YOUR INFORMATION First Name : Middle Name : Last Name : Birth/Maiden Last Name : Date of Birth : Gender : Address : City : State : Zip Code : County (PA only) : Email : Phone : Emergency contact name and telephone : Are you a new student? Yes No Student ID Number : Professional Personal ID (PPID from PDE) : Do you require handicap accessibility? Yes No Employer (School District) : Position : RACE/ETHNICITY The Federal Government requires that Wilson College reports student race/ethnicity information as part of our annual data collection. The information will not in any way be part of the institution’s admission process and decision with regard to the applicant. What is your ethnicity? Hispanic or Latino Not Hispanic or Latino What is your race? American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Are you a U.S. citizen? Yes No If you are not a U.S. Citizen, please list your Country of Citizenship, Type of Visa, and Country of Birth. There is no need to provide Ethnic Background. : COURSE REGISTRATION 1. Course Number and Section : Course Title : Please type the year and semester for which this registration applies : Course Day(s) and Time(s) : DEFERRED PAYMENT OPTION Students may elect to defer their tuition payment by accepting the online Deferment Agreement available through their MyWilson Portal Self Service. The Deferment Agreement must be accepted for EACH TERM during which student would like to choose this option. There is a non-refundable Deferred Payment Fee of $50.00 per 16-week semester for the convenience of deferring payment. A link to the Self-Service Deferment Agreement Acceptance instructions is listed on the right-hand side of the ISTE program webpage. New students that are registering for their first graduate course can choose this option after the course registration has been processed, and MyWilson portal login information has been provided. FINANCIAL CONSENT AGREEMENT Wilson College requires all students to have a completed Financial Consent agreement on file. Effective the Fall 20 semester, students are required to review and accept the new Financial Consent agreement through their MyWilson Portal Self Service. Course registrations cannot be processed until the agreement has been accepted. Please take a moment to log on to your MyWiIlson portal and accept this agreement. There is a link on the right-hand side of the ISTE webpage that lists step-by-step instructions. You may contact the One-Stop Student Services Center (ssc@wilson.edu) if you have difficulty accessing and/or completing the agreement. Students that are registering for their first graduate course must accept the Financial Consent Agreement after their course registration has been processed, and MyWilson portal login information has been provided. I have completed the new online Financial Consent Agreement (effective Fall 2020) Yes No WILSON TERMS AND CONDITIONS / DEFAULT OF FINANCIAL OBLIGATIONS It is the student's responsibility to inquire to the Office of Financial Aid to determine if she/he qualifies for Financial Aid for this semester. Please contact the Business Office with questions concerning payment. All payments must be made to the Business Office. *I agree that in default of any financial obligation to Wilson College, I agree to pay all costs and expenses incurred by Wilson College, including collection agency costs and reasonable attorney fees, in collection of any sum that is due. *If agree that if I owe a financial obligation to Wilson College, Credit Bureau reports may be reviewed by collection agencies. *I understand that in the event of default that academic transcripts and grades will not be released until the debt is paid in full. *By agreeing and submitting this form, I agree that the above information is correct, and confirm my understanding of the Financial Obligation as described above. I agree that the information entered into this form is correct, and understand my Financial Obligation as described above. I agree Submit Leave this field blank
