Tuition Payment Worksheet

• General Information

• Full Name*
• City & State (or Region/Country)*
• Email Address*
  
• Phone Number*
• Purpose*– Select One –An applicant seeking admissionA current student requesting to change my programA continuing/returning student applying for a new programA former student seeking readmissionOther

• Registration Information

• Academic Level of Study*– Select One –Bachelor’sMaster’sDoctoralUnclassifiedUnsure
• When will you start taking classes?*– Select One –Fall QuarterWinter QuarterSpring QuarterSummer QuarterUndecided
• Academic Year*

• Financial Resources Information

  The following resources are available for me to pay for my education:

• Personal Funds*
  • Yes, all
  • Yes, some
  • None
• Federal Financial Aid (FFA)*
  • I have never used FFA and I will not be using FFA to study at FIU.
  • I have never used FFA but intend to use FFA to study at FIU.
  • I have used FFA in the past and intend to use FFA to study at FIU.
  • I have used FFA in the past but will not be using FFA to study at FIU.
• Educational benefits from employer, tribe, church, sponsor, etc.*
  • Yes
  • No
• If you checked yes to the question above, name your sponsor and other relevant information here:
• Scholarships or awards (i.e. AmeriCorps)*
  • Yes
  • No
• If you checked yes to the question above, name your scholarship and other relevant information here:
• Veteran/Military education benefits*
  • Yes
  • No
• If you checked yes to the question above, check any/all of your benefits:
  • 
    Montgomery GI Bill–Active Duty (Ch 30)
  • 
    Vocational Rehab (Ch 31)
  • 
    Post 9/11 GI Bill (Ch 33)
  • 
    Dependents Educational Assistance (Ch 35)
  • 
    Tuition Assistance (TA)-Army
  • 
    Tuition Assistance (TA)-Air Force
  • 
    Tuition Assistance (TA)-Navy/Coast Guard

• Special Rates

  *Restrictions Apply!

• I am a full-time International/YWAM missionary and may be eligible for the International Missionary/YWAM rate*
  • Yes- I will complete the request form on the website under the Student Life tab.
  • No
• Date of Submission*
  
  MM
  
  DD
  
  YYYY