Payment Form

APPOINTMENT FOR PERSONAL CONSULTATION

To receive forms, brochures and more detailed information a deposit of R999/max 1 hour(This amount must be paid upfront) , via EFT/Direct Deposit or R629 via Credit Card is required. A banking deposit can be done and proof of payment to be faxed or e-mailed to our office.

Should you wish to pay via credit card, please telephone in. (Does not include membership fees)

You may also pay directly into our bank account: 

FNB
ACC 549 911 60613
BRANCH 222 826
ANSARYS AGENCIES
REF YOUR NAME

Name:
Profession:
Area of Residence:
Telephone:
Cell:

Email:

  Payment Details
   
CREDIT CARD  
Name of card holder
Card No:
Expire Date: mm yyyy
CVC No: 
ID/Passport No:
 
 

I,above mentioned name Id/Passport no........................... and holder of the Credit Card Number,agree and AUTHORIZE ,Ansarys Agencies CC to charge the sum of R629 from my Credit Card for the assessment of my case and profile,and for the registrations forms,I will NOT have any future disputes and I am aware this sum is NOT REFUNDABLE once I understand the payment is for the initial service Costs
I Authorize  and Submit

 

 

 
 
 
Once your profile is assessed by the panel, the fee and options of membership will be available, you  may then email the forms/make payments (via internet, direct deposit/credit card) and you will be sent the original forms via post (later). You will join temporarily  via email  filled forms.



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