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International Student Payment Form

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- The Diocese of Davenport welcomes you to our International Student Program. We are very excited you have chosen us for your education in the United States.
  
  We offer 2 forms of payment:
  
  1. Credit Card/Debit
  2. By Mail
  
  We will process and mail you the original I-20 and supporting documents once payment is received. The I-20 can only be sent to the student no one else, so please make sure the students’ address is correct.
  
  $300 payable to the Diocese of Davenport for processing, shipping, etc. (Non-Refundable)
  
  This payment only covers these items, 1 year tuition, additional fees and or application fees are handled with the school directly.
- Student Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student First Name REQUIRED Please fill out this field. Please enter valid data.
- Foreign Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
- Province/Territory State REQUIRED Please fill out this field. Please enter valid data.
- Postal Code REQUIRED Please fill out this field. Please enter valid data.
- Country REQUIRED Please fill out this field. Please enter valid data.
- Home Phone REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Student Date of Birth (MM/DD/YYYY) REQUIRED Please fill out this field. Please enter a date.
- Parent Last Name REQUIRED Please fill out this field. Please enter valid data.
- Parent First Name REQUIRED Please fill out this field. Please enter valid data.
- School Attending REQUIRED Please fill out this field. Please enter valid data.
- Term Fall Spring
- Year REQUIRED Please fill out this field. Please enter valid data.
- Credit Card/Debit - Please press "Pay Now"
  Mail - Please press "Pay Later"
  
  $300 payable to the Diocese of Davenport for processing, shipping, etc. (Non-Refundable)
  
  BY MAIL
  
  Fee:$300
  
  Check and Money Order payments are payable to Diocese of Davenport.
  
  Mail to:
  Diocese of Davenport - International Students
  780 W. Central Park Avenue
  Davenport, IA USA 52804-1901
- Fee REQUIRED 300.0 – Fee Please fill out this field.
Total:

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