B21 Enrollment Agreement Yes We Can

  • Student Information

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  • Program

  • Payment Information

  • Any credit card/debit card payment will be subject to a 3% processing fee

  • By checking this box I agree to provide bank or credit card information below and authorize Cybertek as an "Authorized cardholder and user” to make all tuition payments on the due date through the automated payment system.

  • ID Information

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  • Please use WHITE background. You can use your Smart Phone to take the photo.

  • Emergency Contact Information