THIS APPLICATON IS NOT FOR THE SCHOOL OF PHARMACY STUDENTS.

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

ECSI c/o Presbyterian College 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

Social Security Number:
___________________________________________________________
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

Social Security Number:
___________________________________________________________
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
12 Month Plan (T1012) 12 $45.00 04/15/2010 03/15/2011 08/10/2010
Regular Annual Plan (T1010) 10 $45.00 06/15/2010 03/15/2011 08/25/2010
Fall Semester Plan* (T10F5) 5 $35.00 06/15/2010 10/15/2010 08/25/2010
Spring Semester Plan* (T10S5) 5 $35.00 11/15/2010 03/15/2011 01/12/2011
Lump Sum Payment Due Now (T1001) -- $0.00 -- -- 01/07/2011
*Notes: (1) Advance or Escrow Deposits-ineligible for payment using the Tuition Payment Plan. Deposits must be paid directly to Presbyterian College.


Student Status
Tuition: Select One
Annual ($27,580.00)
Semester ($13,790.00)
 
Housing: Select None or One
Typical Double-Annual ($4,260.00)
Typical Double-Semester ($2,130.00)
Single*-Annual ($5,270.00)
Single*-Semester ($2,635.00)
Super-single*-Annual ($5,680.00)
Super-single*-Semester ($2,840.00)
Carol International House-Annual ($4,790.00)
Carol International House-Semester ($2,395.00)
Senior Hall-Annual ($6,050.00)
Senior Hall-Semester ($3,025.00)
Townhouse-Annual ($5,820.00)
Townhouse-Semester ($2,910.00)
Scottish Arms Apartments-Annual ($3,390.00)
Scottish Arms Apartments-Semester ($1,695.00)
 
Meal Plan: Select None or One
Any 17 Meal Plan-Annual ($4,410.00) (Kilt Cash-$100/year)
Any 17 Meal Plan-Semester ($2,205.00) (Kilt Cash-$50/semester)
Any 8 Meal Plan+-Annual ($2,744.00) (Kilt Cash-$300/year)
Any 8 Meal Plan+-Semester ($1,372.00) (Kilt Cash-$150/semester)
 
Notes:
* Single Room-Room designed for one (1) occupant. Super-Single Room-Room designed for two (2) occupants but assigned to one (1) occupant for an extra fee to ensure that no roommate will be assigned to the room.
+ Available only to residents of Senior Hall, Townhouses, Scottish Arms Apartments, student teachers and commuters. You must contact Residence Life to ensure that you have completed your paperwork for the Eight Meal plan.


Mandatory Fees: (Select all that apply)
General Fee-Annual ($2,000.00)
General Fee-Semester ($1,000.00)
Technology Fee-Annual ($600.00)
Technology Fee-Semester ($300.00)

Optional Fees: (Select all that apply)
Note: Choosing fees on this application will only include them in the amount to be paid on this payment plan. All necessary paperwork must still be completed at Presbyterian College.
Applied Music Fee (1/2 hour credit)-Fall (one class) ($300.00)
Applied Music Fee (1/2 hour credit)-Fall (two classes) ($600.00)
Applied Music Fee (1/2 hour credit)-Fall (three classes) ($900.00)
Applied Music Fee (1 hour credit)-Fall (one class) ($475.00)
Applied Music Fee (1 hour credit)-Fall (two classes) ($950.00)
Applied Music Fee (1 hour credit)-Fall (three classes) ($1,425.00)
Applied Music Fee (1/2 hour credit)-Spring (one class) ($300.00)
Applied Music Fee (1/2 hour credit)-Spring (two classes) ($600.00)
Applied Music Fee (1/2 hour credit)-Spring (three classes) ($900.00)
Applied Music Fee (1 hour credit)-Spring (one class) ($475.00)
Applied Music Fee (1 hour credit)-Spring (two classes) ($950.00)
Applied Music Fee (1 hour credit)-Spring (three classes) ($1,425.00)

Additional special fees may be required for matriculation or graduation at Presbyterian College. However, those fees do not qualify for payment utilizing the Tuition Payment Plan. Additional information is available on the Presbyterian College website: www.presby.edu/stuact.


Deposits:

Advance Deposit ($300)-Paid by upperclassmen. Deduct the Advance Deposit from the contract amount to be paid to Presbyterian College.


All Other Deposits: ______________________ (Total of all deposits and pre-payments you have already made or any credits on your student account.)

Notes: Advance Deposit ($300)-Paid by upperclassmen. Deduct the Advance Deposit from the contract amount to be paid to Presbyterian College. Escrow Deposit ($400)-Paid by incoming freshmen and transfers and held until graduation or withdrawal from Presbyterian College. Do not deduct Escrow Deposit from the contract amount.

Deposits may NOT be paid to Presbyterian College through the Tuition Payment Plan. Deposits must be paid directly to Presbyterian College.


Financial Aid:
(as it appears on your award letter. Do not include Work Study.)
Your award letter-includes loan amounts offered to you. All loans require paperwork which must be completed to apply for the loan funds. Include in the calculation below only those loans for which you intend to apply. If you do not intend to apply for loans offered on your award letter, do not include them below. If you have questions about loan types or amounts, please contact the Financial Aid Office at Presbyterian College. If you apply for loans that are denied, you are responsible for the amount of the loan. You may contact ECSI and adjust your contract by that amount.

DO NOT USE COMMA, DOLLAR SIGNS or SPECIAL CHARACTERS

Federal Subsidized Stafford Loan:
______________________
Federal Unsubsidized Stafford Loan:

 ______________________
Federal Plus Loan:

 ______________________
Federal Perkins Loan:

 ______________________
All Other Loans:

 ______________________
All Grants and Scholarships:

 ______________________ (Including private-such as Vocational Rehabilitation, State, and Federal scholarships and grants)
529 Plan or other State Pre-Pay Plans:

 ______________________
Any other Third Party Payments (employer, etc):

 ______________________


Payment Plan Totals

Total Tuition and Fees:
______________________
(-) Less Deposits:

 ______________________
(-) Less Financial Aid:

 ______________________
Total Amount to Finance:

 ______________________ (Tuition and Fees minus Deposits minus Financial Aid)
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.

Any unpaid balance on the student account at the end of the tuition payment plan period is due directly to Presbyterian College upon receipt of an invoice.


Billing and Payment Information
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