Enter Payment Info
Please use this form as a way to accurately keep track of your payments

For Payment info, we only need enough info to connect your payment with your permit id#

After you enter your info we will  match your payment. When your payment is confirmed we will send you a confirmation text/receipt.

If you do not receive some sort of confirmation of payment please contact us at 7187918807.

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Lesson #
Date *
ДД
.
ММ
.
ГГГГ
Phone# (Use the same phone # for all forms) *
Permit ID# (Digits only, No spaces, no other characters) *
Email
Instructor (Enter your instructor's phone# or 7187737376 if you do not yet have an instructor)
Invoice#
Enter your Transaction Id# (Check your transaction history from your form of Payment) - If you paid cash then enter the word: CASH - or you can enter your FB name if you paid through FB and can't locate the transaction# *
Amount paid *
Form of Payment
Services related to this transaction (Check all that apply)
Taken By (Cash payments)
Request a Receipt
Notes
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