10.6.3 Student Financial Responsibility Agreement (Example)
10.6.3 Student Financial Responsibility Agreement (Example)
(Last Modified on April 9, 2019)
STUDENT REGISTRATION / FINANCIAL AGREEMENT
This Agreement is entered into between the Student and the Board of Regents of the University System of Georgia, by and on behalf of [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ]. In exchange for registering for classes and receiving education services from [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ], I understand and agree that my eligibility to enroll in classes is expressly conditioned upon acceptance of all terms and conditions set forth in this Agreement.
I understand and agree to the following:
When I register for any class at [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] or receive any service from [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ], I accept full responsibility to pay all tuition, fees and other associated costs assessed as a result of my registration and/or receipt of services on or before the due date.
If I drop or withdraw from some or all of the classes for which I register, I will be responsible for paying all or a portion of tuition and fees in accordance with the published refund schedule.
I am personally responsible for payment of all money due regardless of my eligibility for financial aid or other assistance.
Financial aid or other financial assistance I may receive will be used to pay any and all money due to [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ], including tuition, fees, campus housing and meal plans, student health insurance, parking permits, service fees, fines, bookstore charges, or any other amount, in accordance with the terms of the aid or assistance. If some or all of my financial aid or other assistance is revoked because I drop or withdraw from classes and/or from school, I will repay all revoked aid that was disbursed to my account.
If I fail to pay all money due by the due date, [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] will place a financial hold on my student account, cancelling my class registration and preventing me from registering for future classes, obtaining transcripts or receiving my diploma.
If I fail to pay all money due by the due date and fail to make payment arrangements acceptable to [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ], [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] may refer my account to a collection agency, and I will be responsible for paying the collection agency fee, which may be based on a percentage of up to 15% of the debt, together with all costs and expenses including reasonable attorney’s fees, necessary for the collection of my account.
I authorize [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] and its agents to contact me at my current and any future cellular phone number(s), email address(es) or wireless device(s) regarding my delinquent student account(s)/loan(s) or any other debt I owe to [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ], or to provide general information from [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ]. I authorize [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] and it agents to use automated telephone dialing equipment, artificial or pre-recorded voice or text messages, and personal calls and email messages, in their efforts to reach me.
I am responsible for keeping [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] records up to date with my current physical address(es), email address(es), and phone numbers by [explain or refer to institution’s procedure]. My responsibility to do so will continue upon leaving [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] for any reason for purposes of continued communication regarding any amounts that remain due and owing to[ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ].
I am subject to and responsible for complying with all applicable [ ¶¶ÒõÉçÇø¶ÌÊÓƵ institution ] and Board of Regents of the University System of Georgia policies and procedures.
This Agreement shall be governed by the laws of the State of Georgia without regard to choice of law’s provisions, and all actions arising under this Agreement will be filed and litigated exclusively in the appropriate courts within the State of Georgia.
I understand and agree to the all of the terms and conditions above.
[Student]
↑ Top