Tuition Deferral Agreement Red Deer College by liaoqinmei

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									                                           Student Funding & Awards
                                           Red Deer College                               TUITION DEFERRAL
                                           100 College Blvd.
                                           Box 5005
                                           Red Deer, Alberta
                                                                                                AGREEMENT
                                           CANADA T4N 5H5
                                           Telephone: 403.342.3254
                                           Fax:        403.342-3262
                                           Web-site: www.rdc.ab.ca
The personal information that you provide on this form is being collected under the authority of the Post-Secondary Learning Act, the
Income and Employment Services Act, and the Freedom of Information and Protection of Privacy Act of Alberta. It will be used by Student
Funding and Awards in order to accommodate the deferral of tuition payment. The information will be protected in compliance with the
provisions of the Freedom of Information and Protection of Privacy Act. The information will be retained by the department in accordance
with approved Information Management guidelines, after which it will be destroyed in a secure manner. If you have any questions about the
collection and use of this personal information, please contact the Student Funding and Awards office, Red Deer College, 100 College
Blvd., Box 5005, Red Deer, Alberta, T4N 5H5, Telephone: 403. 342.3254.

STUDENT INFORMATION
LAST NAME                                       FIRST NAME                                   DATE (DD-MM-YYYY)


STUDENT ID #                                    PROGRAM OF STUDY                             TERM


ADDRESS                                                               CITY                               PROVINCE


POSTAL CODE                                     CONTACT PHONE                                EMAIL ADDRESS



REASON FOR DEFERRAL




    PAYMENT SCHEDULE                            DATE                       AMOUNT

         Installment #1

         Installment #2

                                                        TOTAL


TERMS AND CONDITIONS
    1.    I must notify Red Deer College of any change in address and/or telephone number.
    2.    I understand that if:
          a)   any payment is not received by the scheduled date, and/or
          b)   any payment returned to Red Deer College marked Non-Sufficient Funds or Stop Payment
          This agreement becomes null and void, and all outstanding amount(s) will be sent to a Collection Agency for immediate action.
    3.    By signing this agreement, I acknowledge that I owe the amount(s) stated and agree to pay Red Deer College the outstanding
          balance as detailed on my account.

STUDENT SIGNATURE                                                     DATE


STUDENT FUNDING & AWARDS OFFICIAL                                     DATE



                                  Copy 1 – Student Funding & Awards   Copy 2 – Student
                                                                                                                                    07/12

								
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