Bushnell University
Secure Payment Form
*** DEBIT CARD PAYMENTS ONLY ***
To pay by credit card please click your
browser's back button or return to
www.bushnell.edu/paymybill
and select Pay by Credit Card
Student Information
Student ID #
First Name
Last Name
This payment is for:
Select One
Student Account Payment (Tuition, fees, etc.)
Tuition Deposit ($200)
Tuition, Room, and Board Deposit ($300)
Third Party Payment
Study Abroad Payment
Other
Payment Information
Today's Date
Payment Amount
Add to School Database?
Yes
No
Enable Automatic Payments?
No
Yes
Schedule of Automatic Payment
Disabled
Daily
Weekly
Biweekly
Monthly
Bimonthly
Quarterly
Biannually
Annually
Total Number of Automatic Payments
Date of Next Automatic Payment
Credit Card Information
Name as on Card
Card Billing Address
Card Billing Zip
Card Number
Card Expiration Date
CVV2/CID
Email Address (Required for your receipt)
Phone Number
Submit
