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Qurtuba Online Academy pre-approved payment form

This form is to be completed if you intend to make a pre-approved payment as per agreement with Qurtuba Online Academy Finance.

"*" indicates required fields

Request Type*

Payment Request

Please enter a number greater than or equal to 5.
Please provide Details for the Request being made.

*If this relates to specific students, please indicate the student details as well.

Payment

If you already have pre-approval, please enter details below to process and complete payment.
Please enter the code provided to you
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Price: R500.00

Personal Details

Kindly complete you basic details below before completing the process.
Name*

Payment Total

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