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Pay Invoice
Personal Information
Fields marked with a * are REQUIRED in order for the transaction to be approved. Missing information will automatically be declined.
First Name:
*
Last Name:
*
City:
*
State:
*
Phone
*
Email Address:
*
Invoice
Please refer to your invoice and enter the number below: If you don't have an invoice number enter a short description.
Invoice Number/Description
*
Invoice Amount:
*
Note see new fee schedule as of 1/2021 above.
(no dollar signs: e.g. 50.00, not $50.00)
Credit Card Information:
VISA, MasterCard, and American Express ONLY. Discover is NOT accepted.
Cardholder Name:
*
Credit Card Number:
*
Month
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
Security Number:
*
It is a 3 or 4 digit code embossed or imprinted on the signature panel on the reverse side of Visa, MasterCard and on the front of American Express cards.
A 4% convenience fee will be applied to all transactions. This fee is to cover the processing charges and ensure smoother service for your convenience.
Basic Fees as of 1/2022
Short Form Application $495
Exam Fee $175 (+$200 in-office fee)
Annual Fee $350
Recertification Fee $350
Forms
Additional Online Directory Form
For detailed fees, please click
here
.