Application for Payment Plan

Student Name

Student ID

Phone Number

Current Address

Tuition Fee $

Original Due Date

Original due dates must be on the 26th of each month*

Payment Plan Fee (see above)

The amounts you entered in the 1st, 2nd or 3rd amount doesn't add up to the amount in your Total Amount"

1st Due Date

2nd Due Date

Ammount $

The 1st Amount needs to be at least 50% of your tuition fee otherwise the application might be declined!

3rd Due Date

Ammount $

Total Amount $ *

Full payment must be made within 14 days from today’s date.

Terms and Conditions Apply!

To accept the plan please click on Terms and Conditions Apply!.

Your Signature

Date