University of Portsmouth

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STEP 1 - YOUR DETAILS
The University is currently phasing in a new webpay system, please refer to the menu on the left of the screen for payment types, if the option is not available please select from 'Payment Details' section below.

The University accepts the following card types only:

The University will not accept American Express, Electron and Diners Club cards.

PAYMENT BY CREDIT/DEBIT CARD

*	Indicates a required field.
**	Please select only one option. If you need to pay for more than one type please come back and fill in the form again.

Student Personal Details:

Surname/Family Name: *

Forename(s): *

Date of Birth: *

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Contact Details:

Telephone Number: * (no spaces)

E-Mail Address: *

Verify E-Mail Address: *

Student Registration Details:

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Student ID / HEMIS Number: *

Verify Student ID / Hemis Number: *

Course Name:

Payment Details:

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What would you like to pay for?: * **

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