Registration Payment Form - Trusting Connections

Final Step: Initiation Fee Payment

Payment Information

As the final step of our Registration process, we will need to collect a $65 Initiation Fee. This Initiation Fee will be applied toward any Sitter Service Membership you select or the Initial Placement Fees.

Family Name/Business Name:(Required)

Email(Required)

Please enter the email address we have on file for your family’s main contact.

Name (as it appears on card/account)(Required)

First Last

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please select a payment option:

ACH/Bank Account** (Recommended, see below)

Credit Card (Subject to a 3% processing fee)

**ACH transfers are inherently more secure. When you make an ACH payment, it processes through an encrypted, secure system. The payment is then processed in a safe, secure environment, giving your credentials increased protection.

Account Number(Required)

Routing Number(Required)

Account Type(Required)

Checking

Savings

Card Type(Required)

Expiration Date(Required)

Credit Card Number(Required)

Signature(Required)

By signing above you authorize Trusting Connections to charge the account you provided a one-time $65 Initiation Fee.

Date(Required)

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Final Step: Initiation Fee Payment

Payment Information

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