Student Name High School
Date of Birth Phone Number__________________ Email Address
Home Address ______________________________________________________________________________
Street City/State Zip
Anticipated Graduation MM/YYYY
Registration for Term: Fall (August December)
Overall HS GPA MATC ID #
Please initial each line to verify you have read, understand, and agree to the following policies:
I understand that upon enrollment I am a college student and agree to abide by all the policies, procedures, and
decisions of the college as outline in the current High School Student Handbook. I give permission to Manhattan Area
Technical College to release my academic records to the above-named high school related to my concurrent enrollment.
By selecting ‘Yes’ and signing this form, I understand I am giving permission to the institution to share certain pieces
of information with the designated individual(s) listed below, including attendance, disciplinary referrals/actions,
financial aid, grades, and student account (under FERPA regulations).
Yes No If yes, please list parent/guardian information:
Student Signature Date
Parent/Guardian Permission:
I am the parent or legal guardian of the above named student. I hereby consent to his/her enrollment in the
Manhattan Area Technical College Concurrent Enrollment Program. Under the Family Educational Rights and Privacy
Act (FERPA), I will not have access to the academic records of my student without his/her written consent.
Parent/Guardian Signature Date
Course Schedule
MATC Course Title
I authorize the student to enroll in the following course(s), provided that the student has taken the placement test,
or submitted appropriate ACT scores and has met any necessary courses pre-requisites.
Counselor/Administrator Approval Signature Date
Concurrent Enrollment Form
Payment of Fees/Promise to Pay
By agreeing to the terms outlined in the Registration Agreement, and therefore acknowledging this Student Financial Responsibility Agreement (“Agreement”), I
understand that when my student register(s) for any class at, or receive any service from, Manhattan Area Technical College (“MATC” or “College”), I accept full
responsibility for the payment of tuition, fees, and other College charges assessed as a result of my students registration, and/or receipt of services. I understand that,
regardless of any expected reliance on any third-party resources, including but not limited to financial aid, family resources, employer reimbursement, government
assistance, or any other external resources, I remain personally and solely responsible for paying any and all outstanding balances.
I consent to receive all financial notifications from MATC via electronic means. This includes receiving all communications via the institution’s primary method of
contact, which is my student email account, or by phone/text to any active phone number provided by me in my student record, including using
automated telephone dialing equipment or artificial or pre-recorded voice or text messages.
Communications may include, but are not limited to, notices of billing, statement changes, payment plan changes, payment due notifications, late payment notices,
account holds, collections, legislative notice requirements, tax document availability, and other student business related notices.
My student will specifically consent to receive my year-end 1098T tax form electronically via my student account portal at MATC Online, unless I have taken the
appropriate measures to opt-out of electronic delivery. To opt out, I must send written notice to:
Manhattan Area Technical College
Attn: Student Account Specialist
3136 Dickens Ave
Manhattan, KS 66503
Should my student choose to opt out of electronic delivery, written notice must include my student ID, specific request to opt-out of the electronic delivery option for my
1098T document, and verification of my current address on file with the institution. If my address is incorrect, I understand my student must update their address
information via MATC Online student portal prior to submitting this request.
My students request must be received by the MATC Business Office no later than October 31st of the tax year for which I wish to elect paper delivery.
If my student does not fulfill the opt-out requirements by the stated deadline, he/she will be able to view and print a copy of their 1098T by accessing my MATC Online
student portal. Although the duration of this agreement is indefinite, my student may withdraw their consent by following the instructions above. Confirmation of my
consent withdrawal will be sent to my student email account.
After my student register(s), I understand that their bill/statement will be made available online, and my student will be sent notification of its availability to
their College ( e-mail address. If they do not receive an e-mail notification, I agree that my student is still responsible for the required
Payment Due Date
I understand there are scheduled due dates for tuition and fees for each semester. Due dates can be found online at I
understand that if I have entered into a payment plan agreement, I am responsible for any adjustment in due dates.
Assessment of Finance Charges
I understand MATC will assess a monthly finance charge of $25.00 on any outstanding balance owed to the College if I fail to pay in full by the due date, or
fail to maintain timely payment plan payments.
Tuition Adjustments
I understand and agree that if my student drops or withdraw from some or all classes for which they register, they will be responsible for paying all, or a portion
of, tuition and fees in accordance with the published tuition refund schedule at MATC. 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 students failure to attend class or receive a bill does not
absolve me of my financial responsibility as described above.
Delinquent Account/Collections
Financial Hold: I understand and agree that, if I fail to pay my student(s) account balance or any monies due and owing to the College by the scheduled due date, the
College will place a financial hold on my student(s) account, preventing them from registering for future classes, requesting transcripts, or receiving their diploma.
Collection Agency Fees: I understand and accept that if I fail to pay my student(s) account bill or any monies due and owing to MATC by the scheduled due date, and
fail to make acceptable payment arrangements to bring their account current, the College may refer my delinquent account to a collection agency. I further understand
that I am responsible for paying the collection agency fee which may be based on a percentage at a maximum of 35% of my delinquent account, together with all costs
and expenses, including reasonable attorney’s fees, necessary for the collection of my delinquent account. I also understand that my delinquent account may be reported
to one or more of the national credit bureaus.
Electronic Communication: I authorize MATC and its agents, representatives, attorneys, and contractors (including collection agencies) to contact me at the current or
any future mobile phone number, home phone number and email address I provide, including by way of automated telephone dialing equipment, or artificial or
prerecorded voice or text messages, for purposes of collecting any portion of my student financial obligation which is past due.
Parent Financial Responsibility Agreement
Tuition and Fees
Tuition and Fees should be paid by the first day of each semester and are determined by the number of credit hours in which a student is enrolled, plus additional costs
such as required tools, uniforms, etc. Students who have not met their financial obligation within 10 business days after the start of the semester for fall and spring
semesters may be dropped from their courses with Manhattan Area Technical College. The payment arrangement deadline for the summer semester is 5 business days after
the start of the semester. The deadline does not apply to financial aid and VA education benefit recipients who have completed the entire financial aid or VA certification
process. For students receiving financial aid or assistance, payment will be expected from the first financial aid disbursement. If financial aid or VA education benefits are
not sufficient to cover the full tuition and fee balance, students are responsible for the remaining balance owed. Students should contact the Office of Financial Aid to
determine their status in this process.
Payment for classes is due no later than 10 business days after the start of the semester for fall and spring courses, and 5 business days after the start of the semester for
summer courses. Students who have not paid, or made payment arrangements, through the Student Account Specialist by the payment due date will be locked out of, and
subsequently dropped if payment arrangements are not made following lockout, from their courses. Students whose courses have been dropped may re-enroll if courses are
still available and payment arrangements are made at the time of enrollment.
Students’ account balances may be paid using a credit or debit card by selecting My Account Information available on this page when signed in. Questions
regarding online payments may be directed to the Student Account Specialist at 785.320.4512 or
To mail payments, students should send check or money order with full name, ID#, and program to:
Manhattan Area Technical College
Attn: Student Account Specialist
3136 Dickens Avenue
Manhattan, KS 66503
Payment Plan
MATC offers a payment plan as an option. The MATC payment plan allows students to pay for tuition, student fees, and course fees in monthly installments when
enrolled in non-continuing education courses for fall, spring, and/or summer.
No interest or finance charges are assessed, however a 10% down payment plus a $15 non-refundable set-up fee are due at the time the payment plan agreement is
signed. MATC accepts cash, check, money orders, credit, and debit. The remaining balance will be divided into monthly payments over the current semester, due by the
fifteenth (15th) of each month. Payments made after the due date will be assessed a $25 late payment fee.
Note: Certificates and degrees will not be awarded until payment is made in full.
What Students Need to Know about Payment Plans
A Payment Plan Business Hold will be placed on the student’s account. Once the balance has been paid in full, the hold will be lifted. A business hold prevents
students from enrolling in additional courses, upcoming semesters, and/or receiving grades, transcripts, and degrees/certifications.
Students are responsible for the full amount of tuition, fees, and other charges on their account that are deferred via the payment plan, unless they officially
drop and/or withdraw within the refund period.
Failure to attend classes does not constitute an official drop. Students are still responsible for the balance due on their accounts.
Final payments are due prior to the last day of the class in that semester.
For any changes, students must contact the Student Account Specialist at 785-320-4512 or
Students will not be able to register in additional classes or upcoming semesters if there are any outstanding balances on their accounts. Accounts will be turned
over to collections and/or the Kansas Set Off program if left unpaid at the end of the semester.
Printed Name:
Phone Number:
Social Security Number:
Parent/Guardian Signature: Date: