AP Seminars Credit Card Payment 2023
Submission of this form does NOT immediately charge your card.  That will be done manually by AP Seminars once this form is received.  Your payment will be confirmed by e-mail.
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1.  LAST Name of Participant *
2.  FIRST Name of Participant *
3.  Primary Phone (FORMAT, PLEASE: XXX-XXX-XXXX) *
4. Primary e-mail (personal, not school) *
5. Subject registered for *
6a. What is this payment for? *
Check one of the first two options, then any others that apply.
Required
6b. Explanation of "Other" in 6a
7a.  Credit Card Number (Visa, MasterCard, Discover, Am Ex; FORMAT WITH DASHES AS SHOWN BELOW) *
VERY IMPORTANT: FORMAT WITH DASHES AS SHOWN        Visa, MC, Disc: XXXX–XXXX–XXXX–XXXX;                                                         AM EX: XXXX–XXXXXX–XXXXX (not XXXXXXXXXXXXXXXX)
7b. Credit Card Expiration Date *
IMPORTANT: FORMAT AS FOLLOWS:  MM_YY (not MM/YY)
7c. Credit Card 3 or 4-digit Security Code  (code on back of card) *
9. Comments?
Submit
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