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TOWANDA AREA SCHOOL DISTRICT
4TH ANNUAL BLACK KNIGHT BASH

Purchase Tickets to the 4th Annual Black Knight Bash



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First Name: *
Last Name: *
Address: *
City: *
State: *
Zip Code: *
Phone Number: *
Email Address: *
Number of Tickets: *

Bank Account Information
Name on Account: *
Name of Financial Institution: *
Account Type: *
Account Number: *
Bank ABA Routing Number: *


Authorization Agreement for Prearranged Payments

By hitting "Submit", I hereby authorize my financial institution and Towanda Area School District to charge the account specified above for Education Foundation payments as designated. I agree that each charge to my account shall be the same as if I had signed a check to purcahse tickets. This authority will only remain in effect for the payment(s) specified above. I have the right to stop payment of a charge by notifying my financial institution before the stated due date. I understand that both the financial institution and Towanda Area School District reserve the right to terminate this payment plan and/or my participation therein. Failure to notify Towanda Area School District of closing my bank account or to maintain sufficient funds will result in additional service charges.