WAYLAND BAPTIST UNIVERSITY
_____________ Campus
I have read, understand, and agree that this is a legally binding instrument with all conditions herein. I am fully responsible for payment of all costs incurred by enrolling.
I will submit official WBU forms to WBU to DROP, ADD, or CHANGE a class. I understand and agree that the amount of refund due my account will be based upon the date I submit the official forms. The refund schedule is as follows:
I understand and agree that my account must be paid in full in order to re-enroll for future terms, receive transcripts, and/or graduate. If I default on any portion of my financial obligation to Wayland Baptist University I will be responsible for additional costs such as but not limited to reasonable collection costs, late fees and/or attorney fees.
STUDENT INFOMATION
Student PRINTED Name Student email
Student SIGNATURE Cell Phone Number
________________________________
Student ID Date
Current Address WBU Official
REFERENCE INFORMATION
________________________________________ ______________________________________
Name Cell Phone Number
________________________________________ ______________________________________
Name Cell Phone Number
PROMISSORY NOTE
I have requested and been approved to pay tuition costs on the installment plan, paying a minimum of 1/3 of said costs at the time of registration and the second and final installments on the dates listed below.
Term ______________ TOTAL Tuition costs or balance after FA $____________________
On or before
First 1/3 installment Due: 1st day of class $ ____________________
Second 1/3 installment. Due:30 days from 1st day of class $ ____________________
Final 1/3 installment. Due: 60 days from 1st day of class $ ____________________
I understand that failure to make payments as scheduled above will result in a Non-Refundable fee of $50 for each late payment.
_____________________________________
Student SIGNATURE
AZ State requirement please do not remove.