Payment Arrangement Form

Payment Arrangement Form

Please fill out all information and agree to the monthly payment plan. After submissions you will receive your first invoice in 48 hours and they will be reoccurring until final payment is made.
Please register for the Current class(es) needed this track(Only one Kingdom Wellness course can be taken at a time and VIP can only be chosen with a certification course)
Quanity
Total

Payment Plan Arrangements are as follows and will be processed the 15th of every month:

Rows	2 Monthly payments	3 Monthly Payments	5 Monthly Payments(email Course Only)	6 Monthly Payments(email course only)
Kingdom Wellness Theory Certification
Kingdom Wellness Theory (Email Course)
VIP one on One

Payment Arrangements for this course are as follows:

Rows	4 Weekly Payments	2 Payments Bi- Weekly
Dancing Dismantling Strategist
Restoring Divine Purity

Name

First NameLast Name
E-mail
example@example.com
Contact Number
Format: (000) 000-0000.
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I understanding that by signing below I am signing up for Monthly/Weekly/Bi-Weekly reoccurring payments to be charged to my account until my courses are paid for. I understand that I will be asked to keep my card on file for payments to be charged at the scheduled time. I understand that any NSF Fees will be added to my outstanding balance. I further more understand that if I miss a payment without approval of KSWU administration I will be withdrawn from my courses.
Should be Empty: