Residency Payment

Resident First Name

Resident Last Name

Email

Phone

Address

City

State

Zip Code

Identity Verification

By selecting "Yes" and making payment, I am verifying my identity as the "resident" named above who is enrolled in the COTMU Residency Program

Name of person financially responsible for payment

Relationship to resident named and verified above

Email for person financially responsible for payment

Phone contact for person financially responsible for payment

Term

Resident - Semester ($725)

Resident - Full Year ($1450)

1st payment due by September 1, 2nd payment by January 1.

Semester

Fall Payment

Spring Payment

Payment

Credit Card Number

Expiry Date

CVC/CVV

COTMU Residency Payment