GOVERNORS STATE UNIVERSITY  
Summer 2014 PAYMENT PLAN AGREEMENT FORM

 I hereby acknowledge and agree to the following:
   
If I register for classes from April 11 through May 24, 2014, I will pay my total semester balance as follows:

 

Installment

Due Date

Percentage
Due

                 

1

May 29, 2014

One-half

 

2

June 26, 2014

One-half

 

  • A $20 non-refundable payment plan charge will be assessed on all accounts not paid in full by the first installment date.
  • Unpaid account balances will result in my name being placed on the university hold list, which will prevent future registrations, release of transcripts and denial of other student services.
  • Account balances not paid by the installment date are subject to a $100 late fee, may be disclosed to credit reporting organizations, assessed collection costs, litigation costs, court costs or attorney fees incurred by the university in collection of amounts due.
  • I realize that I am liable for unpaid tuition and fees unless I officially drop within the 100% refund period. Failure to attend classes does not constitute an official withdrawal.
  • Failure to have met prior payment plan obligations may prohibit me from entering into a payment plan with the university for future terms.
Student Name:  
Student ID#:  
Date:  

 

*By submitting this form electronically, I agree to the terms and conditions listed above.  

*Scheduled payment date reminders will be sent to your GSU e-mail account.