Pre-Authorized Payment – PAP Form Mandatory Automatic Fee Withdrawal FormPlease complete this form to have monthly fees automatically withdrawn from your account. Please return this form with a scanned void cheque or bank information file. Start Date: September 2021 End Date: May 2022 Student Name #1 First Last Grade #1*Junior CasaSenior CasaGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8HifdhStudent Name #2 First Last Grade #2Junior CasaSenior CasaGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8HifdhStudent Name #3 First Last Grade #3Junior CasaSenior CasaGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8HifdhStudent Name #4 First Last Grade #4Junior CasaSenior CasaGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8HifdhPayee InformationPayee Name* First Last Parent Email* Enter Email Confirm Email Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Select the withdrawal day of the month*135810Consent I (we) authorize Al Huda Islamic Center of Canada to process a debit, in paper, electronic, or another form in the fixed amount (provided by Al Huda Elementary) on my (our) account on or after the above selected day of each month beginning September 2021 and ending May 2022.We recommend that you retain a copy of this form for your records. Any charges incurred by Al Huda Islamic Center of Canada Inc. due to insufficient funds at the time of withdrawal and/or other fees charged related to the automatic withdrawal of funds for the purpose of fee payment are the sole responsibility of the payee and will be passed on as such. Please upload your scanned void cheque or bank account information*Accepted file types: jpg, png, pdf, doc.Payee Signature*