Course Payment

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Student Information

Student ID *

Please provide a valid student ID.

Student Name

Phone

Course Selection

Select Course *

Please select a course.

Course Fee

Lab Fee

Material Fee

Payment Information

Payment Method *

Credit Card

Bank Transfer

PayPal

Card Number *

Please provide a valid card number.

CVV *

Please provide CVV.

Expiry Month *

Please select expiry month.

Expiry Year *

Please select expiry year.

Cardholder Name *

Please provide cardholder name.

Billing Address

First Name *

Please provide first name.

Last Name *

Please provide last name.

Address *

Please provide address.

City *

Please provide city.

State *

Please select state.

ZIP Code *

Please provide ZIP code.

Payment Summary

Course Fee: $0.00

Lab Fee: $0.00

Material Fee: $0.00

Processing Fee: $2.50

Total Amount: $0.00

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