Debit/Credit.Card Payment

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Online Dog Grooming Diploma PayPlans:
Select Your Diploma Plan: 1@$99+15@$93.34 - DIPLOMA 1@$99+15@$120 - DIPLOMA+PRACTICUM

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Online Groomer Tech PayPlans:.
Select Your Groomer Tech Plan: 1st @ $99+8@$112.50 - GROOMER TECH 1st @ $99+8@$125.00 - GROOMER TECH + PRACTICUM

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Applicant Info:.

First Name:

Last Name:

Email Address:

Mailing Address:

City:

Province / State: 
Please Select... Alberta British Columbia Manitoba New Brunswick Newfoundland Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ------------------------- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Outside North America Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington (State) Washington, D.C. West Virginia Wisconsin
Country:

Zip / Postal Code:

Phone:

Applicant Date of Birth: (mm/dd/yyyy)

Social Insurance Number: xxx xxx xxx (Canadian Applicants Only)

To be eligible for an official Canadian Tax Credit, the federal government requires your social insurance number be included on the official receipt.

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Credit Card/Debit Card Info

Credit/Debit Card #

Card Expiry Date:

mm/yy

Card Verification Code (CVC)
(3 or 4 digit number)

CVC #
Exact Name on Card:

Relationship to Applicant:

My Own Credit Card Spouse, Partner, Friend, Other

Discount Code

How did you find the JKL Website?
Please Select One: JKL Member Google Other Search Engine Facebook You Tube Instagram Tik Tok Petgroomer.com Web Surfing Bookmark Other
 If your selection is not listed above, please add:     
  

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By clicking the 'Submit' button below,

I agree to pay $99 today and acknowledge that the first monthly payment will be automatically processed one month from today's date, and will continue for all subsequent months until paid, in accordance with the Enrollment Agreement.
I confirm I have read and agree to the terms of the Enrollment Agreement and confirm my submission represents my signature just the same as if I had actually signed this contract.
I confirm that I am the authorized cardholder OR have full written permission from the cardholder to use this card for this purchase.