Request to pay membership via EFT or cash-Dragonfly Dance

Request to pay membership via EFT or cash

Generally, we require membership fees to be paid via credit or debit card or direct debit. In some circumstances we will accept alterntive payments methods (such as EFT or cash). There is an additional fee of $5 per 4 weekly payment to pay by one of these methods. If you wish to apply to pay via an alternative method, please complete the form below. Payment details for EFT payments BSB: 805 050 Account Name: Move Through Life Pty Ltd Account Number: 102628872 Reference: your name

First Name

Last Name

Please describe the reason you are unable to pay via credit/debit card or direct debit.

Please enter the amount you will be paying every 4 weeks (your membership fee plus the $5 surcharge)

Please confirm the date you would like to start your EFT of cash payments

What payment method will you use for payment?

EFT

Cash

Square (tapping your card to pay electronically when you visit the studio)

I confirm that I understand the following:

I am responsible for being aware of my payment due dates and ensuring that I pay before that date
I understand that I need to pay an additional $5 in each four-weekly payment in addition to the regular membership fee
Advising Dragonfly Dance when I have made a payment (if paying by EFT) by sending an email to support@dragonflydance.com.au
Ensuring that I fulfil the payment requirements in my membership agreement, especially the requirement to pay three x four-weekly payments for each 12 week membership
Advising Dragonfly Dance if I wish to cancel my membership or put it on hold with two weeks notice using the relevant online form (cancellation form, hold form)