Billing Worksheet Instructions

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					                   STUDENT ACCOUNTS BILLING WORKSHEET INSTRUCTIONS

                                                       * I M P O RTA N T *
To fill out this form online or on your computer you MUST use Adobe Acrobat Reader version 7 or higher. If you are unsure
            whether you have the required software, go here to get the latest version - http://get.adobe.com/reader/.
     This form uses auto-calculations for many fields. To ensure calculations remain accurate, TAB or click out of fields
                                         (instead of using return/enter) after entering data.
          If you would like to fill this form out manually, print the blank form out and follow the instructions below.

                   Information regarding tuition/fees and payment schedules can be referenced online at
                                         cca.edu/students/handbook/tuition_fees.

      You can access your billing statement online by logging into your WebAdvisor account at webadvisor.cca.edu.
                        Please note that statement balances do not reflect pending financial aid.

Form Section                      Field(s)                                       Instructions

 Student Info     Name, CCA ID, Phone, - Please enter complete information in the appropriate fields.
                    Cell Phone, E-Mail,
                         Undergraduate/ - Do NOT use your Social Security Number in place of your CCA ID Number.
                    Graduate, Visual &    Your CCA ID is 7 digits long and should have been assigned to you when you
                  Critical Studies Major  were accepted to CCA. If you do not have a CCA ID number, please contact the
                                          Student Records office.

                                             - You must check either the Undergraduate or Graduate checkbox to make use
                                               of the auto-calculation features in this form.

                                             - Visual & Critical Studies Majors Only: Be sure to check this box to ensure all
                                               fields calculate correctly.

        Fees                        Units    - Enter the number of units you are taking. The default amount is 15 units. If you
                                               are not taking 15 units, please key in the appropriate amount.

                                  Tuition    - Please list tuition amounts per semester. For the Schedule of Tuition & Fees,
                                               please click on the link at the top of this form.

                         Registration Fee - This is a non-refundable fee that applies to all students upon registration.

                           Insurance Fee - This fee may be waived by completing and returning the Insurance Waiver
                                           Form by September 14th for the Fall term and February 1st for the Spring term
                                           to the Student Accounts Office. If you have completed and returned the waiver
                                           form, check the Waive Insurance Fee checkbox.

                                             - Note that insurance fees apply only to full-time students taking 12 or more units
                                               OR visual & critical studies majors taking 9 or more units.

                            Activities Fee   - This fee applies only to full-time students taking 12 or more units OR visual &
                                               critical studies majors taking 9 or more units.

                            Materials Fee    - Please refer to the Schedule of Tuition & Fees for a list of all classes with
                                               materials fees.

                                 Housing - Use the drop-down box on the billing worksheet or go to cca.edu/students/
                                           housing/halls for housing rates. If you have not received your housing
                                           assignment, please enter the charge for Clifton Hall (Single/Double) and revise
                                           your worksheet as soon as you become aware of any changes. Housing
                                           assignments can be viewed by logging in to your WebAdvisor account (see link
                                           above).

                                             - If you are only applying for Spring housing enter the Spring Only rate amount
                                               for your housing assignment found online at cca.edu/students/housing/halls.

                         Housing Deposit - $750. This includes a $500 non-refundable fee and $250 refundable damage/
                                           cleaning deposit.

                Subtract Payments Made - Enter the total amount of any payments/deposits that have previously been
                                         made.
                                  Total Fees    - Enter the total of all fees in this section.

  Financial Aid                 Scholarships    - List all CCA or other institutional scholarships here. Scholarships from
                                                  institutions outside of CCA may only be listed upon providing written proof
                                                  from the granting institution to the Student Accounts Office.

                                      Grants    - List all grants including SEOG, Cal Grants, and Pell Grants.

                       Direct, Subsidized, - Enter amounts for all loans that are being accepted. Deduct origination fee(s) if
                  Unsubsidized, PLUS, and    applicable. Checking the origination fee checkboxes deducts the specified
                            Perkins Loans    percentage from the amount originally entered in the applicable field(s). This
                                             fee may apply only to Direct Subsidized, Direct Unsubsidized, and/or Direct
                                             PLUS Loans.

                                                - PLUS Loans - Please enter only the amount for which you have already been
                                                  approved.

                                                - Perkins Loan - The Master Promissory Note for this loan must be signed in the
                                                  Student Accounts office during the Add/Drop period.

                                  Other Aid     - Other aid may include outside student loans from alternative lenders. In order to
                                                  include alternative loan amounts on the billing worksheet, students must also
                                                  submit documentation of finalized approval amounts from lenders. Pre-
                                                  approval notices are not acceptable.

                                   Total Aid    - Enter the total amount of all scholarships, grants, loans and other aid.

                   Payment Due & Refund - Subtract Total Aid from Total Fees.
                                    Due
                                        - If fees exceed financial aid, enter the resulting amount in Payment Due. This is
                                          the amount you owe.

                                                - If financial aid exceeds fees, enter the resulting amount in Refund Due. This is
                                                  the amount to be refunded to you.

Payment Plans *                  Pay In Full - The Payment Due amount is due July 15th for Fall and November 1st for Spring,
                                               or upon registration if enrolling after these dates.

                                  Six Month     - Fall - The Payment Due amount is spread out in monthly payments, May
                                                  through October. Students may wait to pay their first payment on July 15th
                                                  with no penalties however, you would need to pay for May, June and July in
                                                  order to be current.

                                                - Spring - The Payment Due amount is spread out in monthly payments,
                                                  November through April.

                                                - An automatic credit card payment form is available in the Student Accounts
                                                  Office for the Six Month Plan only.

                                Half & Half     - Fall - Due July 15th and September 1st

                                                - Spring - Due November 1st and January 1st.

                  * Methods of payment include credit card (Visa, MasterCard, American Express and Discover), cash, check, or
                    wire transfer. Please include students name and ID# on all payments.

        Student   The Student is required to sign and date this portion of the worksheet.
      Signature

             Please return complete worksheet to the Oakland or San Francisco campus’ Student Accounts Office:

                  CCA Student Accounts                                                   CCA Student Accounts
                    5212 Broadway                                                          1111 Eighth Street
                   Oakland, CA 94618                                                    San Francisco, CA 94107
                   Fax (510) 594-1941                                                     Fax (415) 551-9261
                                                      STUDENT ACCOUNTS BILLING WORKSHEET                                                                                                             Reset Form

By signing this worksheet below, you agree to satisfy the obligations pertaining to students as they are stated in CCA’s Student Handbook, in its Student Catalog and on
 the College’s Website (and as revised from time to time by the College and as interpreted by the College officers) and to pay amounts due, stated here and in any
     later billing worksheets and/or statements. Information regarding tuition and fees is available online at http://www.cca.edu/students/handbook/tuition_fees.
                                         ** Please refer to the provided instructions for important information on how to effectively use this worksheet **

 Student Info                                                                                                                                  *Please do not use your Social Security Number as your CCA ID

 Name                                                                                                         CCA ID*                                                  Undergraduate              Graduate
 Phone                                       Cell Phone                                             E-Mail                                                        Visual & Critical Studies (MA only)

 Fees Please refer to the Tuition & Fees Schedule                                                   Check boxes to enable applicable semester(s)         Fall 2012                    Spring 2013
 Units     Please enter the number of units you will be or are registering for each applicable semester.

              Undergrad: 12-18 units enter $19,224. >18 units enter $19,224 + $1,602 per additional unit. <12 units enter $1,602 per unit
 Tuition
              Grad: $1,336 per unit

 Registration Fee          This fee is non-refundable.                                                                                                             $115.00                         $115.00
 Insurance Fee         Please see instructions regarding this fee.

   Waive Insurance Fee                This fee can only be waived if a waiver form is submitted by 09/14/12 (Fall), and/or 02/01/13 (Spring)

 Student Activities Fee             Please see instructions regarding this fee.

 Materials Fee         Please refer to the Tuition & Fees Schedule

 On-Campus Housing Specify Housing:
 Housing Security & Cleaning Deposit                        Apply $750 to applicable semester only. For full year, apply to Fall only.

 Subtract: Payments & Deposits Made
                                                                                                                                  Total Fees

 Financial Aid Please copy amounts listed on your Financial Aid Award Letter                                                                             Fall 2012                    Spring 2013
 CCA Scholarship
 Scholarship please specify:
 Scholarship please specify:
 SEOG Grant
 Cal Grant
 Pell Grant
 Direct Subsidized Loan                                                                Deduct 1% origination fee for this loan
 Direct Unsubsidized Loan                                                              Deduct 1% origination fee for this loan
 Direct PLUS Loan - See Directions                                                     Deduct 4% origination fee for this loan
 Perkins Loan                                                                                      No origination fee for this loan
 Other Aid DO NOT INCLUDE WORKSTUDY
                                                                                                                   Total Financial Aid
                            Payment Due Total Fees exceeds Total Financial Aid (Choose Payment Plan)
                                      Refund Due Total Financial Aid exceeds Total Fees (No Payment Plan)

 Payment Plans                                                         Select One                  Fall 2012                                       Select One           Spring 2013
                                          Payment in Full                                           Due July 15th                                                  Due November 1st
   Six Month Plan Divide Payment Due by 6                                   Due 1st of Month, May - Oct.                                             Due 1st of Month, Nov. - Apr.
 Half & Half Plan Divide Payment Due by 2                                          Due July 15th & Sep. 1st                                                 Due Nov. 1st & Jan. 1st

• I assume and agree to satisfy all of my financial obligations of these educational benefits as a student at CCA.
• I understand that it is my responsibility to update my address information. Failure to receive a reminder bill does not relieve you of the responsibility to make a
  payment.
• Failure to pay by the due date will result in a $25 late fee assessed to your account. Also, further delinquency may result in your account referred to an outside
  collection agency. Please note that you will be liable for all costs and legal fees incurred in the collection process.
• I hereby authorize CCA and/or its agents, including collections agencies, to contact me in an effort to collect outstanding debt, by use of pre-recorded messages,
  voice messages and other calls and to record calls, and by using all forms of telecommunications, including cellular phone, and/or all forms or electronic
  technology.

   Student Signature                                                                                                                                                  Date

				
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posted:9/25/2012
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