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CREDIT CARD PAYMENTS

Visa and MasterCard are accepted. After submitting the information below, you be will
be re-directed to our secure credit-card processing site where you will enter your credit
card information. Please allow 3-5 business days for payment processing.

If you have questions about filling out this form, before you submit the form please
call (828) 328-7104 or email stella.carpenter@lrc.edu

Amount of Payment: $  
Payment is for:
Cardholder's Name:
Student's Full Name:
Address where your credit card statement is mailed:  Address:  
 City:     
 State:    
 Zip:      
Phone:
Email:

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