UCF - Student Academic Resource Center

Pegasus Success Program
Financial Responsibility Form
Summer 2008

Please complete and submit this form as soon as you have accepted your place in the Pegasus Success Program 2008.

In order to register you for the appropriate Pegasus Success Program courses, we request that you complete the following information. If you fail to complete and submit this online form your admission into the program may be jeopardized.

Required Personal Information

First and Last Name:
Social Security Number:
Street Address:
City:
State:
Zip Code:
Phone Number:
E-mail address:
Desired Major or Undecided:

Please read and sign acknowledging the following statement:

I acknowledge that the Student Academic Resource Center will register me for two courses (six credit hours) for the summer B 2007 term.

I accept responsibility for payment of my semester tuition and fees by the published deadline of TBA. I understand that if I fail to pay my tuition and fees by the deadline, I will be charged a $100.00 Late Payment Fee, my records will be put on hold, my account will be referred to a collection agency and I may incur other financial consequences.

I acknowledge that by digitally submitting this form, and typing my name where a signature is required, I verify that I understand and agree to all of the terms outlined above.

Signature:
Date:

NOTE: Please print the screen and save a copy of this form for your files prior to submitting it online.

SARC Home | Contact Us

Student Academic Resource Center
Student Success Center
Student Development and Enrollment Services
E-mail: studentsuccesscenter@mail.ucf.edu
Last Updated: March 20, 2008 by Michael Brown