Please print and complete this application, then mail it to:

ECSI c/o The George Washington University TPP Application
181 Montour Run Rd
Coraopolis, PA 15108

If you need help completing this form, please contact ECSI toll free at 866-927-1438.

Student Information

Student ID Number:
___________________________________________________________
Name (First MI Last):

 ___________________________________________________________
Address 1:

 ___________________________________________________________
Address 2:

 ___________________________________________________________
City/State/Zip:

 ___________________________________________________________
Email:

 ___________________________________________________________
Home Phone:

 ___________________________________________________________
Work Phone:

 ___________________________________________________________
Fax Phone:

 ___________________________________________________________
Cell Phone:

 ___________________________________________________________

Person Financially Responsible
Name (First MI Last):

 ___________________________________________________________
Address 1:

 ___________________________________________________________
Address 2:

 ___________________________________________________________
City/State/Zip:

 ___________________________________________________________
Email:

 ___________________________________________________________
Home Phone:

 ___________________________________________________________
Work Phone:

 ___________________________________________________________
Fax Phone:

 ___________________________________________________________
Cell Phone:

 ___________________________________________________________

Tuition Payment Plan

Select a plan: Select One
  Description Months Fee Start Date End Date Sign Up By
10 Month Plan (T1010) 10 (5 Fall/5 Spring) $55 before 7/10
$75 from 7/11 to 7/31
$125 from 8/1 to 8/20		 06/05/2010 03/05/2011 08/20/2010
5 Month Fall Plan (T10F5) 5 $40 before 7/10
$55 from 7/11 to 7/31
$85 from 8/1 to 8/20		 06/05/2010 10/05/2010 08/20/2010
5 Month Spring Plan (T10S5) 5 $40 before 12/10
$55 from 12/11 to 12/31
$85 from 1/1 to 1/20		 11/05/2010 03/05/2011 01/20/2010


Student Status

Fall Tuition: Select One
Entering Fall 2010 or Spring 2011 ($21,430)
Entering Fall 2009 or Spring 2010 ($20,805)
Entering Fall 2008 or Spring 2009 ($20,196)
Entering Fall 2007 or Spring 2008 ($19,605)
Entering Fall 2006 or Spring 2007 ($18,895)
Entering Fall 2005 or Spring 2006 ($18,185)
Entering Fall 2004 or Spring 2005 - SEAS, ESIA, SMPA ($17,500)
Entering Fall 2004 or Spring 2005 - CCAS, SB ($17,000)
Entering Spring 2004 and Prior - NON-SMPA ($17,435)
Entering Spring 2004 and Prior - SMPA Major ($17,935)
Entering Spring 2004 and Prior - SMPA Minor ($35,370)
Dual Degree - BA/MD Fall 2010 7 Year Cohort ($29,572.50)
Dual Degree - BA/MD Fall 2009 7 Year Cohort ($28,164.50)
Dual Degree - BA/MD Fall 2008 7 Year Cohort ($26,823.50)
Dual Degree - BA/MD Fall 2007 7 Year Cohort ($25,546)
Dual Degree - BA/MD Fall 2006 7 Year Cohort ($24,100)
Dual Degree - Integr. Eng./MP Fall 2010 ($29,572.50)
Dual Degree - Integr. Eng./MP Fall 2009 ($28,164.50)
Dual Degree - Integr. Eng./MP Fall 2008 ($26,823.50)
Dual Degree - Integr. Eng./MP Fall 2007 ($25,546)
Dual Degree - Integr. Eng./MP Fall 2006 ($24,100)
Dual Degree - Integr. Eng./MP Fall 2005 ($22,500)

 Spring Tuition: Select One
Entering Fall 2010 or Spring 2011 ($21,430)
Entering Fall 2009 or Spring 2010 ($20,805)
Entering Fall 2008 or Spring 2009 ($20,196)
Entering Fall 2007 or Spring 2008 ($19,605)
Entering Fall 2006 or Spring 2007 ($18,895)
Entering Fall 2005 or Spring 2006 ($18,185)
Entering Fall 2004 or Spring 2005 - SEAS, ESIA, SMPA ($17,500)
Entering Fall 2004 or Spring 2005 - CCAS, SB ($17,000)
Entering Spring 2004 and Prior - NON-SMPA ($17,435)
Entering Spring 2004 and Prior - SMPA Major ($17,935)
Entering Spring 2004 and Prior - SMPA Minor ($35,370)
Dual Degree - BA/MD Fall 2010 7 Year Cohort ($29,572.50)
Dual Degree - BA/MD Fall 2009 7 Year Cohort ($28,164.50)
Dual Degree - BA/MD Fall 2008 7 Year Cohort ($26,823.50)
Dual Degree - BA/MD Fall 2007 7 Year Cohort ($25,546)
Dual Degree - BA/MD Fall 2006 7 Year Cohort ($24,100)
Dual Degree - Integr. Eng./MP Fall 2010 ($29,572.50)
Dual Degree - Integr. Eng./MP Fall 2009 ($28,164.50)
Dual Degree - Integr. Eng./MP Fall 2008 ($26,823.50)
Dual Degree - Integr. Eng./MP Fall 2007 ($25,546)
Dual Degree - Integr. Eng./MP Fall 2006 ($24,100)
Dual Degree - Integr. Eng./MP Fall 2005 ($22,500)


Student Status (Continued)

Fall Tuition (Continued): Select One
Dual Degree - BA/JD Fall 2010 6 Year Cohort ($27,075)
Dual Degree - BA/JD Fall 2009 6 Year Cohort ($25,970)
Dual Degree - BA/JD Fall 2008 6 Year Cohort ($24,915)
Dual Degree - BA/JD Fall 2007 6 Year Cohort ($24,115)
Dual Degree - BA/JD Fall 2006 6 Year Cohort ($22,750)
Dual Degree - BA/JD Fall 2005 6 Year Cohort ($21,250)
SJD Admit Fall 2010 or Spring 2011 ($21,999.50)
SJD Admit Fall 2009 or Spring 2010 ($21,102.50)
SJD Admit Fall 2008 or Spring 2009 ($20,505)
SJD Admit Fall 2007 or Spring 2008 ($19,099)
SJD Admit Fall 2006 or Spring 2007 ($18,155)
Classical Acting Fall 2010 Cohort ($9,406)
Classical Acting Fall 2009 Cohort ($9,132)
Executive MBA (Main Campus) - Fall 2010 Cohort ($21,250)
Executive MBA (Main Campus) - Fall 2009 Cohort ($20,213)
Executive MBA (Main Campus) - Fall 2008 Cohort ($19,250)
Executive MBA (Main Campus) - Fall 2007 Cohort ($18,500)
Part-Time Undergraduate and Non-Degree ($1,192/Credit)

 Spring Tuition (Continued): Select One
Dual Degree - BA/JD Fall 2010 6 Year Cohort ($27,075)
Dual Degree - BA/JD Fall 2009 6 Year Cohort ($25,970)
Dual Degree - BA/JD Fall 2008 6 Year Cohort ($24,915)
Dual Degree - BA/JD Fall 2007 6 Year Cohort ($24,115)
Dual Degree - BA/JD Fall 2006 6 Year Cohort ($22,750)
Dual Degree - BA/JD Fall 2005 6 Year Cohort ($21,250)
SJD Admit Fall 2010 or Spring 2011 ($21,999.50)
SJD Admit Fall 2009 or Spring 2010 ($21,102.50)
SJD Admit Fall 2008 or Spring 2009 ($20,505)
SJD Admit Fall 2007 or Spring 2008 ($19,099)
SJD Admit Fall 2006 or Spring 2007 ($18,155)
Classical Acting Fall 2010 Cohort ($9,406)
Classical Acting Fall 2009 Cohort ($9,132)
Executive MBA (Main Campus) - Fall 2010 Cohort ($21,250)
Executive MBA (Main Campus) - Fall 2009 Cohort ($20,213)
Executive MBA (Main Campus) - Fall 2008 Cohort ($19,250)
Executive MBA (Main Campus) - Fall 2007 Cohort ($18,500)
Part-Time Undergraduate and Non-Degree ($1,192/Credit)
Number of Credits:
Fall Credits _____________________
Spring Credits _____________________


Student Status (Continued)

Housing: Select None or One
Level 1 ($6,720)
Mount Vernon Campus ($7,500)
Level 2 ($8,300)
Level 3 ($9,280)
Level 4 ($10,150)
Level 5 ($10,450)
Level 6 ($11,550)
Level 7 ($12,650)
Level 8 ($15,500)
Housing for Affiliated and Exchange Programs - Tier One ($12,000)
Housing for Affiliated and Exchange Programs - Tier Two ($11,000)
Housing for Affiliated and Exchange Programs - Tier Three ($9,800)

 Meal Plan: Select None or One
Freshman ($3,400)
Sophomores ($2,500)
Juniors ($2,000)
Seniors ($1,000)
Meals for Affiliated and Exchange Programs - Full Meal Plan ($3,000)
Meals for Affiliated and Exchange Programs - Half Meal Plan ($1,500)
Additional Colonial Cash:
Fall _____________________
Spring _____________________
Please Note: This worksheet is for budgeting purposes only. Actual charges are assessed by the university. If you budget for additional Colonial Cash you must contact GWorld (GWorld@gwu.edu) to have the additional amount put on the GWorld card.

* A full-time program is defined as 12-17 credit hours per semester; a part time program is fewer than 12 credits per semester. Undergraduates taking more than 17 credits per semester will be charged at the rate of 1 credit hour for each credit exceeding that limit. Undergraduates in the School of Engineering and Applied Science who are required to take 18 or 19 credits in some semesters will be charged at the rate of 1 credit hour for each credit exceeding that limit. Incoming and continuing undergraduate Honor students will be allowed to take up to 19 credit hours with no additional charge for their first four semesters.
** Tuition is fixed for up to 10 consecutive semesters as long as the student maintains full-time continuous enrollment. Undergraduates taking more than 17 hours (18 or 19 for SEAS students) per semester will be charged at the per credit hour rate then in effect for each credit hour exceeding that limit.
*** The Fall and Spring semesters constitute a year.


Mandatory Fees: (Select all that apply)

Fall Student Association Fee Entering Fall 2008 to Current ($1.50/credit hour to a maximum of $22.50 per semester)
Spring Student Association Fee Entering Fall 2008 to Current ($1.50/credit hour to a maximum of $22.50 per semester)
Fall Student Association Fee Entering prior to Fall 2008 ($1/credit hour to a maximum of $15 per semester)
Spring Student Association Fee Entering prior to Fall 2008 ($1/credit hour to a maximum of $15 per semester)


Applicable Mandatory Fees: (Select all that apply)

Fall Engineering Fee ($8)
Spring Engineering Fee ($8)
Graduation Fee ($100)
Graduation Fee - Late Registraion ($135)
Registration for Continuous Enrollment ($35)
Fall Study Abroad Fee - All Programs ($400)
Spring Study Abroad Fee - All Programs ($400)
Fall Student Association Fee for Affiliated and Exchange Programs Entering Fall 2008 to Current ($22.50)
Spring Student Association Fee for Affiliated and Exchange Programs Entering Fall 2008 to Current ($22.50) ($22.50)
Fall Student Association Fee for Affiliated and Exchange Programs Entering Prior to Fall 2008 ($15)
Spring Student Association Fee for Affiliated and Exchange Programs Entering Prior to Fall 2008 ($15)


Deposits:

Total deposits and pre-payments you have already made to the school for each semester.

Fall Deposits: _____________________
Spring Deposits: _____________________
First Time Student Deposit (Freshman/Transfer Students) ($550)


Financial Aid:

Enter your Financial Aid as it appears on your award letter. Do not include Work Study. If you have questions, please contact the Financial Aid Office at The George Washington University.


Federal Stafford Loan:
______________________
Federal Plus Loan:

 ______________________
All Other Loans:

 ______________________
Grants and Scholarships:

 ______________________
Outside Grants and Scholarships †:

 ______________________
† From sources other than The George Washington University, not included on your award letter


Payment Plan Totals
  Fall Spring  

Total Tuition and Fees:
______________________
______________________
(Total of Tuition, Housing, Meals, and Fees for each semester)
(-) Less Deposits:

 ______________________

 ______________________

 (Total of all Deposits for each semester)
(-) Less Financial Aid:

 ______________________

 ______________________

 (Total of all sources of Financial Aid and divide by 2 for each semester)
Total Amount to Finance:

 ______________________

 ______________________

 (Tuition and Fees minus Financial Aid)
Number of Months:

 ______________________

 ______________________

 (See Payment Plan Information for selected plan from above)
Monthly Payments:

 ______________________

 ______________________

 (Total Amount to Finance divided by number of months in selected plan)
Application / Participation Fee:

 ______________________

 ______________________

  
First Payment †:

 ______________________

 ______________________

 (Includes months past due and application/participation fee)
† - The application fee is due immediately. If the plan has not yet started, your first monthly payment is not due until the first due date.


Billing and Payment Information
Please sign me up for Electronic Bills
Electronic Bills replace paper bills, provide 100% of the same information, are archived for up to 10 years, and are available within minutes of preparation. When an electronic bill is prepared, you will receive an Email notifying you to return to our web site and review your billing statement.

Complete your payment options below.
Automatic Payments from Checking/Savings

You can make each future payment automatically from your checking or savings account. To do so, please check the box below and fill in the following information. If you are required to make a payment now, you will be given the opportunity to do this after submitting the application.
I would like to sign up for automatic payments
Account Holder Name: __________________________________________
Account Type: Checking Savings
ABA/Routing Number: __________________________________________
Account Number: __________________________________________
I (we) hereby authorize Educational Computer Systems, Inc. to initiate debit entries to my (our) account in the entity named above ("institution"), and I (we) authorize the institution to accept and to debit the amount of such entries to my (our) account. A one-time debit shall be made to cover the application fee and any past due payments. A debit shall be made each month equal to the amount due for that month's payment.