Early Start Agreement and Instructions3 by 21D755G9

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									Early Start Program




_________________________________
Date

_________________________________
Name of School / School Board

_________________________________
Address

_________________________________
Address


RE: _____________________________
    (Student Name and NSU ID Number)


Dear Nicholls State University:

____________________________________, hereby agrees to pay $_________________ for the
(School name or school board name)                          (amount of payment)

above named student enrolled at Nicholls State University for the _________________ semester.
                                                           (semester paying for, ex. Fall 2012)

We understand the amount will be billed to us after the beginning of the semester and payment is

due upon receipt of the invoice.

Thank you.


________________________________
Authorized Signature

________________________________
Date
Instructions:

   1. This form can be reproduced as necessary.

   2. Insert current date and contractor address. This address will be used to bill the
      contractor.

   3. All information must be completed (student name, ID, amount of payment and applicable
      term) and the form must be signed by a designated representative of the school / school
      board for the form to be accepted by NSU Fee Collection Center.

   4. Completed forms must be submitted to the Fee Collection Center no later than the fee
      payment deadline for each semester. The deadline for each term can be found on our
      website at www.nicholls.edu/fees.

   5. A form for each student will need to be completed and submitted for each semester in
      which the student enrolls.

   6. Forms containing strikeouts or other changes will not be accepted.

   7. The contractor will be billed after the beginning of the semester and payment is due upon
      receipt of the invoice.

								
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