Payment Portal for registered/ enrolled student only

South-West Medical Academy Student Payment Form

Call us if you have trouble with this form 501-647-0264. This is not our main registration link. If you are trying to register for a class, please go back to the main screen and click enroll. Please only fill out this form if you are a current student making a payment on your tuition. For detailed information about each program, visit our main website. Give us a call for any other questions. Payments are to be made under your legal name or we will suspect fraud and dismiss you from the program. No Refunds
Enrolled Student Legal Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Student E-mail
example@example.com
Mobile Number

Area CodePhone Number
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select The Course with your instructor name beside it or select a deal below

Type Payment Amount Here

USDNo Payments less than $100.00 accepted !

Credit Card

Afterpay

South-West Medical Academy Student Payment Form