PAYMENT FORM Student Name*FirstLast Student E-mail:* Date of Birth:*01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Student ID: Program: Fee:Student ID Card $10Student ID Card Replacement $15Application fee $30Registration fee $25.00Official Transcript Request $10Late Payment Fee $35Degree Diploma Gold Embossed - $100Degree Diploma Frame - $150TESOL Materials Fee $139Change in Program Fee $450 Housing: Holding Deposit AgreementSelect oneHousing: Deposit $250Housing: Deposit $500 Rent Payment $ ______________________________________ F-1 International Students Fee:Pathway Application fee - $100I-20 Processing $100I-20 Deferral Fee $100Foreign Transcript Evaluation - $100Foreign Transcript Translation - $65 (one page)Foreign Transcript Translation - $130 (2 pages)CPE Exam Fee $50Course by Course Evaluation - $185Internship Course $715 (Doctoral Level Students - Weekend)Internship Course $630 (Doctoral Level Students)Internship Course $575 (Master Level Students)Internship Course $630 (Master Level Students - Weekend)Internship Course $435 (Bachelor Level Students) Dependent I-20 Processing Fees:Select the option below1 dependent - $1002 dependents - $2003 dependents - $3004 dependents - $4005 dependents - $500 Tuition: $ . DollarsCents Other fees: (Any Fees not listed above) $ . DollarsCents______________________________________ Note:________________________________Domestic Students - Degree Program Tuition 1.1. Undergraduate:Select one3 credits - $9456 credits - $18909 credits - $283512 credits - $3780 1.2. Graduate Program:Select amount3 credits - $15756 credits - $31509 credits - $4725 1.3. MBA weekend - Domestic:Select amount3 credits - $17256 credits - $34509 credits - $5175 1.4. DBA Programs:Select amount3 credits - $17256 credits - $34509 credits - $5175 1.5. DBA Weekend ProgramsSelect amount3 credits - $18906 credits - $37809 credits - $5670 1.6. Graduate Certificate ProgramsSelect amountGraduate TESOL Certificate - $4725 Graduate Certificate in Marketing - $6300Graduate Certificate in Organizational Leadership - $4725Graduate Certificate in Executive Management - $6300___________________________F1 International Students - Degree Program Tuition 2.1. Undergraduate ProgramSelect one3 credits - $13056 credits - $26109 credits - $391512 credits - $5520 2.2. Graduate Program:Select amount3 credits - $17256 credits - $3450 2.3. Doctor ProgramsSelect amount3 credits - $18906 credits - $37809 credits - $5670 2.4. MBA weekend - F1: Select amount3 credits - $18906 credits - $37809 credits - $5670 2.5. Doctor Weekend ProgramsSelect amount3 credits - $21456 credits - $42909 credits - $6435 2.6. Graduate Certificate ProgramsSelect amountGraduate TESOL Certificate - $5175 Graduate Certificate in Marketing - $6900Graduate Certificate in Organizational Leadership - $5175Graduate Certificate in Executive Management - $6900___________________________4. Certificate Program Tuition Certificate ProgramsTESOL Certificate - $2600 Certificate Programs - F1TESOL Certificate - $3400___________________________Total Payment Total:SubmitResetAfter submitting this form, please make your payment through the PayPal form provided to complete your transaction. You can also make your payment using your own PayPal account or make a payment with your credit card. Thank you.