
Macon Campus and Mercer
Regional Centers
MONTHLY PAYMENT PLAN
Enrollment Application
Effective Spring 2007
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Terms & Conditions In order to enroll in Mercer University's Monthly Payment Plan, please complete the enrollment form listed below and return it along with:
After we have received these items, we will send you payment coupons to remit with each month's payment. The due date and the amount will be printed on your payment coupons. 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. Please note that the health insurance premium cannot be included in the payment plan. If the amounts listed on this form are different than the total charges indicated on your tuition account, or if you have left this form blank where you should have filled in the amount that you owe for this semester, please note that Mercer will compute the correct amounts. The Monthly Payment Plan payments will be based on your total tuition and other charges that are actually due. If you add additional classes, meal plans, housing charges, etc. to your tuition account after enrolling in this plan, your monthly payments will increase accordingly. By enrolling in the Monthly Payment Plan, you agree to pay the correct amounts due, whether they are reflected in this form or not. Failure of a participant to pay an installment amount within 15 days of the due date will result in a $25 late fee. Any missed payment will prevent registration for subsequent semesters of attendance. Any account that is not paid by the end of the semester will be forwarded to collections. 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. Students whose accounts are sent to collection are not eligible to participate in future payment plans with Mercer University. If the account is sent to collection, the student agrees to pay The Corporation of Mercer University, the outstanding principal balance, interest, and 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 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 was placed with a collection agency or attorney. Please note: Student Health Insurance Premiums must be paid by the first day of class and cannot be included in the Monthly Payment Plan. If you have any questions about the Monthly Payment Plan, contact the Bursar's Office at (478) 301-1111 or 1-800-342-0841. I, the undersigned participant, hereby apply for enrollment in the Mercer Monthly 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 Monthly 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______________________________________________ Mercer Student Identification No._________________________ Address_____________________________________________ City______________________ State____________________ Zip Code__________________ Home Phone_____________ Work Phone_______________________ Ext._______________
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| Worksheet | ||
| Tuition Charges | $_________________ | |
| Meal Plan charges | $_________________ | |
| Housing charges | $_________________ | |
| Other fees (lab fees, etc.) | $_________________ | |
| Insurance Premium (unless waived) | $_________________ | |
| Total Charges | $_________________ | |
| Estimated Financial Aid (from invoice) | $_________________ | |
| Other Financial Aid (please list source and amount) | $_________________ | |
| Total Financial Aid | $_________________ | |
| Total tuition for the Monthly Payment Plan | (Total charges - total financial aid) | $_________________ |
| Divide:Total by
4 months Total by 3 months |
(fall and spring terms) (summer term) | $_________________ |
| Add:$35 enrollment fee | $____35.00________ | |
| Total amount of first payment | $_________________ | |
For assistance in completing the worksheet, please refer to our tuition rate page for tuition and housing fees, and refer to our auxiliary services page for meal plan fees. If you enrolled in our extended Education Centers, please refer to our Extended Education rate page.
Please forward this signed agreement and your check to:
Mercer University
Attn: Office of the Bursar
1400 Coleman Avenue
Macon, GA 31207
or fax this signed agreement and a
completed credit card form to:
(478) 301-2663