Promissor
y
Note
Deferred Room & Board Payments Semester: ________________
All students who register for classes are required to pay all applicable charges in full on or before
Registration Day unless they have been approved for Deferred Room and Board Payments. In order to be
eligible for deferred payments, you must be signed up for Room and/or Board at NMIMT and be registered
as a full time student. One third of room and/or board plus all other charges must be paid on or before
Registration Day. Two more designated dates will be set up for paying the remaining balance of room
and/or board charges. There is also a non-refundable $25.00 per semester fee.
By signing below, I acknowledge and understand if Deferred Room and/or Board Payments are not made in
accordance with dates specified in this contract, I may be denied the privilege of participating in the
Deferred Room and Board program in future semesters and this debt may be turned over to an attorney,
collection agency, or any other collection method deemed necessary by NMIMT. I will be responsible for
all expenses incurred in the collection process.
I further understand that if these payments are not made or if this debt is not paid on the designated dates, I
may be subject to New Mexico Institute of Mining & Technology’s administrative actions, including but
not limited to administrative withdrawal, hold on transcripts and/or, diplomas, completion of courses and
eviction from premises.
Pmt Due Dates Amounts
Student’s Name (Please Print) Banner ID
1
st
$
2
nd
$
3
rd
$
Signature Date
Total $
Campus Mailing Address Permanent Home Address
Return completed form to Student Accounts in Fidel, room 231.
BUSINESS OFFICE USE ONLY
Signature Date Entered
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Revised 12/06/09
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