Payment Options Form
Please check one:
Full payment
Installment
CCA members may pay in full or make two, four, or twelve separate payments. Make your check payable
to CCA and mail the forms to:
CCA
P.O. Box 75068
Baltimore, MD 21275-5068
If you are using a credit card, complete all forms and fax to (202) 336-6828. For more information, please
contact CCA at (202) 336-6700.
Line A
Write your total Dues Amount here
(Use your total dues amount from Section I, line 2, or Section II line 4 on the
previous page.)
$______________________
Line B
Choose your installment option and calculate service charge
:
1. Semi-Annually: multiply line (A) by 1.03 (3% service charge)
$______________________
2. Quarterly: multiply line (A) by 1.04 (4% service charge)
$_______
______________
3. Monthly: multiply line (A) by 1.05 (5% service charge)
$______________________
Line C
Determine your payment
1. If you choose semi-annually, divide line (B)(1) by 2
$______________________
2. If you choose quarterly, divide line (B)(2) by 4
$______________________
3. If you choose monthly, divide line (B)(3) by 12
$______________________
Payment
:
Line D
Enter the amount from line (A), (C1), (C2), or (C3)
$______________________
Line E
Voluntary Career Training Foundation (CTF) Contribution
(Suggested amount is $125 per school)
$______________________
Line F
Add amounts from line (D) and line (E)
GRAND TOTAL
$______________________
Payment Type:
Check
Credit Card
Select Credit Card:
Amex
Visa
MasterCard
Exp. Date _____/_____/_____
Charge Amount $_____________________
Account #____________________________ Authorized Signature_______________________________
NOTICE
·
Every teaching facility that is classified as a "main campus", a "branch", or "additional location" for purposes of the program participation agreement with
the Department of Education or by the accrediting agency shall be considered a school location for purposes of dues.
