Payment Option Form

Math Made Simple LLC • (843) 214-0548 • www.mathmadesimplesc.com

You have two payment options:

1.  Receive your invoice in the mail, by fax, or by email. Send back payment by check or money order, or pay online at www.paypal.com.

2.  Pay for each month in advance and receive a discount.

Specify your choice of payment plan below, and then choose one of the billing options below.

____ I am choosing the Regular Billing option.

Regular hourly rate: ____ (1 hour per week @ $40/hr) OR ____ (More than one hour per week @ $37/hr)

With regular billing, invoices are sent after the 15th and last day of each month and must be paid within ten days.

____ I am choosing the Advanced Payment option.

Advanced payment hourly rate: ____ (1 hour per week @ $37/hr) OR ____ (More than one hr per week @ $35/hr)

If the student will probably tutor: 1 hour per week, then you pay for four hours up front.

2 hours per week, then you pay for eight hours up front.

Please also choose one of the options below. Student’s Name______

Option 1 ~ Pay by check, money order: send to 106 Hemingway Circle, Summerville, SC 29483.

____ Please send my invoice

____ in the mail

____ by email ~ My email address ______

____ by fax ~ My fax number is ______

and I will return my payment in the mail. Please make checks payable to Math Made Simple LLC.

Option 2 ~ Pay online at www.paypal.com ***Be sure to include your PAYPAL email address!

____ Please send my invoice

____ in the mail

____ by email ~ My PAYPAL email address ______

____ by fax ~ My fax number is ______

and I will send my payment via Paypal.com to

______

Signature Date