MDII Out Of State Enrollment - National Digital Equity Center

Payment for Out-Of-State Class

You have enrolled in an NDEC class from a state other than Maine where you are not part of a pre-paid NDEC classes program. The cost per class is $50.00. Please complete the payment form below to pay online with a credit or debit card.

Name of Person Enrolled*
First Last
Company or Organization, if applicable
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Address If Different From Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
# of Out of State Classes Quantity
Price: $50.00
Will you pay for your subscription yourself or will a referring organization pay for your subscription?
- Self Pay
- Referring Organization
If payment is from a referring organization, please note that your access to classes will begin when payment is received from that organization.
If self pay, will you be paying by check or by credit/debit card or PayPal online?
- Pay by check
- Pay by credit/debit card or PayPal (see below).
If paying by check, please address check to: National Digital Equity Center 297 Bath Rd Wiscasset, ME 04578 We will notify you when your payment is received.
Payment Method

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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