Cornerstone University Student Financial Services: Student Financial Agreement
Legal disclosure of billing policies and processes; to be completed by all Undergrad and GRTS students.
Email *
7 digit Student ID# *
First Name   *
Last Name *
Payment of Fees / Promise to Pay *
I understand that when I register for any class at Cornerstone University or receive any service from Cornerstone University I accept full responsibility to pay all tuition, fees and other associated costs assessed as a result of my registration and/or receipt of services, including but not limited to student health insurance, parking permits, bookstore charges, service fees and fines, housing charges and/or fines and any other education related charges. I further understand and agree that my registration and acceptance of these terms constitutes a promissory note agreement (i.e., a financial obligation in the form of an educational loan as defined by the U.S. Bankruptcy Code at 11 U.S.C. §523(a)(8)) in which Cornerstone University is providing me educational services, deferring some or all of my payment obligation for those services, and I promise to pay for all assessed tuition, fees and other associated costs by the published or assigned due date.)                                                                                     I understand and agree that if I drop or withdraw from some or all of the classes for which I register, I will be responsible for paying all or a portion of tuition and fees in accordance with the published tuition refund schedule in the online academic catalog located at my.cornerstone.edu. I have read the terms and conditions of the published tuition refund schedule and understand those terms are incorporated herein by reference. I further understand that my failure to attend class or receive a bill does not absolve me of my financial responsibility as described above.
Required
Delinquent Account / Collections *
Financial Hold: I understand and agree that if I fail to pay my student account bill or any monies due and owing Cornerstone University by the scheduled due date, Cornerstone University will place a financial hold on my student account, preventing me from registering for future classes, requesting transcripts, receiving my diploma, or beginning a new semester.                                                                                                                                                                                          Late Payment Charge: I understand and agree that if I fail to pay my student account bill or any monies due and owing Cornerstone University by the scheduled due date, Cornerstone University will assess late payment and/or finance charges at the rate of $100 for the first month and $25 each month thereafter on the past due portion of my student account until my past due account is paid in full.  For those with a recorded payment plan agreement, a $10 per month late fee will be assessed after the 25th of each month with a missing payment.                                                                                                                                   Collection Agency Fees:  I understand and accept that if I fail to pay my student account bill or any monies due and owing Cornerstone University by the scheduled due date, and fail to make acceptable payment arrangements to bring my account current, Cornerstone University may refer my delinquent account to a collection agency. I further understand that I am responsible for paying the collection agency fee that is based on a percentage at a maximum of 33 1/3 percent of my delinquent account, together with all costs, fees, and expenses, including reasonable attorney’s fees, necessary for the collection of my delinquent account. Finally, I understand that my delinquent account will be reported to one or more of the national credit bureaus.
Required
Untitled Title
Communication *
Method of Communication:  I understand and agree that Cornerstone University uses e-mail as an official method of communication with me, and that therefore I am responsible for reading the e-mails I receive from Cornerstone University on a timely basis.                                                                                                                                                                                Contact:  I authorize Cornerstone University and its agents and contractors to contact me at my current and any future cellular phone number(s), email address(es) or wireless device(s) regarding my delinquent student account(s)/loan(s), any other debt I owe to Cornerstone University, or to receive general information from Cornerstone University. I authorize Cornerstone University and its agents and contractors to use automated telephone dialing equipment, artificial or pre-recorded voice or text messages, and personal calls and emails, in their efforts to contact me. Furthermore, I understand that I may withdraw my consent to call my cellular phone by submitting my request in writing to Cornerstone University or in writing to the applicable contractor or agent contacting me on behalf of Cornerstone University.                                                     Updating Contact Information:  I understand and agree that I am responsible for keeping Cornerstone University records up to date with my current physical addresses, email addresses, and phone numbers by contacting the Student Financial Services office. Upon leaving Cornerstone University for any reason, it is my responsibility to provide Cornerstone University with updated contact information for purposes of continued communication regarding any amounts that remain due and owing to Cornerstone University.
Required
Financial Aid *
I understand that aid described as “estimated” on my Financial Aid Award does not represent actual or guaranteed payment, but is an estimate of the aid I may receive if I meet all requirements stipulated by that aid program.                                                          I understand that my Financial Aid Award is contingent upon my continued enrollment and attendance in each class upon which my financial aid eligibility was calculated. If I drop any class before completion, I understand that my financial aid eligibility may decrease and some or all of the financial aid awarded to me may be revoked.                                                                                       If some or all of my financial aid is revoked because I dropped or failed to attend class, I agree to repay all revoked aid that was disbursed to my account and resulted in a credit balance that was refunded to me.                                                                                    I agree to allow financial aid I receive to pay any and all charges assessed to my account at Cornerstone University such as tuition, fees, campus housing and meal plans, student health insurance, parking permits, service fees, fines, bookstore charges, or any other amount, in accordance with the terms of the aid.                                                                                                         Federal Aid:  I understand that any federal Title IV financial aid that I receive, except for Federal Work Study wages, will first be applied to any outstanding balance on my account for tuition, fees, room and board. Title IV financial aid includes aid from the Pell Grant, Supplemental Educational Opportunity Grant (SEOG), Direct Loan, PLUS Loan, Perkins Loan, and TEACH Grant programs.  I authorize Cornerstone University to apply my Title IV financial aid to other charges assessed to my student account such as parking permits, bookstore charges, service fees and fines, and any other education related charges. I further understand that this authorization will remain in effect until I rescind it and that I may withdraw it at any time by contacting the Student Financial Services office.                                                                                                                                                         Prizes, Awards, Scholarships, Grants:   I understand that all prizes, awards, scholarships and grants awarded to me by Cornerstone University will be credited to my student account and applied toward any outstanding balance. I further understand that my receipt of a prize, award, scholarship or grant is considered a financial resource according to federal Title IV financial aid regulations, and may therefore reduce my eligibility for other federal and/or state financial aid (i.e., loans, grants, Federal Work Study) which, if already disbursed to my student account, must be reversed and returned to the aid source.
Required
Method of Billing *
I understand that Cornerstone University uses paper billing as its official billing method, therefore I am responsible for keeping my contact information up-to-date.  Bills can also be viewed online through Self-Service at my.cornerstone.edu and are due by the first day of class for commuter/online students or prior to moving onto campus for resident students.  Balances are due separately for the summer, fall, and spring terms.  I further understand that failure to review my paper or electronic bill does not constitute a valid reason for not paying my bill on time. E-bill information is available on Self-Service.
Required
Payment Options *
Payment plans are split over 4-6 months per semester with a $55 service fee applied.  Length of plan is determined by how early it is started.  All semester payment plans must be paid-in-full by the last day of that semester.                                                          Self-Pay Plans: Cash, check, money order, and debit/credit card payments can be made in the Accounting Office.  Electronic checks and debit/credit card payments can be made through Self-Service which is available at my.cornerstone.edu.  A 2.5% service fee will be charged for each debit/credit card transaction.                                                                                                     Auto-Withdrawal Payment Plan: Nelnet, a third party vendor, manages the auto-withdrawal payment plan.  Access to this plan is available at mycollegepaymentplan.com/cornerstone.  Debit/Credit card transactions incur a 2.95% fee for each transaction. Nelnet imposes a $30 insufficient funds fee to all returned payments.
Required
Billing Errors *
I understand that administrative, clerical or technical billing errors do not absolve me of my financial responsibility to pay the correct amount of tuition, fees and other associated financial obligations assessed as a result of my registration at Cornerstone University.
Required
Returned Payments / Failed Payment Agreements *
If a payment made to my student account is returned by the bank for any reason, I agree to repay the original amount of the payment plus a returned payment fee of $30. I understand that multiple returned payments and/or failure to comply with the terms of any payment plan or agreement I sign with Cornerstone University may result in cancellation of my classes and/or suspension of my eligibility to register for future classes at Cornerstone University.  
Required
Withdrawal *
If I decide to completely withdraw from Cornerstone University, I will follow the instructions in the online academic catalog located at www.cornerstone.edu which I understand and agree are incorporated herein by reference.
Required
Privacy Rights & Responsibilities *
I understand that Cornerstone University is bound by the Family Educational Rights and Privacy Act (FERPA) which prohibits Cornerstone University from releasing any information from my financial and education record without my written permission. Therefore, I understand that if I want Cornerstone University to share information from my education record with someone else, I must provide written permission by contacting the Registrar’s office. In addition, I understand that if I want Cornerstone University to share information from my financial record with someone else, I must provide written permission by contacting the Student Financial Services office.  I further understand that I may revoke my permission at any time as instructed in the same procedure.
Required
IRS Form 1098-T *
I agree to provide my Social Security number (SSN) or taxpayer identification number (TIN) to Cornerstone University upon request as required by Internal Revenue Service (IRS) regulations for Form 1098-T reporting purposes. If I fail to provide my SSN or TIN to Cornerstone University, I agree to pay any and all IRS fines assessed as a result of my missing SSN/TIN.         I consent to receive my annual IRS Form 1098-T, Tuition Statement, electronically from Cornerstone University. I understand that if I do not consent to receive my Form 1098-T electronically, a paper copy will be provided. I understand that I can withdraw this consent or request a paper copy by contacting the Accounting & Finance office.  
Required
International Withholding Tax *
International students are required to pay income taxes on the portion of their scholarships that exceed the cost of tuition, fees, and books in a calendar year.  Cornerstone will calculate this amount at the end of the calendar year, pay the income tax to the federal government, and apply that amount to the student's tuition statement. The student is responsible to repay that amount to Cornerstone University.  (paragraph added 6-13-19)
Required
Student Age *
I understand and agree that if I am younger than the applicable age of majority when I execute this agreement that the educational services provided by Cornerstone University are a necessity, and I am contractually obligated pursuant to the "doctrine of necessaries."
Required
Entire Agreement *
This agreement supersedes all prior understandings, representations, negotiations and correspondence between the student and Cornerstone University, constitutes the entire agreement between the parties with respect to the matters described, and shall not be modified or affected by any course of dealing or course of performance.  This agreement may be modified by Cornerstone University if the modification is signed by me.  Any modification is specifically limited to those policies and/or terms addressed in the modification.  
Required
This agreement remains in effect during a student's entire enrollment at Cornerstone University including its subsidiary Grand Rapids Theological Seminary. By submitting this document, I acknowledge that I have read and fully understand the contents of the Student Financial Agreement.
Electronic Signature *
Enter your full name and student ID number as your electronic signature
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Cornerstone University.