SDUIS Credit Card Submission Form

Full Name *

First Name Last Name

E-mail *

Billing Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number

My Products

APPLICATION FEE Non-refundable one-time fee $ 75.00

TUITION $ 390.00

TUITION $ 400.00

LATE REGISTRATION FEE $ 65.00

LATE PAYMENT FEE $ 65.00

I-20 RUSH FEE $ 20.00

CHANGE OF PROGRAM $ 150.00

CPT $ 100.00

OPT $ 100.00

COMPREHENSIVE EXAM Re-take fee $ 90.00

PETITION TO GRADUATE $ 300.00

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

I am authorizing the San Diego University for Integrative Studies to charge tuition payment and related fees for the amount stated above. A confirmation will be emailed to you once payment is processed.

Credit Card Payment Form