Payment Declaration Form
Course payment or payment arrangements must be made within fourteen (14) days of the start of the term.
Term:
Summer
Fall
Winter
Spring
Student First Name:
Student Last Name:
EC Email Address:
ID# (back of ID card):
Totals
Tuition
Part-time Adult Undergraduate
$450 per Credit Hour
x
0
.5
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
Credit Hours
-
Graduate
$700 per Credit Hour
x
0
1
2
3
4
5
6
Credit Hours
-
Audit
Adult Undergraduate
$225 per Credit Hour
x
0
1
2
3
4
5
6
7
8
9
10
11
12
Credit Hours
-
Graduate
$350 per Credit Hour
x
0
1
2
3
4
5
6
Credit Hours
-
Fees
(check all that apply)
Parking Decal (valid through 8/31/18; only one decal needed per academic year)
$30
Directed Study, Independent Study
$50 per Course
x
0
1
2
3
Course
-
Payment Options
(check all that apply)
Payment by Credit Card via
MyEC.Elmira.edu
(instructions on Student Portal)
Payment by financial aid (contact Office of Financial Aid 607-735-1728 or finaid@elmira.edu)
Other & Third-Party Options
(check all that apply)
Elmira College Staff/Dependent (Tuition Waiver form at
MyEC.Elmira.edu
/ Employee tab-bookmark)
Graduate Assistant (Tuition Waiver form at
MyEC.Elmira.edu
/ Employee tab-bookmark)
Teacher Credit Award Letter (send original letter to the Business Office 607-735-1760)
Senior Citizen / Alumni Audit Discount
Veterans Benefits (contact the Office of the Registrar 607-735-1895)
EOP Award (send original letter to the Business Office 607-735-1760)
Employer Deferral (Application form to be completed)
Deferred Payment:
$30
deferred payment fee. (see
Deferred Payment Schedule
)
Students who fail to make payments on or before the scheduled date of payment will be charged a late payment fee of $50.00 for each late payment. In addition, the student will be responsible for the payment of all reasonable attorney’s fee and other costs and charges necessary for the collection of any amount not paid when due. All refunds or adjustments are at the option of Elmira College and, if any, will be made only after strict compliance with the withdrawal procedures as published in the current Elmira College Bulletin.
Before pressing submit, please save a copy of this page for your records.
Disclaimer: Keep in mind that this is not a bill. Please refer to your official billing statement in
MyEC.Elmira.edu
portal for the final amount due.
TOTAL TUITION & FEES: