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Centenary University

For Deposit and Miscellaneous Payments Only

Please provide the information requested below. Fields marked with a * are required.

* denotes mandatory fields

STUDENT INFORMATION

*

Student ID or Last 4 of SSN:

*

Student First Name:

*

Student Last Name:

Term/Program:

Notes:

PAYMENT INFORMATION

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Apply Payment To:

*Payment Amount

$ .

*Payment Options:

Debit Card

Debit Card

E-Check

Credit Card

ACI Payments, Inc. is licensed as a money transmitter by the New York State Department of Financial Services, the Georgia Department of Banking and Finance, and by all other states and territories, where required. NMLS #936777. 6060 Coventry Dr, Elkhorn NE 68022. 1-800-487-4567