_____________ 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 PRINTED Name                                                            Student email

Student SIGNATURE                                                                 Cell Phone Number

Student ID                                                                                Date         

Current Address                                                                        WBU Official    


________________________________________              ______________________________________
Name                                                                                        Cell Phone Number

________________________________________              ______________________________________
Name                                                                                        Cell Phone Number


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.

AZ State requirement please do not remove.