HERS Payment Form
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Please complete this form so we may properly apply your payment. You will receive a receipt from HERS via email. Please contact HERS at 303-871-6738 with any questions.
Name and Contact Information
First Name
Last Name
Name of Institution
Email
Phone Number
Preferred Method of Contact
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Email
Phone
Payment Information
Amount (please do not enter $ or commas)
Please note invoice number to which this payment should be applied
Institute attending, if paying tuition
If this payment is for someone other than yourself, please note their name
Message
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Contact Information