Bushnell University
Secure Payment Form
*** CREDIT CARD PAYMENTS ONLY ***
To pay by debit card please click your
browser's back button or return to
www.bushnell.edu/paymybill
and select Pay by Debit 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
Convenience Fee (2%)
Total Amount
Add to School Database
Yes
No
Enable Automatic Payments?
No
Yes
Automatic Payment Schedule
Disabled
Daily
Weekly
Biweekly
Monthly
Bimonthly
Quarterly
Biannually
Annually
Total transactions 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
Phone Number
Email Address (Required for your receipt)
Submit
