Payment for Services

DO NOT USE THIS FORM if you are making a payment for an EMT or AEMT class. log in and then click "My Acct" and then "My Enrollments" to make an EMS class payment.

Paying an Invoice? *

Yes

Invoice Number

Invoice Amount *

First Name *

Last Name *

Organization

Address *

City *

State *

Zip *

Phone *

Email *

Comment

Service Fee *

Invoice Payments Incur a 3% Service Fee

Coupon

Total Amount

Discount Amount

Gross Amount

Payment method *

MasterCard, Visa, Discover, American Express
Paypal

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

Verification code*

Payment for Services

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