
Cecil B. Day Campus
DEFERRED PAYMENT PLAN
Enrollment Application
Terms & Conditions In order to enroll in Mercer University's Deferred Payment Plan, please complete the enrollment form below and return it along with:
After we have received these items, we will send you a payment coupon for the final payment which will be due 30 days after the last official day of class for the semester. The due date and the amount will be printed on your payment coupon. You must sign a new agreement and pay the $35 enrollment fee for each semester that you are enrolled. In order to avoid a late payment fee of $25.00, the enrollment process should be completed by the first official day of class for the semester. The $35.00 enrollment fee is non-refundable. Effective January 1, 1999, students who have been turned over to collections on or after September 1, 1998, are no longer eligible to participate in any of Mercer University Atlanta Campus' payment plans. Failure to make payment within 15 days of the due date will result in a $25.00 late fee. Registration in the currently enrolled semester is subject to cancellation if the student fails to pay the balance on a previously contracted semester. This signed agreement form constitutes a contract between the student and the university. Failure to comply with the Terms and Conditions could result in collection procedures being initiated. If the account is sent to collections, the student agrees to pay the Corporation of Mercer University the outstanding principal balance, interest, and the costs of collection as necessary for the recovery of any amount not paid when due. The student also agrees to pay all costs of collection, including attorney's fees and expenses, should it be necessary for Mercer University to place the account with a collection agency or an attorney. The student also understands that collection costs will be a minimum of 33 1/3% or up to 67% of the outstanding balance at the time the matter is placed with a collection agency or attorney. If you have any questions about the Deferred Payment Plan, contact the Atlanta Bursar's Office at (678) 547-6121. I, the undersigned participant, hereby apply for enrollment in the Mercer Deferred Payment Plan. By placing my signature below, I acknowledge that I have read and will be required to comply with all of the Terms and Conditions of the Deferred Payment Plan as set forth in this Agreement. I understand and intend for this application to constitute a legally binding agreement between the undersigned and Mercer University. Student's Signature____________________________________ Date_________________________________________________ Term________________________________________________
Student Information Name_______________________________________________ Student Number_______________________________________ Home Address________________________________________ City______________________ State____________________ Zip Code___________________ Home Phone_____________ Work Phone________________________ Ext._______________ |
***Please note that the Health Insurance Premium can not be included in your Deferred payment plan. The premium must be paid in full with the first payment.***
| Worksheet | ||||
| Down Payment | $ 175.00 | Total tuition charges | $__________ | |
| Add: Enrollment Fee | $ 35.00 | Less: Down payment amount | $ 175.00 | |
| Add: Health Insurance Premium (unless waived through Bearport) | $ 373.00 | Less: Health Insurance Premium (if not waived) | $ 373.00 | |
| Add: Any amounts not reimbursed by employer | $________ | Less: Amount paid for unreimbursed tuition and fees | $__________ |
|
| Amount of First Payment | $________ | Balance due at the end of the semester | $__________ | |
For assistance in completing the Worksheet, please refer to our tuition rate page.
Please forward this signed agreement, proof of your eligibility for company reimbursement, and your check to:
Mercer University
Bursar's Office
3001 Mercer University Drive
Atlanta, GA 30341
Or fax this signed agreement, proof of your eligibility for company reimbursement, and a completed credit card form to:
(678) 547-6135