If you wish to pay for your training tuition with a credit card please print this form, fill it out and fax it to M.O.V. Training Services at 763-422-0729.  M.O.V. Training Services accepts only Visa and MasterCard.
Name(s) of students for whom this tuition charge is being applied:
__________________________________________________________________

Class(es) you will attend, ___________________ Class date(s): ________________________________

M.O.V. Training Services Invoice number being paid (if you know it): ________________________________
Card type (circle): Visa       MasterCard    Discover     American Express      
Name as it appears on the card: ___________________________________

Card number (please print large and clearly): ____________________________________     Card Code*: _________
Expiration Date: _______________________________

Card billing address (REQUIRED): Street: __________________________________ City/State: __________________  Zip: ______________

Amount to be charged:
Total of all tuition (s): ____________________________________

I the undersigned agree to charges on my account equal to the mount stated above.

Signature of cardholder: _____________________________________      Date:  ____________

Phone number of card holder: _________________________________________

Person to contact about this information: _________________ Contact phone number: ___________________________

PLEASE NOTE: The charge will appear on your credit card statement as a charge to M.O.V. Training Services

* Card code on Visa, MasterCard and Discover cards is the last 3 numbers printed on the signature bar on the back of the card. For American Express it is 4 numbers just above the card number on the front of the card.

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