LAMAR STATE COLLEGE – PORT ARTHUR Business Office
Short Term Loan Application for Tuition and Fees 409.984.6126
BusinessOffice@lamarpa.edu
INSTRUCTIONS: Please print legibly. The borrower must sign the application. Incomplete or illegible
applications will not be processed!
Name (print): Student ID#
Home Address (Local): Phone:
Emergency Contact Information: Name: Phone:
If you fail to repay this loan on or before its due date you will not be allowed to register for future semesters and a hold will be placed on your
account unless paid in full. I understand by signing this application, that I am solely responsible for repaying this loan. If I am expecting to
repay this loan from monies received from financial aid it is my responsibility to complete that financial aid process.
OFFICE USE ONLY
TUITION/FEES: I plan on repaying this debt from (source):
SHORT TERM LOAN FEE: $20.00
LOAN AMOUNT (50%): DUE DATE:
(The balance will be placed on installments, split into 2 equal payments.)
Payable within 60 days of the start of the semester. This amount will at least be the minimum needed to meet the State of
Texas, paid-student requirements but in no case to exceed the total amount of Tuition and Fees of the current semester.
After the due date an annual interest of 5% will be assessed.
1. The anticipation of pending receipt of further financial aid (e.g. Pell Grant, Stafford Loan) does not extend the due date of this
note.
2. If the student withdraws from the college and receives a portion of his/her fee as a refund, the refund will be applied to the loans
and maker will be responsible for the balance. If the student withdraws after the refund date, he/she remains responsible for the
loan balance and a hold will be placed on all college records until balance is paid in full.
3. The student of this note authorizes Lamar State College Port Arthur to deduct the amount due hereon, plus any fees or penalties
assessed hereto, from ANY financial aid awarded to the maker prior to full repayment of this note. Upon such deduction, the
balance (if any) of said financial aid will be disbursed to the student.
4. As with all other obligations to Lamar State College Port Arthur, past due loans are regularly submitted to collection agencies and
credit bureaus. The collection agency fee is generally 33.33% of the owed amount (to be paid in addition to the amount owed to
Lamar State College Port Arthur).
This application is accurate and complete to the best of my knowledge. I understand payments must be made to Lamar State
College Port Arthur. I authorize Lamar State College Port Arthur to apply any financial aid received toward my loan even if the
payments are not yet due.
I promise to pay all sums disbursed under the terms of the Note. Loan amount will be paid on scheduled due date. I have
read the above and upon my signature of this loan agree to comply with the provisions as stated therein.
Signature of Debtor: Date:
