Nyack.edu Secure Payment Form


 

ATS Doctor of Ministry Application Fee

Description: Use this form to pay the non-refundable $50 application fee for ATS' Doctor of Ministry program.

You must provide your full name, address, phone number, and email address below.
Quantity: 1
Price: 50

CUSTOMER INFORMATION

First Name:
Last Name:
Street Address:
City:
State:
Zip Code:
Country:
Phone:
Valid Email:
Your Relationship to Nyack/ATS:
Other?
Comments:

BILLING INFORMATION

Amount Due:
$50
Card Number:
CID Number: (code on back of card)
Card Expiration Month: (format MM, e.g. '04' for April)
Card Expiration Year: (format YYYY, e.g. '2021')