Special Checkout | College Admission Central

[MM_Form type='checkout'] [MM_Form_Message type='error']

[MM_Form_Section type='accountInfo']

Account Information

First Name: [MM_Form_Field type='input' name='firstName' class='form-control']

Last Name: [MM_Form_Field type='input' name='lastName' class='form-control']

Email: [MM_Form_Field type='input' name='email' class='form-control']

Username: [MM_Form_Field type='input' name='username' class='form-control' isRequired='true'] Please choose your username carefully. It will be your publicly-visible name on CollegeJabber™. Do not use your full name if you wish to remain anonymous on Jabber. Do not use your email address. Upper/Lower/Mixed case OK.

Password: [MM_Form_Field type='input' name='password' class='form-control']

Phone: [MM_Form_Field type='input' name='phone' isRequired='false' class='form-control']

[/MM_Form_Section] [MM_Form_Section type='billingInfo']

Billing Details

Credit Card: [MM_Form_Field name='ccNumber' class='form-control']

Security Code: [MM_Form_Field name='ccSecurityCode' class='form-control']

Expiration Date: [MM_Form_Field name='ccExpirationDate' class='form-control']

Billing Address

Address: [MM_Form_Field name='billingAddress' class='form-control']

City: [MM_Form_Field name='billingCity' class='form-control']

State: [MM_Form_Field name='billingState' class='form-control']

Zip: [MM_Form_Field name='billingZipCode' class='form-control']

Country: [MM_Form_Field name='billingCountry' class='form-control']

[/MM_Form_Section] [MM_Form_Section type='shippingInfo']

Shipping Address

Shipping Method: [MM_Form_Field name='shippingMethod' class='form-control']

Shipping is the same as billing [MM_Form_Field name='shippingSameAsBilling']

[MM_Form_Subsection type='shippingAddress']

Address: [MM_Form_Field name='shippingAddress' class='form-control']

City: [MM_Form_Field name='shippingCity' class='form-control']

State: [MM_Form_Field name='shippingState' class='form-control']

Zip : [MM_Form_Field name='shippingZipCode' class='form-control']

Country: [MM_Form_Field name='shippingCountry' class='form-control']

[/MM_Form_Subsection]

[/MM_Form_Section] [MM_Form_Section type='coupon']

Coupons

[MM_Form_Field name='couponCode' class='form-control'] Apply Coupon [MM_Form_Message type='couponSuccess'] [MM_Form_Message type='couponError']

[/MM_Form_Section]

[MM_Form_Data name='productName']

[MM_Form_Data name='productDescription']

Product Price: [MM_Form_Data name='productPrice']
Shipping Price: [MM_Form_Data name='shippingPrice']
Discount: [MM_Form_Data name='discount']
Total Price: [MM_Form_Data name='totalPrice']

[MM_Member_Decision isMember='true']

[MM_Form_Field type='input' name='gift'] Is this a gift?

[/MM_Member_Decision]

Join College Admission Central absolutely risk-free. If you are not pleased with your monthly membership for any reason, you can cancel it with no further obligation. Just click the “Cancel Membership” button and no further billing will occur.

I accept the terms & conditions of membership in College Admission Central

[MM_Form_Field type='input' name='captcha' style='clean'] [MM_Form_Button type='all' label='Submit Order' id='submitorderbutton']

[/MM_Form]