Student Financial Responsibility Statement
Please take time to become familiar with Ancilla College policies regarding your student financial
By registering for classes at Ancilla College (AC), you agree to assume financial responsibility for all charges billed to your
student account including, but not limited to tuition, course fees, books, health insurance, returned checks, parking and
library fines, and non-returned or damaged lab items or rental textbooks (hereafter referred to separately and collectively
as “Student Obligations”). You understand AC is advancing value to you in the form of educational services and that your
right to register is expressly conditioned upon your agreement to pay these student obligations. You acknowledge that you
have read, understand and agree to the following provisions:
Financial Aid - If your federal or institutional financial aid is either not received by AC or you later lose eligibility to
retain financial aid for the semester, you assume responsibility for paying all student obligations for this term.
Third Party - If your third-party sponsor (military, employer, governmental agency, etc.) fails to pay AC, you
assume responsibility for paying the amount the sponsor originally promised to pay on your behalf.
Hold on Student Account - A “HOLD” will be placed on your records if your student obligations remain unpaid. As
long as the hold remains in effect, it will prevent your ability to register for future semesters, add classes for the
current term, and receive official transcripts.
Collection Information and Reminders - AC or its designated collection agency may use an automated calling
system and pre-recorded voice or text messages to contact you by phone regarding any outstanding account,
student obligations or reminders to any current or future phone number you have provided to the college,
including any number to a cellular phone or wireless device.
Collection Fees and Credit Reporting - Delinquent debts may be reported to a credit bureau and referred to
collection agencies and pursued through legal action against you. You agree to pay all reasonable costs and
expenses of collecting unpaid charges, including collection agency fees (which may be based on a percentage up
to a maximum of 15% of the debt), attorney fees and court costs. This Agreement shall be construed in
accordance with Indiana law and you consent to the jurisdiction of the District Court of Marshall County, Indiana,
or the Federal District Court of Indiana regardless of your domicile at the time of such suit.
How to Avoid Financial Responsibility
You are required to officially drop classes in order to avoid financial responsibility. If you decide not to attend a
class, you must officially drop that class within the stated refund periods.
Your financial aid eligibility may be affected. Be aware that dropping classes may reduce your eligibility for
financial aid, resulting in debt owed by you. Do NOT assume you will be dropped automatically if you do not pay
your tuition or if you do not attend classes.
Courses not dropped will be graded and you will have a financial obligation for the course.
Ancilla College does not offer payment plans. _____ Initials
All semester balances must be paid in full prior to the first day of classes or you risk
being administratively dropped from all enrolled classes. _____ Initials
Student Printed Name Student Signature
__________________ __________________ ___________________________________
Student ID Semester ID Date
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