Payment Authorization for SAGE Scholars Program Your Name(Required) First Last Email(Required) Mobile #(Required) Billing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Which SAGE Program?(Required)SAGE Basic - $79 billed monthlySAGE Max - $119 billed monthlySAGE Basic - $869 billed annually (save $79)SAGE Max - $1,309 billed annually (save $119)Choose your planCard Account Number(Required) MC/VISA/AMEX/DiscoverCVV Code(Required) 3 or 4 digitsExp Date (mm/yy)(Required) Disclosure and Advisor Consent(Required) Strategies For College Inc. administers the SAGE Scholars Tuition Rewards Program for The Vermont Agency, Northern New England Agency and NPA Financial. By completing this form, I agree that Strategies For College, Inc. may bill my credit card for the SAGE plan indicated above.Signature(Required) Reset signature Signature locked. Reset to sign again NameThis field is for validation purposes and should be left unchanged.
