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California State University, Long BeachCalifornia State University, Long Beach

Short Term Loan Application for Registration Fees


INSTRUCTIONS:


1. Complete the form and use the button below to display a printer friendly version.

2. Print the "Printer Friendly Version" of the form.

3. Return the form with signatures to the Bursar's Office at BH-155.


Fields with * are required.

APPLICANT INFORMATION
STUDENT STATUS (Check one) *
ENROLLMENT STATUS (Check one) *
AGREEMENT CONTENT (Blank spaces filled out at Cashier Window)

In accepting this SHORT TERM LOAN, I certify that I am currently an admitted student for the _______________ semester and have not previously submitted payment for basic registration fees for this semester. I understand that the University, by approving this agreement, does not guarantee my enrollment in any classes. I understand and agree to all of the following terms in accepting a short term loan for 100% of basic registration fees in the amount of $ _______________for the _______________ semester:

Changes to your academic load or subsequent fee increases may affect the amount of your payments. Fee increases may not be included as a part of your contract, but are still your responsibility. For up to date information on payment amounts and due dates please refer to your account at http://My.CSULB.edu. From the main menu, go to Finances and Aid then click on Total Due Charges.

I agree to pay a $15.00 non-refundable processing fee for receiving this loan. I understand that this short term loan will be automatically applied to my student account within five working days of the date the University approves this agreement.

I agree to repay this loan on or before __________________________. If I fail to make the loan payment by the due date, all future services, including, but not limited to, registration will be withheld by CSULB until I pay the amount due in full. I understand that I may need to make payment before the loan’s due date in order to participate in Early Registration.

THIS CONTRACT IS THE ONLY NOTICE OF THE AMOUNT OF PAYMENT DUE AND DUE DATE I WILL RECEIVE.

PAYMENTS Payment can be made through https://My.CSULB.Edu

Payments may be made in person at the University Cashiers Office BH 148.The mailing address for payments is CSULB, University Cashiers' Office, BH 148, 1250 Bellflower Blvd., Long Beach, CA 90840-0103.

DELINQUENT PAYMENTS If I submit payment after _______________________, I agree to pay a $10.00 missed deadline fee and my account will be coded as delinquent. If I make a total of two delinquent payments while participating in any installment plan or short term loan agreement during my attendance at CSULB, I will become permanently ineligible for ANY future installment plans or short term loans.

REFUNDS I remain responsible for payment of this loan in full regardless of whether I increase/decrease my unit load. If I increase my unit load to more than six units, I will pay the difference between the two fee structures. I understand that if I decrease my unit load or withdraw from the University within the refund deadlines published in the Schedule of Classes, I will be eligible to receive a refund from the University of applicable fees or tuition. ALL PROCESSING FEES ARE NON-REFUNDABLE.

If Financial Aid is received subsequent to the signing of this contract, I agree to repay the loan on or before the due date. I understand that my loan payment will be deducted from my account when my Financial Aid is disbursed if a payment has not already been made. I understand that an award of Financial Aid does not cancel my payment obligation.




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