CIPA PROGRAM PAYMENT OPTION(S)
FORM
PAYMENT OPTION(S) FORM
CANDIDATE REGISTRATION NUMBER (CRN) __________________________________________________
(leave empty if you do not have it)
CANDIDATE NAME __________________________________________________
There are three payment options available: Full payment or payment in either 2 or 4 installments. The
amount payable, in US Dollars, for each option is mentioned as follows. You are required to circle the
payment option/amount which you intend to make in order to register for the CIPA Program.
Currency: USD Full Payment Payment in 4 Installments Payment in 2 Installments
1st 2nd
3rd 4th 1st 2nd
No Discount
Total Fee Payable by Candidate 2200 550 550 550 550 1100 1100
After 10% Discount
Total Fee Payable by Candidate 1980 495 495 495 495 990 990
After 20% Discount
Total Fee Payable by Candidate 1760 440 440 440 440 880 880
Payment Option Description Fee Components are:
Full Payment Option
You pay once and in full to register for the
complete CIPA Program
1) Program Registration Fee; 2) 4 Study Texts; 3) Shipment Costs; 4) 4 Mock Exams; 5) 4 Exam Sittings (one sitting per module); 6) PER Fees; 7) CIPA Certificate Fee
4 Installment Option
You pay in four installments: each
installment registers you for one module
of your choosing
First installment includes: 1) Program Registration Fee; 2) 4 Study Texts; 3) Shipment Costs; 4) 1 Mock Exam; 5) 1 Exam Sitting; 6) PER Fees; 7) CIPA Certificate Fees Second, Third, and Fourth installment includes: 1) 1 Mock Exam and 2) 1 Exam Sitting per module for 3 modules
2 Installment Option
You pay in two installments: each
installment registers you for two modules
of your choosing
First installment includes: 1) Program Registration Fee; 2) 4 Study Texts; 3) Shipment Costs; 4) 2 Mock Exams; 5) 2 Exam Sitting2; 6) PER Fees; 7) CIPA Certificate Fees Second Installment includes: 1) 1 Mock Exam and 2) 1 Exam Sitting per module for 2 modules
I fully understand the payment options plan and agree to pay all Fees applicable in full and on time to the best of my ability.
CIPA PROGRAM PAYMENT OPTION(S)
FORM
CANDIDATE SIGNATURE: ____________________________________ DATE: _____________________
