Leap of Language Inc.

37171 Sycamore Street, Apt. 633 Newark, CA 94560



Authorization for Credit Card Use

By signing this form you give Leap of Language Inc. permission to debit your account for the amount indicated on or after the indicated date. This is permission for current and future services as outlined in this agreement, and does not provide authorization for unrelated debits or credits to your account.

Credit Card Type:

Credit Card Authorization