Payment

How Many Students are you Enrolling?

OneTwoThreeFour

Student #1

Information

First Name

Middle Name

Last Name

Enrolling in Grade

Does Student #1 get tuition-assistance?

NoYes

Initial payment for Student #1

Enrollment Fee ($750) + Facility Fee ($1,000): $

Initial payment for Student #1 (as stated in the contract): $

Student #2

Information

First Name

Middle Name

Last Name

Enrolling in grade

Does Student #2 get tuition-assistance?

NoYes

Initial payment for Student #2

Enrollment Fee: $

Initial payment for Student #2 (as stated in the contract): $

Student #3

Information

First Name

Middle Name

Last Name

Enrolling in Grade

Does Student #3 get tuition-assistance?

NoYes

Initial payment for Student #3

Enrollment Fee: $

Initial payment for Student #3 (as stated in the contract)t:

Student #4

Information

First Name

Middle Name

Last Name

Enrolling in Grade

Does Student #4 get tuition-assistance?

NoYes

Initial payment for Student #4

Enrollment Fee ($750): $

Initial payment for Student #3 (as stated in the contract): $

Payment

Total Initial Payment for all Students: $

Payment Method

Bank Withdrawl

Credit Card

Name on Account

Bank Name

Bank Routing Number

Bank Account Number

Account Type

CheckingSavings

Name on Card

Card Number

Code

Billing Email

Billing Address

First Name

Last Name

Street

Address Line 2

City

State/Province

Postal Code

Country

EBGIS - Make Your Initial Enrollment Payment Online