Payment Update Form

Please fill out this form, providing EITHER updated credit card or ACH information, and we will update it for you.

Thank you!

*Please note that this is a secure form.

Student's Name

First Name

Last Name

Credit Card Number

We accept Visa, Mastercard, Discover, and American Express credit cards. We also can process payment via ACH direct withdrawal from your checking account. If you would like to pay with ACH, please skip the fields for credit card information and just fill out the fields for ACH information.

Credit Card Expiration Date

MM/YY

Credit Card Security Code

This is the 3-digit code typically found on the back of your credit card.

ACH Routing Number

ACH Account Number

You may leave all the ACH fields blank if you already filled in the credit card fields above!

Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Notes (not required)

Payment Update Form

Thank you!

LOCATIONS:

INSTRUMENTS:

2021 EXPRESSIONS MUSIC ACADEMY © All Rights Reserved.