Student Financial Responsibility and Contact Consent Form - 2023/2024
All students are required to demonstrate acknowledgement of their financial responsibility when they register for classes at Coker University. Please read the following information and click the corresponding boxes to acknowledge that you have read the form.
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Email *
First Name *
Last Name *
ID Number *
What is your student type? *
PAYMENT OF FEES/PROMISE TO PAY
I understand that when I register for any class at Coker University or receive any service from
Coker 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. This includes material costs, damage and replacement costs, and any citations issued. 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 Coker 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 at https://www.coker.edu/academics/office-academic-records/academic-catalogs/. 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.

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 Coker University.
Acknowledgement *
Required
DELINQUENT ACCOUNT/COLLECTION
Financial Hold: I understand and agree that if I fail to pay my student account bill or any monies due and owing Coker University by the scheduled due date, Coker University will place a financial hold on my student account, preventing me from registering for future classes, requesting transcripts, or receiving my diploma.

Collection Agency Fees: I understand and accept that if I fail to pay my student account bill or any monies due and owing Coker University by the scheduled due date, and fail to make acceptable payment arrangements to bring my account current, Coker University may refer  my delinquent account to a collection agency. I further understand that if Coker University refers my student account balance to a third party for collection, a collection fee will be assessed and will be due in full at the time of the referral to the third party. The collection fee will be calculated at the maximum amount permitted by applicable law, but not to exceed forty percent of the amount outstanding. Finally, I understand that my delinquent account may be reported to one or more of the national credit bureaus.

Acknowledgement *
Required
IRS FORM 1098-T
I agree to provide my Social Security number (SSN) or taxpayer identification number (TIN) to
Coker 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 Coker 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
Coker 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 Coker University’s Office of Student Finance.

Acknowledgement *
Required
COMMUNICATION AND CONTACT
Method of Communication: I understand and agree that Coker 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 Coker University on a timely basis.

Contact: I authorize Coker 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 Coker University , or to receive general information from Coker University I authorize Coker 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 the Office of Academic Records or in writing to the applicable contractor or agent contacting me on behalf of Coker University.

Updating Contact Information:  I understand and agree that I am responsible for keeping
Coker University records up to date with my current physical addresses, email addresses, and phone numbers by following the procedure at http://webadvisor.coker.edu/WebAdvisor/html/ChangeofStudentnameaddresstypeorlocation.pdf. The linked procedure is incorporated herein by reference. Upon leaving Coker University for any reason, it is my responsibility to provide Coker University with updated contact information for purposes of continued communication regarding any amounts that remain due and owing to Coker University.


Acknowledgement *
Required
ENTIRE AGREEMENT
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 Coker University are a necessity, and I am contractually obligated pursuant to the “doctrine of necessaries.”

This agreement supersedes all prior understandings, representations, negotiations and correspondence between the student and Coker 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 Coker University if the modification is signed by me. Any modification is specifically limited to those policies and/or terms addressed in the modification.


Acknowledgement *
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