The refund calculation form is a calculation sheet used to ... - acces

The refund calculation form is a calculation sheet used to determine refunds owed to studentswho cease instruction, whether through withdrawal or termination, prior to the completion of theprogram.SCHOOL NAMESCHOOL LOCATIONREFUND CALCULATION FORM(terms)STUDENT NAME: ______________________________________________Social Security #: (last four digits only) XXX-XX-___________ D.O.B. ___/___/___Program ___________________________________ Hours ________Start Date ___/___/___ Last Date of Physical Attendance ___/___/___Scheduled Graduation Date ___/___/___ Hours Offered to Student _______Schedule: _____ hours each week for _____ weeksThis schedule divides the program into _____ terms. The student’s last date of physicalattendance occurred during week number _____ of term number _____.Total tuition for the program $__________ Tuition per Term $________Percentage of last term’s tuition retained _______%Student Tuition Liability (amount owed/paid to school) for the Last Term Attended:$______________Student Tuition Liability (amount owed/paid to school) for Previous Terms Completed:$______________Student Liability for Textbooks Accepted: $______________Student Liability for Equipment and/or Student Kit (if required): $_______________Non-Refundable Registration Fee: $______________Total Student Liability: $______________Total Student Payments Including Grant/Loan Payments $______________Refund Due if Payments Exceed Liability: $______________Date of Refund ___/___/___ Check No. __________

SCHOOL NAMESCHOOL LOCATIONREFUND CALCULATION FORM(quarters)STUDENT NAME ____________________________________________________________Social Security #: (last four digits only) XXX-XX-___________ D.O.B. ___/___/___Program _______________________________________ Hours ____________Start Date ___/___/___ Last Date of Physical Attendance ___/___/___Scheduled Graduation Date ___/___/___ Hours Offered to Student __________Schedule: _____ hours each week for _____ weeksThis schedule divides the program into _____ quarters. The student’s last date of physicalattendance occurred during week number _____ of quarter number ______.Total tuition for the program $__________ Tuition per Quarter $__________Percentage of last quarter’s tuition retained __________%Student Tuition Liability (amount paid/owed to school) for the Last Quarter Attended:$_______________Student Tuition Liability (amount paid/owed to school) for Previous Quarters Completed:$_______________Student Liability for Textbooks Accepted: $_______________Student Liability for Equipment and/or Student Kit (if required): $_______________Non-Refundable Registration Fee: $_______________Total Student Liability: $_______________Total Student Payments Including Grant/Loan Payments $_______________Refund Due if Payments Exceed Liability $_______________Date of Refund ___/___/___ Check No. __________

SCHOOL NAMESCHOOL LOCATIONREFUND CALCULATION FORM(mini-program)STUDENT NAME ___________________________________________________Social Security #: (last four digits only) XXX-XX-___________ D.O.B. ___/___/___Program _____________________________________________ Hours _______Start Date ___/___/___ Last Date of Physical Attendance ___/___/___Scheduled Graduation Date ___/___/___ Hours Offered to Student _____Schedule: _____ hours each week for _____ weeksThe student’s last date of physical attendance occurred after _____% of the program.Total tuition for the program $__________Percentage of tuition retained ___________%Student Tuition Liability (Due to School): $_______________Student Liability for Textbooks Accepted: $_______________Student Liability for Equipment and/or Student Kit (if required): $_______________Non-Refundable Registration Fee: $_______________Total Student Liability: $_______________Total Student Payments: $_______________Refund Due if Payments Exceed Liability: $_______________Date of Refund ___/___/___ Check No. _____