School of Radiologic Technology - Regional West Medical Center

Regional West Medical Center School of Radiologic Technology
Tuition Payment Agreement and Enrollment Contract
For the 20__/20__ and 20__/20__ school years
Plan B
I acknowledge that I have received a copy of the catalog for Regional West Medical Center School of Radiologic Technology.
I agree to pay my tuition for the program to Regional West School of Radiologic Technology in 10 monthly installments of one-tenth of
the tuition charges for the year ($200 per month for ten months). These payments will be due on or before the date identified on the
school calendar for ten consecutive months beginning ____________________ for the first year (total of $2,000).
In addition, I agree to pay my tuition for the program to Regional West School of Radiologic Technology in 10 monthly
installments of one-tenth of the tuition charges for the year ($200 per month for five months). These payments will be due
on or before the date identified on the school calendar for ten consecutive months beginning __________________ for
the second year (total of $2,000).
I understand that Western Nebraska Community College, University of Nebraska-Kearney, Chadron State College or
any other institution’s tuition and fees are not included in this amount and I have responsibility to pay them directly to
the respective institution.
I understand a full tuition refund for a term will be made if I withdraw or am discontinued from the program within two weeks
after the beginning of that term. No tuition refunds for a term will be made if I withdraw or am discontinued from the program at
any time after two weeks from the beginning of that term. Refunds are to be determined from the beginning of the term as stated
by the program and the last day of attendance of the student. The program shall make all refunds due within 60 days following
a student’s drop date. I acknowledge that no refunds will be made for purchased books and supplies.
If I withdraw or am discontinued from the program after two weeks in the term, I am not excluded from paying the balance due
for tuition.
I understand payments are to be made on time as specified by this agreement. Progressive disciplinary action will occur if I fail to
make payments on time. I acknowledge that my final grades or my certificate of graduation will not be issued until the balance of
tuition and fees are paid to the program.
I also acknowledge that if I wish to change my payment plan, that I must complete a new Tuition Payment Agreement and
Enrollment Contract.
__________________________________ ___________________________________ _______________________
Student’s name (please print) Student’s signature Date
__________________________________
Program Director’s Signature
___________________________________
Date
_____________________________________________________________________________________________________
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