Deferred Payment Agreement

							                            Deferred Payment Agreement Spring 2010


Name (printed)                                                                   ID #

                                                   WORKSHEET
Balance due on line 9 of Financial Registration Worksheet                 $

Deferred Payment Fee                                                      +$      40.00

Total Due                                                                 =$

Divide into 2 Payments                                                    ÷             2

This is the amount of each payment. (Please check below for due dates.)   =$



$                                                                                Feb. 1, 2010
1st Payment (1/2 of total due)                                                   Due Date

$                                                                                March 31, 2010
2nd Payment (1/2 of total due)                                                   Due Date


_________           I understand there is a $40 Deferred Payment Fee. I also understand that if I do not pay
                    by the above-mentioned dates, I will incur late fees and/or interest charges.



Student Signature                                                         Date



Cell Phone Number




$                                                                                Student Paydays
Potential Work Study – Monthly Payments                                          Due Date
Work Study payment plans must be approved by Karen Garcia.

___ _____           I understand I am responsible to earn and apply my on campus work earnings to my
                    student account. If I work on campus and make regular payments on my account, I will
                    not be charged the $40.00 deferred payment fee. However, if I do not apply monthly
                    payments to my account from my Bethel work checks, I will be charged a $40.00 fee and
                    the balance due will become due immediately. Account balances must be paid in full
                    prior to enrolling for the next semester.


Student Signature                                                         Date



Cell Phone Number