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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________________________________________________________________________________


SIGNATURE: ________________________________________________     POSITION: __________________________________

DATE: _____________________________________________________     FILE: _________________________________________

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