Collin College
Student Third Party Funding Authorization and Release Form
Third Party Entity (the Vendor) must have a valid third party agreement on file with Collin College and/or
have an established tuition assistance program with a formal voucher or PO authorization system pre-
approved and accepted by Collin before anticipated third party funding may be authorized on student
accounts and considered acceptable funding to meet payment deadline requirements.
As an eligible recipient of a tuition assistance program provided by ______________________________ the
Vendor, I offer Collin College (Collin) the attached voucher/PO/or other Vendor issued documentation of
funding eligibility in accordance with payment deadline requirements.
I understand each term I use the Vendor’s tuition assistance program for funding, I need to submit the
required documentation verifying eligibility (voucher, PO, etc.) to the Bursar/Cashier Office in compliance with
payment deadline requirements.
In addition, I authorize Collin to release any and all requested Family Education Rights and Privacy Act
(FERPA) protected student account/course registration information requested by the Vendor to facilitate
invoicing and payments. This FERPA release will remain in effect for this vendor for each and every term for
which funding from this Vendor is used as funding on my student account.
I understand it is my
responsibility to adhere to any degree plan and/or course registration/grade
reports/requirements of the Vendor for program eligibility and invoice payment. In accordance with Collin
College refund practices, any credit on my student account originally funded by the Vendor and eligible for
refund will be issued to the Vendor.
I understand and agree if the Vendor does not make full and timely payment to the College, I accept
responsibility for full payment of any outstanding charges on my student account. I understand my
Collin tuition bill will be posted online in CougarPay and all billing notices will be sent to my college
assigned email address and that it is my responsibility to review and pay any charges on my student
account not funded by the Vendor.
I understand accounts not paid when due are subject to a hold preventing registration and access to
grades and transcripts and that delinquent accounts may be placed with an outside collection agency
and/or reported to the national credit bureau system. I understand I will be responsible for all late
payment fees, percentage based collection fees, attorney fees, interest and any other costs and charges
necessary for the collection of any amount not paid when due. I also understand that all disputes about
registration or payment will be governed in accordance with the laws of the State of Texas, without regard
to the principles of conflicts of laws of the State of Texas. The venue for any lawsuit regarding collection of
a delinquent debt will be in Collin County, Texas.
I have read and agree to the terms above.
Student’s Printed Name
________ ____ _________________________________________ _____________
CWID Student Signature Date
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