Regular Monthly Membership Pre-Authorized Payment
Member Name:
Membership Number:
Monthly Membership:
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Name and Location of Financial Institution:
Account Number: xxxxx xxx
AuthorizationI/We hereby authorize Jeon Eui Taekwondo to direct my Financial Institution to debit my/our bank account, on file or indicated above, as follows:
I/We, the undersigned, have read, understood, and agree to the terms and conditions of this agreement.
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Document Name: Regular Monthly Membership Pre-Authorized Payment
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