Credit Registration & Payment Form

Instructions

  1. Complete the registration form below. Please refer to any course or registration information if provided to you by your instructor.
  2. Be sure to provide your credit card/debit card or Echeck information.
  3. After filling out the form, click the "Submit" button to process.
  4. All information you enter is stored on a secure server and kept strictly confidential.

*Visa, American Express, Discover, MasterCard and Echeck are accepted.

If you have any questions or need to change any information that you've entered, please contact Academic and Professional Programs by calling (800) 950-1144 ext. 3718 or (989) 774-3718, or by e-mailing us at profdev@cmich.edu.

* A non-refundable service fee equal to a percent of the payment amount will be charged for payments made via debit or credit card.

Personal Information (Fields required unless noted)
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A valid date is required.
A valid email address is required.
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Course Information (Fields required unless noted)
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Payment Information (All fields required) A non-refundable service fee equal to a percent of the payment amount will be charged for payments made via debit or credit card.
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A valid account name is required.
This account type is required.
The account number is required.
A valid credit card number is required.
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