Service Fee Payment

Please make a payment through the form below using credit card via PayPal. You can find the information on the service fees and insurance in the Counselling page. If you don’t know how much you are paying, please contact your servicing counsellor.

Payment / サービス料金支払い

Prefix / 敬称 *

First *

First

Last

Email / Eメールアドレス *

Phone / 電話番号 *

Payment Purpose / 支払い目的 *

Program Name / プログラム名 *

Please enter the program name

Details / その他詳細

Please enter the detail if you chose Other.

Your Service Provider / サービス担当者名 *

Service Fee / サービス料金 *

Please enter the service fee amount./ サービス料金の金額をご記入ください。

Total / 合計

If you are human, leave this field blank.