ONLINE PAYMENT FORM
(Part 1- Contact Information Only)
 

Once you fill out this form, we will transfer you to a server secured by Verisign (the most trusted name on the net). Verisign uses the latest advancements in Secure Socket Layer technology so you can input your credit card information safely. Once you confirm your transaction you will receive an e-mail receipt.
 
*Minimum web payments are $10.00
**Please note that we will charge a $25.00 fee to research a disputed web payment.

PLEASE NOTE THAT PAYMENTS MADE AFTER 2PM WILL BE CREDITED THE NEXT BUSINESS DAY.

NOTE: If you do not receive a confirmation page after submitting a payment, DO NOT try to make a second payment. Please contact BASIC (305-474-6900) for further assistance.

   
Name:
Student ID or SSN: 
Select what the payment is for:
Select the form of payment:
Amount:
  (Do not use the dollar sign - '$' Example: 40.00)
Address:
City:
State:
Zip:
Phone:
Email:
Please make sure you enter a valid e-mail address!
 

Once you fill out this form, we will transfer you to a server secured by Verisign (the most trusted name on the net). Verisign uses the latest advancements in Secure Socket Layer technology so you can input your credit card information safely. Once you confirm your transaction you will receive an e-mail receipt.