Secure Payment Form
Order Date:
04/25/24
Transaction details:
Student's Name:
Payment Amount (please consider adding 3% to cover our credit card bank fees-REQUIRED for tuition and registration fees):
Description (e.g. Donation, Tuition, Registration, etc.):
Billing information:
Name as on Card:
Card Billing Address:
City:
State:
Card Billing Zipcode:
Phone Number:
Email Address:
Payment details:
Card Type:
Visa
MasterCard
Discover
Amex
Card Number:
Card Expiration Date:
MMYY
Card ID (CVV2/CID) Number:
[
What is the Card ID?
]
*