Intent to Enroll Fee Form: You do not need to pay the $60 non-refundable tuition deposit at this time if you are applying for
financial aid. Please indicate your financial aid status or method of payment below. If you are paying the fee you can do so by
check or money order drawn from a U.S. Bank or by credit card.
Student ID Number:
(Your ID is printed on your acceptance letter)
Name
Last First MI
Address (Street
Number or P.O. Box)
City State Postal/Zip Code
YES! I accept your offer of admission and will enroll for the
No. I will not enroll at this time.
Fall Spring Semester
Date
Credit Card Information (complete if paying by credit card):
Cardholder Name: Phone:
Address (Street
Number or P.O. Box)
Postal/Zip CodeStateCity
Intent to Enroll
Once your Intent-to-Enroll form has been received and processed by the Admissions Office you will
be allowed to register for classes during one of our advising and registration sessions.
Intent to Enroll Form
Visa
Master Card
Card Number
Expiration Date
Card Holder Signature
Date
CVV2
Agreement: I agree to pay $60.00 (U.S.) according to the card issuer agreement. By signing the payment authorization form, I
acknowledge that the fee is non-refundable and non-transferable.
I am applying for Financial Aid and I intend to enroll at UH Hilo (if yes check box and submit form)
I am submitting my $60 payment. (if yes check box and indicate payment type below)
If submitting payment, indicate method of payment below:
Money Order or Check (attach check or money order drawn from a US Bank and submit form)
Credit Card (complete credit card information below and submit form)
Signature
You may fax the form to: UH Hilo Admissions Office at 1-808-932-7459 or mail the original to: UH Hilo Admissions Office, 200 West
Kawili Street, Hilo,, Hawai`i 96720. Cash payments can only be made by visiting the Business Office on campus.
Please fill in the appropriate information below:
OFFICE USE ONLY:
Choose
One
Choose
One
GENERAL UNDECLARED MAJORS ONLY (Indicate an area of interest below):
By entering your full name above you agree that it is the same as your signature
Agriculture
Business Administration
Hawaiian Studies
Humanities
Social Sciences
Natural Sciences
Education
No area of interest yet
