The Well STEM Education Center

Payment Form

How would you like to allocate your payment? *

Total payment amount: $0.00 (U.S. Currency)

Schedule this payment to occur *

One-time Monthly

Start Date: *

Student Name / Grade Level / Other Comments:

500 characters left

Payment Options *

Debit Card

Checking/Savings Account

Card Number

Expiration Date

Security Code (CVV2)

A 2.19% Processing Fee will be automatically added to your payment.

Account Type(U.S. Banks Only)

Routing Number

Account Number

A $0.25 Processing Fee will be automatically added to your payment.

First Name *

Last Name *

Billing Address *

City *

State *

Zip *

U.S. Phone

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Email *

All payments provided to The Well STEM Education Center comply with U.S. laws and regulations.