I/We hereby authorize Redeemer University College to debit my/our bank account,
as identified on the attached cheque marked “VOID” on the 15
of each month, starting
___________________________ (mmm/yyyy), the amount of $_________________ for
payment of the following account(s):
Student Account _____ Redeemer Student Fund_____ First Year Fund_____
Signature_________________________ Signature_________________________
Name ___________________________ Name ___________________________
Date ____________________________ Date ____________________________
(as required on cheques)
Address: _____________________________________________________
This payment is made on behalf of : _______ an Individual _______ a Business
I may revoke my authorization at any time, subject to providing notice of fifteen (15) days. To obtain a sample cancellation
form, or for more information on my right to cancel a PAD Agreement, I may contact my financial institution or visit
Contact information: Redeemer University College
777 Garner Road East
Ancaster, ON L9K 1J4
905-648-2131, Ext. 4286
I have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive
reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on
my recourse rights, I may contact my financial institution or visit
777 Garner Rd. E. | Ancaster, ON | L9K 1J4
T: 905.648.2131 | F: 905.648.2134 |