
Payment Amount
Student Name
Email Address(For Receipts)
Name on Card *
Card Billing Address *
Card Billing Zip Code *
Card Number *
Card Expiration Date *
CVV *
Name as on Check
Bank Routing Number
Bank Account Number
By submitting this form, you confirm that all information entered for payment is correct and without error. Any error entered in this payment form that results in an incurred cost to Tutor Doctor Indy will be the sole responsibility of the payee. Please make sure to confirm that you have entered all information without error to avoid any mischarges, declines etc.