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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 ID #
First Name
Last Name
This payment is for:
Today's Date
Payment Amount
Convenience Fee (2%)
Total Amount
Add to School Database
Enable Automatic Payments?
Automatic Payment Schedule
Total transactions of Automatic Payments
Date of Next Automatic Payment
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)