____________  SEMESTER __________
WSCC DISCLAIMER STATEMENT FOR
NON-INSTITUTIONAL SCHOLARSHIPS
The policy below is in accordance with STATE B0ARD POLICY 803.01 TUITION: GENERAL

            ALABAMA DEPARTMENT OF  POSTSECONDARY EDUCATION FUNDING PROCEDURES FOR STUDENTS SPONSORED BY PRIVATE AGENCIES
           REQUIRE  A SIGNED STUDENT DISCLAIMER. THE STUDENT WILL BE RESPONSIBLE FOR PAYMENT OF TUITION, FEES, ETC., IF PAYMENT IS
           NOT RECEIVED WITHIN 30 CALENDAR DAYS AFTER REGISTRATION ENDS.

 

________________________________________                                                               _____________________________________
COMPANY                                                                                                                               CONTACT PERSON 

________________________________________                                                               _____________________________________
ADDRESS                                                                                                                                PHONE

________________________________________                                                               _____________________________________
CITY                STATE                     ZIP                                                                                    FAX

 

 

I, ______________________________ (SS#_________________), understand  the above 
   PRINT STUDENT’S NAME
named company is sponsoring my tuition, fees, etc., for the Fall Spring Summer Semester_________. _____________________ is the last day to register for _______ Semester ______.  If this payment is not received  by ______________________ I will pay the amount immediately or be administratively withdrawn. 

 

TUITION ____________                                                                        _____________________________
                                                                                                                   STUDENT’S SIGNATURE
FEES______________

INSURANCE_________                                                                      _____________________________
                                                                                                                  DATE 

 

 

FOR WSCC USE ONLY
 

______________________________                 _____________________________________                                _____________________
FUNDS RECEIVED                                                 DATE BILLED STUDENT                                                                      ACCOUNT NUMBER 

 

 Forms Page Updated 8 July, 2003