This form can only be used to authorize the University of Hawaii – West O’ahu to use your credit card for a particular purpose. It is also limited to the aforementioned location.
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The form must contain the date, student’s full and legal name (first, middle, last), student’s UH (University of Hawaii) ID number, purpose for which you are authorizing the University of Hawaii – West O’ahu to use your credit card, what type of credit card is it (visa, master), the total amount that is to be charged on the credit card, the full 16 digit credit card number, expiration date of the credit card, credit card holder’s card code which is a three digit verification number (Card code can be found in back of the credit card in the signature box.), card holders full and legal name, (last, first, middle), credit card holder’s complete address including the city, state and the zip code and the credit card holder’s phone number.
Lastly, sign the document below the undertaking certifying that the information provided above is true to the best of my knowledge and that I agree to pay the aforementioned fee and if the fee is for an application then I acknowledge that it is valid only for the semester specified on the application and that the application fee is non-refundable and non-transferable. Mail or fax this document to: University of Hawai‘i – West O‘ahu Business Office, 91-1001 Farrington Highway Kapolei, HI 96707 Phone: (808) 689-2890 Fax (808) 689-2891.
University of Hawaii West O’ahu Credit Card Authorization Form
