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Terms and Conditions

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Payer Information

Please provide your information.

Student ID or SSN#*
First Name*
Last Name*
Phone Number*
Email Address*

Pay To
Pay ToPay Amount
Application Fee   $

   

Enrollment Reservation Fee   $

   

Late Fees   $

   

Housing Security Deposit   $

   

Campus Housing-Single (Not for deposit)   $

   

Campus Housing-Double (Not for deposit)   $

   

Extra Original Diploma   $

   

Health Insurance - Student - Medical Sciences   $

   

Health Insurance - Spouse - Medical Sciences   $

   

Health Insurance - Child/ren - Medical Sciences   $

   

Health Insurance - Clinical Sciences   $

   

Professional Liability Malpractice Insurance   $

   

Note Services Fee   $

   

SGA Fee   $

   

Educational Resource Fee   $

   

Residence Permit Fee   $

   

Other/Miscelleaneous   $

   

Total: $  0.00


Payment Method & Account Information

Please provide your payment type and payment account information.

Effective Payment Date 4/26/2017
E-mail Address*


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