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SAMPLE
CONSERVATIVE
THEOLOGICAL UNIVERSITY
12021 Old St. Augustine Road
Jacksonville, FL 32258
Phone (904)-262-8275
1-800-GO-BIBLE
(Admissions
Only)
Application
for Finance Agreement
(Please Print or Type)
Student Information
Student
ID# (SS#) _________ - ___________
-
Date:_________________________________________________________________
Degree
Level:
Institute Associates Bachelor
Masters
Doctoral
Name
(last, first, middle) :
__________________________________________________________________________________________
Home Address
____________________________________________________________________________________________________
City
_________________________________________________
State
_________________________ Zip Code
____________________
Current
Mailing Address (if different from above)
_______________________________________________________________________
City
__________________________________________________
State
__________________________ Zip Code
__________________
Home Phone ( )_____________________________
Message Phone (
)______________________E-Mail
___________________________
Check here if this is a new address or telephone
number. ____
Please Read Carefully:
The
Alternative Payment Plan allows the student to
contract with the
University for regular payments toward tuition
only, to defer full
payment at the time of registration. A
one & one half (1
1/2%) service charge on the balance is
assessed monthly by the University.
I
request CTU to finance a total $____________ for
my Associate;
Bachelor; Masters: Doctoral level studies. Academic
hold shall
be placed on any account with balances not
in accord with this
agreement or unpaid monthly payments.
Minimum
monthly payments must be at least $100.00
for Undergraduate level students, $150.00
for Masters level students, and
$275.00
for Doctoral level students. Payments must be
made by check or money
order. Actual payment amount is determined by
amount financed and
length of time.
1,
____________________________________________________________,
therefore
understand, submit and agree to the following
type
or
print your name
payment plan for my tuition expenses in order to
defer full payment at
the time of registration:
MINIMUM
PAYMENT: I
agree to pay each month the amount of $
____________ until current
tuition contract is paid in full.
PAYMENT DUE DATE:
(Day of the month upon which
payment will be made) ___1st or 15th (circle
one)
BEGIN
DATE:
(The date on which payments will begin. Must be
30 days of
Registration) _________________________
NOTICE: A separate
financial, term payment contract must be
signed with this agreement.
Student Signature:
_______________________________________________________________________________ Date:
__________________
Do Not Write Below This
Line________________________________________________________________________________
CTU
AUTHORIZED APPROVAL SIGNATURE
SIGNATURE:
________________________________________________
POSITION:
__________________________________
DATE:
_____________________________________________________ FILE:
_________________________________________
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