ContractDecember 23rd, 2015
FiledDecember 23rd, 2015Page 1 of 2 HARRISON MIDDLETON UNIVERSITY3345 South Rural Road Tempe, Arizona 85282-5404 Phone 1-877-248-6724 Fax 1-800-762-1622Master's 4 Credit Course Enrollment AgreementI have submitted an Application for Admission and have been accepted to Harrison Middleton University. I am enrolling in an Omnibus Course and I am submitting the Omnibus Course Enrollment Agreement Addendum. Student Information First Name Middle Name Last Name Sex Date of Birth (mm/dd/yy) Street Address Social Security Number (U.S. Citizens) Country City State (if you reside in the U.S.) Province Zip/Postal Code E-mail Address Day Phone Evening Phone Course InformationMaster's 4 Credit Hour Course Expected Start Date: Expected End Date: (mm/dd/yy) (mm/dd/yy) Program Name: Course Name: Payment InformationI want to pay my course tuition in full (one-time payment). A third party will pay my tuition. (If checked fill out Page 3 - Third Party Payment.) Tuition Payment ScheduleOne Time Enrollment Fee: $200.00 (paid
ContractDecember 23rd, 2015
FiledDecember 23rd, 2015Page 1 of 2College of the Humanities and SciencesHARRISON MIDDLETON UNIVERSITY1105 East Broadway Road Tempe, Arizona 85282 Phone 1-877-248-6724 Fax 1-800-762-1622Master's 4 Credit Course Enrollment AgreementI have submitted an Application for Admission and have been accepted to Harrison Middleton University. I have submitted an Application for Admission, approval pending. To accelerate the enrollment process, I am submitting a Master's Enrollment Agreement now. I understand that if I am not eligible for admission, the full application and enrollment fee will be credited to my charge card account. Student Information First Name Middle Name Last Name Sex Date of Birth (mm/dd/yy) Street Address Social Security Number (U.S. Citizens) Country City State (if you reside in the U.S.) Province Zip/Postal Code E-mail Address Day Phone Evening Phone Course InformationMaster's 4 Credit Hour Course Expected Start Date: Expected End Date: (mm/dd/yy) (mm/dd/yy) Program Name: Course Name: