Wiley University - Acceptiva

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RECEIPT

Soccer Program Fee

This page is designated for payment of the Wiley University Soccer Program Fee.

New Students: $150
Returning Students: $75

The soccer program fee helps support the student-athlete experience by contributing to team gear, training resources, team-building activities and other program needs throughout the season.

For questions or concerns regarding your payment, please contact Amia Richardson, Student Accounts Receivable, at (903) 927-3207 or acrichardson@wileyc.edu.

Qty

Description

Amount

Total

New Student Soccer Fee

$150.00

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Returning Student Soccer Fee

$75.00

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Total: $0.00

Student Name: *

Student ID number: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Point of Contact E-mail: *

A receipt will be e-mailed to this address.

Point of Contact Mobile: *

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *