Enrollment Form

The Future of higher education is here!

It is not where you go to school that matters; it's what you do while

there! Therefore, choose a school that gives you maximum

freedom and the lowest tuition!

Traditional schools of brick and mortar are dead; a

thing of the past. They just don't know it!

We are in full compliance with the 2007 Texas Supreme

Court decision prohibiting the legislature from

regulating religious education!

Symposium University

The Globe’s Leading Virtual University

www.symposiumedu.org

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!

Name: ____________________________________________________________________________________________________

Program/Degree/Selection: __________________________________________________________________________________

Mailing Address: ___________________________________________________________________________________________

Email Address: _____________________________________________________________________________________________

Phone Number: ____________________________________________________________________________________________

Occupation: _______________________________________________________________________________________________

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.

Cancellation Policy

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: ____________________________

Signature