CPS Payment Options Form

Student Information
Full Name*
Email*
Home Phone*
Work Phone
Student ID*
Date of Birth*
MM slash DD slash YYYY
Payment Options
Each College of Professional Studies student must complete the Payment Options Form. This gives the Business Office the information needed to process your tuition account. Please read the details below for a description of each option.
1. Pre-pay: Students using this payment method may register for a full semester of courses; however, courses not paid at the time of registration will be coded “pre-registered.” The student is responsible for ensuring that payment is received by the Business Office by the registration deadline. Payments may be made by check, money order, cashier’s check or credit card. Students may also make payment online by credit card or ACH transfer, preferably through my.indianatech.edu.
2. Financial Aid: Students using financial aid to pay for their tuition are responsible for ensuring that all proper paperwork is completed in a timely manner. A FAFSA must be on file with our financial aid office BEFORE registration. Students whose aid does not cover the entire tuition charges must make sufficient arrangements with the Business Office. Students who do not qualify for aid or their aid is canceled for any reason will be required to pay their account in full and provide a new Payment Option Form for future courses.
3. Post-9/11 GI Bill ®: (Chapter 33)
4. VA Vocational Rehabilitation: (Chapter 31)
5. Military Tuition Assistance: Students utilizing Army, Navy, Air Force, or Marine Corps tuition assistance.
6. Direct Billing: Some employers may wish to have their employees’ tuition billed directly. Students should contact their admissions representative or the Business Office for more information. *Option only available to students that receive employer reimbursement. If student intends to pay out of pocket, they must choose Pre-pay.
7. Voucher/Authorization Process: Students whose employer uses a voucher system will choose this option. Vouchers are an approval for each course obtained by the student from the employer. The voucher or authorization form is due to the Business Office by the registration deadline of each session.
8. Deferment Tuition Plan: Students who receive tuition assistance from their employer or from other GI Bill ® assistance must complete the deferment section of the Payment Option Form. These students qualify to defer the tuition for 45 days from the end date of each session. If the tuition is not received by the scheduled due date, a $50.00 late fee will be posted to the student account. For military students: fill in the information about the military benefit you receive.
9. Corporate Discounting: Corporate Discounting is only available to approved companies. Requires additional paperwork along with Business Office review and approval. This is not a payment option, you will need to select how tuition after the discount will be paid.
10. Multiple payment methods may be used in conjunction with one another. The method that pays the largest part of tuition will be considered the primary method. It is the student’s responsibility to ensure that the payment requirements of their primary method are consistently met to ensure that they are cleared for each session and do not incur late fees.
Select one of the following payment options.*
- Pre-pay
- Financial Aid
- Post 911 GI Bill ®
- VA Vocational Rehabilitation
- Military Tuition Assistance
- Direct Billing
- Voucher/Authorization Form Process
- Deferment for Employer Assistance
*Subject to approval by the Business Office. You will be contacted if another option is required
Date FAFSA Filed*
Employer*
Deferment Information
Employer*
Phone*
Employer Contact Person*
Annual Employer Assistance Amount*
Description of Reimbursement Policy*
I understand and agree that:
- I alone am fully responsible for full payment of all tuition, fees and books by the indicated due date, regardless of whether or not I receive payment from my employer. It is my responsibility to provide all necessary information (including grades) to my employer according to their policy regarding reimbursement.
- The university may contact my employer to determine whether I am eligible for the indicated tuition reimbursement.
- Any balance outstanding after the indicated due date will incur a late fee of $50 in addition to the monthly late charges.
- I will not be permitted to register while I have a past due balance and any current registrations may be canceled.
- I have read and accepted this agreement and understand this form must be filed each academic year
Verification
All the information listed on this application is, to the best of my knowledge, accurate and truthful. I have elected to pay for my tuition as selected above. I understand that my account is my responsibility, regardless of whether or not I receive payment from my employer or other financial assistance and I agree to follow Indiana Tech’s payment policies. I understand that in the event my account is more than 30 days past due I will be assessed a $50.00 late charge per month on the past due balance. Due to lack of payment, the university may give my account to an outside agency to seek restitution. Furthermore, in the event the university has to incur any expenses collecting this account, I agree to pay all the costs of collection. This includes, but is not limited to, collection agency fees up to 50%, court costs, and/or any reasonable attorney fees. I authorize the university to release financial information about my account to those involved with collecting the balance due.
Tuition Policy Force Majeure Events
Indiana Tech may terminate or temporarily suspend performance of any part of this Contract, without notice, in the event Indiana Tech’s obligations and/or duties under this Contract are prevented or delayed, either directly or indirectly, by consequence of a Force Majeure Event. A Force Majeure Event means a cause or event beyond the reasonable control of Indiana Tech, including, but not limited to, an act of God, natural disaster, act of war, act of terrorism, or act of the public enemy; national emergency, moratorium, riot, public protest, or demonstration; flood, tidal wave, fire, explosion, bomb detonation, nuclear fallout, windstorm, tornado, hurricane, sinkhole, earthquake, or other casualty, disaster, or catastrophe; epidemic, pandemic or other infectious disease, or other similar causes; any existing or future laws or acts of the Federal or any state government (including specifically, but not exclusively, any orders, rules or regulations issued by any official or agency of any such government) resulting in a complete or partial shutdown; or any other cause or causes (whether or not similar in nature to any of those specified above) beyond Indiana Tech’s reasonable control, irrespective of whether such contingency is specified herein or is presently occurring or anticipated.In the case of a Force Majeure event, Indiana Tech reserves the right to determine how and by what method educational instruction will be provided to the student. Educational instruction may be provided through methods consistent with Indiana Tech’s philosophy, as practicable under the circumstances, and at locations removed from the regular instructional rooms or buildings, including virtual instruction. Indiana Tech assumes no responsibility or liability for failure to perform any terms or conditions of this Contract due to circumstances beyond its control. No refund, recompense, or compensation is provided for tuition of fees and/or financial aid in the event Indiana Tech must change its method of instruction, suspend or close due to a Force Majeure Event, nor retribution for discomfort. Indiana Tech shall not be responsible for any failure to provide educational programs or instruction in the event Force Majeure conditions exist. In such event, Indiana Tech shall not be obligated to refund any amount the student already paid pursuant to the Contract. Nothing in this Contract shall be construed to relieve the student of his/her payment obligations under this Contract, or waive any right or claim of Indiana Tech for payment under the terms of this Contract. Governing Law and Interpretation. This Agreement shall be interpreted, enforced, and governed under the laws of Indiana. This Agreement shall in all respects be interpreted, enforced and governed by and under the laws of the State of Indiana, without regard to choice of law principles. Should any arbitrator or court of competent jurisdiction declare any provision of this Agreement unenforceable, all other provision of this Agreement shall not be affected and will remain enforceable.By typing your name, you are agreeing to these terms and conditions.
Entering your first and last name below constitutes a legal signature confirming that you acknowledge and agree to the above terms.
Full Name*

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