LifeWays North America

Early Childhood Certificate Training Payment Plan

First name

Last name

Email

Today's Date

Month

Day

Year

Training Location and Start Date

SECTION ONE: PAYMENT PLAN OPTIONS

For more information on our income-based Tuition Model, please see the Admissions and Fees page on our website.

Note: The prices for auditing the LifeWays Early Childhood Certificate Training are $600 less (due to no mentor assigned for auditing student). Contact Kari Cottrell at finances@lifewaysnorthamerica.net if you choose to audit the training.

To determine your tuition please mark your income bracket.

Income Bracket A -$90,000 and above: $6,450 tuition

Income Bracket B -$75,000 - $89,999: $6,200 tuition

Income Bracket C -$74,999 and below: $5,950 tuition

OPTION 1 - PAYMENT IN FULL PRIOR TO START OF TRAINING:

Please mark if paying in full. Credit/debit card charged now for:

Income Bracket A: $6,450

Income Bracket B: $6,200

Income Bracket C: $5,950

OPTION 2 - 50% UPFRONT & MONTHLY INSTALLMENT PAYMENTS

A $100 processing fee is assessed for all payment plans, of which $50 is included in the first payment.

To confirm your 50% upfront payment and installment plan payments please mark your income bracket:

Income Bracket A: $3,275

Income Bracket B: $3,150

Income Bracket C: $3,025

AND Monthly Installment Plan SET-UP for Option 2:

I would like to set up a monthly installment plan for the remaining half.

I will contact Kari Cottrell at finances@lifewaysnorthamerica.net after completing this form.

OPTION 3 - INDIVIDUALIZED PAYMENT PLAN

A $100 processing fee is assessed for all payment plans.

I would like to discuss creating a payment plan other than the options listed above. I will contact Kari Cottrell at finances@lifewaysnorthamerica.net after completing this form.

PLEASE NOTE: FUNDAMENTALS RETREAT PARTICIPANTS

I have attended and paid tuition for the Fundamentals Retreat prior to this training and/or I work for the LifeWays Representative Site and will need a customized payment plan to include these discounts.

Yes, and I will contact Kari Cottrell at finances@lifewaysnorthamerica.net after completing this form.

Name of Representative Site

PLEASE NOTE: EARLY BIRD DISCOUNT

To qualify for our $225 EARLY ENROLLMENT DISCOUNT, an application and $100 fee must be received AND Contract and Payment Plan must be completed by the early enrollment deadline.

I understand I need to confirm my training location's early bird dates on LifeWay's website.

SECTION TWO: PAYMENT METHOD AUTHORIZATION AND INFORMATION

NOTE: To be able to attend the training you must have on record your signed and approved payment plan, contract and first payment prior to the first day of training.

I agree to the above-checked payment plan and authorize charges as indicated.

CREDIT/DEBIT CARD:

NAME ON CARD

EXPIRATION DATE

SECURITY CODE

BILLING ADDRESS

CELL PHONE

SECOND PHONE NUMBER

ACH

Checking

Savings

Name on Account

Routing Number

Account Number

Signature

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For questions about this form, contact Kari Cottrell at finances@lifewaysnorthamerica.net