Payment Worksheet

PAYMENT WORKSHEET

FALL 2009

FAX 336-316-2942

-----------------------------------------------------Return with Payment-------------------------------------------------

PAYMENT WORKSHEET: Please complete the worksheet and the waiver forms and return with your payment.

Student ID #G_________________ Student Name___________________________________

AMOUNT DUE (SHOWN ON TUITION INVOICE): $_________________

ADDITION(S):

BOOKSTORE PURCHASES + $_________________

_________________________ + $_________________

_________________________ + $_________________

ADDITIONAL DEDUCTION(S)

 

Financial Aid______________ - $_________________

Part Time Status___________ - $_________________

AMS 1-800-635-0120 _ - $_________________

AMOUNT ENCLOSED = $_________________