2021-2022 Automatic Tuition Payments (ATP) Authorization Form
We are excited to offer the safety, convenience, and ease of Tuition Express® – a
payment processing system that allows secure, on-time tuition and fee payments
to be made from either your bank account or credit card.
Payments will be processed beginning with the first business day of each month.
An email address is required to access receipts online at www.MyProcare.com.
Credit union members: please contact your credit union to verify account and routing numbers for automatic payments.
(required)
(check program needed)
1.
$65 $35*
*Liholiho & Pearl Harbor
Kai only (1-hour care)
$
2.
$65 $35*
*Liholiho & Pearl Harbor
Kai only (1-hour care)
$
3.
$65 $35*
*Liholiho & Pearl Harbor
Kai only (1-hour care)
$
Total Monthly Tuition
$
Donation
Kama’aina Kids is a not-for-profit organization. Should you wish to make a tax-
deductible donation to assist our financial aid and scholarship program, please
indicate your donation frequency and amount here:
One-time
Monthly
Donation Amount
$
Section A (Credit Card)
Exp Date
Section B (Bank Account)
*Attach voided check (required)
Bank or Credit Union Name
Routing Transit Number (see sample below)
Account Number (see sample below)
Please note that in addition to the monthly tuition charge, the following fees shall be assessed:
There shall be a $20 one-time processing fee assessed per family for each school year.
There shall be a $25 service charge assessed for any returned checks.
I hereby authorize Kama’aina Kids to initiate credit card charges to the above-referenced credit card account (Section A) OR, initiate debit
entries to my checking or savings account, indicated above (Section B). I am required to give 10 days’ written notice to cancel this
authorization.
Mail or fax form to:
Attn: Accounting Department
Kama’aina Kids Corporate Office
156 Hamakua Drive, Suite C
Kailua, HI 96734
Fax: 261-6066
