PROMISE TO PAY FORM

Entry Term*

Payment Method*

Please choose your payment method

Financial Aid
Installment Plan
Veterans Benefit

Financial Aid Students

As a student who is awarded financial assistance under federal, state, institutional and/or private programs approved by the University, I may use documentary evidence of such award as a condition for registration. I understand that if using financial aid, I have thirty (30) days from the registration date to complete all financial aid paperwork with the Financial Aid Office. Any balance remaining after financial aid money has been received, will be due at the beginning of each semester. Furthermore, I also understand that if I should drop to part-time, withdraw, or be suspended from the University, I accept responsibility for any financial aid Tusculum University is required to return by law to the Department of Education. I hereby agree to pay Tusculum University any resulting balance on my student account after the returns of such funds are made.

Installment Plan Students

I agree to pay each semester in full prior to the start of that semester. Failure to make payments in a timely manner will result in my student account being placed on hold and future registration will not be allowed. I understand that payment plans are available and information may be obtained through the Business Office. Student accounts will be placed on hold for any balances due after the start of a semester.

Use of Title IV Funds to Pay Educationally Related Charges

I authorize Tusculum University to apply any Title IV credit balance that is in excess from Federal Financial Aid that I have been awarded, to charges not relating to tuition, room and board. These charges may include but are not limited to books, supplies, graduation fees, parking fees, library fines etc. I further understand that this is voluntary and is valid from the date of signing through the date of graduation. I also understand that I may make a written request that this authorization for Title IV funds to pay educational related charges be revoked at any time with the Business Office.

Promise of Payment

Charges are due at the beginning of each semester and are payable by either a financial aid award or an installment plan. Tuition and fees are subject to revisions and may change without notice. Continued participation in a registered semester will be allowed if non-payment should occur. However, failure to keep your student account current will result in a Business Office hold and your privileges to register for future semesters will be revoked. Tusculum University reserves the right to withhold grades, transcripts, and diplomas of a student who has incurred a debt to the school or who has taken property which belongs to the school. If the student withdraws, is expelled, suspended, or dismissed from the institution for any reason, the entire unpaid amount shall immediately become due and payable.

I promise to pay to the order of Tusculum University the total amount due for such charges. I understand that if I fail to keep my account current, the University may curtail the services that are being provided to me. Upon occurrence of default, I agree to pay reasonable attorney’s fees, collection fees, and court costs if this instrument is referred to an outside source. By signing below, I agree to these terms for the entire length of my time at Tusculum University and fully intend on registering for courses.

Signature

Are you under the age of 18?*

For students under the age of 18, Parent or Guardian Name and Signature are also required.

YES
NO

Student Name*

First Last

Student ID or SSN*

Please select if you are providing your TU ID Number or Social Security Number. You must provide one.

Student ID Number
Social Security Number

Student ID Number*

Please enter your seven-digit TU Student ID Number

Social Security Number*

Please enter your Social Security Number

Student Signature*

Student Signature Date*

Signature Date

Parent or Guardian Information

For students under the age of 18, Parent or Guardian Name and Signature are required.

Parent or Guardian Name*

Prefix First Last

Parent or Guardian Signature*

Parent or Guardian Signature Date*

Accreditation

UNDERGRADUATE

GRADUATE

PROMISE TO PAY