Hanover College

Payments can only be made once you have received your acceptance letter which include your student ID number.

You must apply to the Summer Academy program of your choice before using this payment form.

Legacy and AHEC students are eligible for a $50 discount. Please subtract this from your total amount owed.

Student Information

Student ID Number

Name of Academy Enrolling In

First Name

Last Name

Email Address

High School Name

Is parent an alum?

SelectYesNo

Total Amount to Pay (in dollars)

Payment Information

Card Number

Expiration

MM010203040506070809101112 / YYYY

CSC

Signature and digits from card #123

On most cards, the 3-digit card security code (CSC) is on the back, to the right of the signature.

XXXX XXXXXX XXXXX1234

On American Express cards, the 4-digit card security code (CSC) is on the front, to the top-right of the card number.

Email Address

Card owner email address; used for email confirmation and receipt.

Confirm Email Address

Must match card owner email address.

First Name

Last Name

Address

City

State

Select

Zip/Post Code

Phone Number

Payment Service Fee

An additional service fee of $0.00 will be added to the payment amount.

Payment Authorization

I authorize Hanover College to initiate a charge to my Credit/Debit Card the amount of $0.00 for: Make Summer Academy Payment.

Please be sure to review all your information for accuracy before submitting this form.