One-Time Credit Card Authorization Form

One-Time Credit Card Authorization Form

Important Payment Info: This form is for one-time authorizations only; credit card data is not stored. For recurring payments, please choose one: (A) complete this form again, (B) e-transfer to businessoffice@astheology.ns.ca, or (C) contact the Business Office (Tue–Thu mornings from 8 AM) at 902-478-7793 or businessoffice@astheology.ns.ca. Thank you. Please note: Your final room number may change due to updated accommodations. (Updated July 2026)
This form is mainly used for the following circumstances:

- Prefer to pay the monthly rental fee yourself instead of the automatic monthly charged method.

- Renting a room in residences for less than a month.

- Renting a room for friends/family.

- Replacing a lost residence keycard ($75 initial fee, $100 for subsequent fees).

- Returning resident paying for the next academic residence's activity fee. The security deposit remains with the AST business office.

- Paying the residence-only campus parking fee.

CADType your total amount for a one-time payment

Room Number
If already assigned a room number
Name Assigned to Room

First NameLast Name
Email Address
Your best email for AST to communicate with you.
Notes (What's this payment for? Describe as much as possible)
By signing below, I acknowledge that I have read, fully understand, and agree to all terms, policies, and financial obligations outlined in this residence application form.
Signature Details
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