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 $ 60.00

TUITION $ 400.00

LATE REGISTRATION FEE $ 50.00

CHANGE OF STATUS $ 100.00

STUDENT SERVICE FEE $ 35.00

COMP. EXAM $ 150.00

PAY-AS-YOU-GO $ 10.00

PAY-AS-YOU-GO $ 15.00

CHANGE OF PROGRAM $ 50.00

REINSTATEMENT $ 100.00

I-20 FORM REPLACEMENT $ 20.00

COMPREHENSIVE EXAM $ 150.00

COMPREHENSIVE EXAM Re-take fee $ 90.00

COMP. BUS PROJECT $ 600.00

ADD A CLASS $ 50.00

DROP A CLASS $ 25.00

I-20 RUSH FEE $ 20.00

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