ࡱ> ?A>M ebjbj== "&WWl&&&&vvv<> l9WX$ Qv[9[[&&b[&8v[J^v 7:kXx0&&&&HOUSING DOWN PAYMENT/ DEPOSIT CREDIT CARD AUTHORIZATION **This form is for the sole purpose of making down payments/deposits for housing.** **Any attempts to use this form other than a housing down payment/deposits will be denied.** **All housing down payments/deposits must be faxed to Enrollment Services on the Brenham campus.** FAX NUMBER 979-830-4169  STUDENT INFORMATION Student Name  FORMTEXT        FORMTEXT        FORMTEXT       Last Name First Name MI Blinn ID  FORMTEXT       SS#  FORMTEXT       Contact number ( FORMTEXT    )  FORMTEXT        CREDIT CARD INFORMATION Card Holder Name  FORMTEXT        FORMTEXT        FORMTEXT       Last Name First Name MI Credit Card Type: Discover  FORMCHECKBOX  Master Card  FORMCHECKBOX  Visa  FORMCHECKBOX  Credit Card Number  FORMTEXT      -  FORMTEXT      -  FORMTEXT      -  FORMTEXT      Credit Card Security Code  FORMTEXT       The credit card security code is the three digit code on the back of the card. Expiration Date  FORMTEXT       MM/YY Billing Zip Code  FORMTEXT       Amount $  FORMTEXT       I agree to pay the above total amount, according to card issuer agreement, as charged by Blinn College.  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