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SECURE ONLINE PAYMENT FORM

 

Amount to be Charged to your Credit Card Account

Payment Amount (Do Not Use The $ Sign) $

Description:

If registering for a CEU Course, please be sure to inclue in the "description of charge" the course title and course code number. If submitting payment for certification or recertification, please be sure to state "certification" or "recertification" and the title of the specialty certication.

 

Credit Card Details:

All transactions are protected by 128 bit (high) encryption, so you can rest assured your submitted information is safe at all times. Credit card details sent directly to Authorize.net - The web's leading online credit card authority - are used for the transaction only. No credit card information is stored by the American Institute of Health Care Professionals, Inc. Once the transaction has been approved, Authorize.net transfer the funds from the purchaser's account in exchange for the services purchased. For more about Authorize.net, and their privacy policy, please see:

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