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Virginia International University
4401 Village Drive
Fairfax, VA 22030
Telephone: (703) 591-7042
Fax: (703) 591-7048
TUITION PAYMENT PLAN AGREEMENT FORM
Purpose of this form: Use this form if you are not able to pay your full tuition balance at the beginning of the semester. You must meet all due dates
that are established by the university. These dates are the same for all students.
Student’s Name: ________________________________________________________________________________
First Middle Last
VIU ID#:___________________ Program of Study: ___________ Semester: _______________________
Address: ______________________________________________________________________________________
Street City State Zip
Tel: ____________________________ E-mail:_______________________________
Terms and Conditions
1. I agree to pay my tuition balance under the terms of Plan _____. I request this benefit from Virginia International University.
2. I agree that the plan can’t be changed or canceled after it gets approved.
3. I agree to pay additional $30 per installment.
4. I agree to pay all my installments on time understanding that this means on or before the due date established.
5. If I pay by check and it is returned for insufficient funds, then I will pay the penalty and late fee plus a $40 returned check fee.
6. Tuition payments received are first applied against the oldest outstanding amounts.
Late Payment Policy
7. Penalty and Late fee. If I fail to pay the full due amount on or before the due date, I agree to pay a late fee of 3% on each installment payment
that is delinquent. I understand that this late fee of 3% will be accumulating until the day I pay the total dues. This penalty and late fee will be
added to my account starting from the day following the due date. Late fee will only apply to the tuition and installment fee and weekends and
holidays are counted towards the late days.
8. Notice. After 1 week of account delinquency I will be informed in writing by Accounting Office of penalty and late fee realization. I understand
that failure to pay my dues could affect my student status.
9. Lose eligibility for payment plan. If I fail to pay my installments on time on more than one occasion, then I will not be eligible for a payment
plan the following semester.
10. Readmission withholding. If I have any outstanding tuition balance, then I will not be able to enroll for future classes until I fulfill my obligation
and I may risk my student status.
I agree, and have read and understood all the above terms and conditions.
Student Signature: _________________________ Date: _______________
Office Use Only
Payment History Paid Fees
Accounting Officer’s Signature: _________________ Date: _______________
Director of Finance’s Signature: ___________________ Date: ________________
We will post the due date reminder around the campus, however, we are not obligated to inform you individually. It’s your responsibility to adhere to the
due dates and avoid any additional fees.
Non-Discrimination Policy
It is the policy of Virginia International University to provide equal educational opportunities for all people regardless of race, color, religion, national
origin, sex, age, marital status, personal appearance, sexual orientation, gender identity and expression, family responsibilities, political affiliation, disability,
source of income, place of residence or business, and veteran status.