CREDIT CARD PAYMENT FORM

From time to time students have a problem with PayPal, so we have now  provided a way to eliminate any frustration. 

We can charge your credit card from our office if you just fill in the information below which sends us an e-mail with your

information we will process it and get back to you.

 

Visa Mastercard Discover American Express

 
  Please type your name exactly as it appears on your credit card

First & Last name       

 

 

 

 

 

 

 

 

 

 

 

 

 Email Address             

 Phone Number           

Street Address            

City State Zip Code    

Payment Amount        

Card Type                  

Card Number             

Expiration Date            

Card Verification #    

If the student name is different then on the credit card add the student name here.

Student Name            

We will contact you once the payment has been successfully received. Or if we have a problem.

 

Help finding your Card Verification Number

 

 

 

 

 

American Express verification number     For Mastercard, Visa or Discover, the card

is on the front.                                                verification number is on the back.

You may type additional comments here

 

Once you click the submit button your information will be sent to us and you will be directed back to the student page.

 

AMES Christian University