PLEASE ENTER THE FOLLOWING
An applicant who has registered for any course, program, or
workshop may use
the following methods of payment;
1. 100% of the total balance due at
2. 50% of the total balance due at
registration and the balance due in four weeks.
If you are paying for your course or program in
full, please enter the payment amount and date ( Month/ Day/Two Digit Year).
If you are making partial payments please enter the three payment amounts and dates (
Month/ Day/Two Digit Year). All payments must be made within four
weeks a part.
You may select the payment method, listed below.
prefer to pay by Credit or Debit Card.
Type or Card
MasterCard, Visa, or American Express)
My Debit Card Number is
My Credit Card Number is
Three Digit Security Code
( Located on the back or the front of your credit or debit card)
Name of Financial Institution
Name as it appears on Debit Card or Credit Card
Address as it appears on Debit or Credit Card
Use of Debit or Credit Card: The
debit card or credit card on file will be used as a method of payment. If you
are making two partial payments, we will notify you in advance of making the
last charge to the card on file. You may then specify if your would like to use
another type of payment.
certify that I have read, understand, and agree with the " Use of Debit or
Credit Card" statement.
I certify that I am
the authorized user of this debit or credit card. I also agree that I will be
responsible for any unauthorized use and held responsible for any balances
due after registration.
This is a secure site. However,
if you do not feel secure providing
this information on line, please call us @ (708)720-4547 or (866)720-4547.