The Globe’s Leading Virtual University
If you have questions, please contact us at 888-506-1106
Please PRINT this form. Fill it out. Scan it. Send as an email attachment!
Mailing Address: ___________________________________________________________________________________________
Email Address: _____________________________________________________________________________________________
Phone Number: ____________________________________________________________________________________________
Prior Education/Degrees/Certifications: _______________________________________________________________________
Payment Information for Credit Card or Debit Card
Name on Card: _____________________________________________________________________________________________
Address of Card Holder: _____________________________________________________________________________________
Credit or Debit Card Number: ________________________________________________________________________________
Expiration Date on Card: ____________________________________________________________________________________
Three Digit Security Code from Back of Card: __________________________________________________________________
I authorize payment of $98 for the Enrollment Fee. Please initial here ________
I authorize SU to charge my credit card, debit card. Please initial here ________
I authorize SU to charge my credit/debit card for the $250 graduation fee upon completion of my program _______
Please initial the line which represents your selection of payment option.
Discounted tuition after $5,000 Tuition Scholarship, if eligible.
Bachelor: $ 9,389 - $5,000 = $4,389 ______ or 12 months at $413 ______ or 18 months at $298 ______
Master: $11,389 - $5,000 = $6,389 ______ or 12 months at $585 ______ or 18 months at $405 ______
Doctor: $13,389 - $5,000 = $8,389 ______ or 12 months at $747 ______ or 18 months at $516 ______ or 24 months at $441 _____
Enrollment Fee of $98 is in addition to tuition.
Graduation Fee of $250 is in addition to tuition.
The Enrollment Fee of $98 is nonrefundable. Once the Proprietary Program Guide/Catalog has been released
to the student, there are no refunds. If a payment plan is selected, the student is obligated to complete the
payment plan. Tuition payments are non-refundable. I agree with the above terms and conditions.
Please accept my enrollment as a member of SU.
_______________________________________ Date: ____________________________