CRX January 2022 – Payment Form Phone Student Information: First Name: * Last Name: * Email Address: * Card Details: Please enter the card details for the credit/debit card you'd like to use below: First Name: * Last Name: * Credit Card Number: * Expiration Date: * CVV: * Zip Code: * Please select a payment amount below: Payment For: Please Select... $700 - Housing Deposit (Non-Refundable) $3300 - Lecture Fee $2000 - Outreach Fee Custom Amount Custom Amount: Payment Total Total: $
