Please check here if you are paying in full by August 1, 2017
and fill out all * fields on first page. ( )
2017-2018FACTS Tuition
Payment Agreement
FACTS Management Company and its subsidiaries provide a payment program for schools across the country. Because FACTS is not a loan program, there is no debt incurred and no credit search. There are no interest or finance charges assessed by FACTS on the unpaid balance.
New to FACTS enrollment: You must setup your account online by July 1, 2017, by going to
Enrollment Fee: The nonrefundable FACTS Enrollment Fee to budget payment(s) through FACTS is $45.00 per school year. This fee will be automatically processed within 14 days of the agreement being completed by Our Lady’s School and posted to the FACTS system.
* These fields are required to complete Agreement.
Student Information:
* First Name ______* Last Name ______Tuition______
* First Name ______* Last Name ______Workbook______
* First Name ______* Last Name ______Building Fee______
* First Name ______* Last Name ______Maintenance Fee_____
* First Name ______* Last Name ______
Responsible Person for Payment:
* First Name ______* Last Name ______
* Address ______* City ______* State ______* Zip ______
* Phone Number ______* Cell Phone Number ______
* Email ______
FACTS Peace of Mind Benefit:
The Peace of Mind benefit will pay any FACTS unpaid balance (except payments in arrears) in the event of the death of the Responsible Party who has entered into this agreement or his/her legal spouse. Coverage does not apply when cancer or complications related to cancer cause death, and the individual has received or been advised to receive medical advice, diagnosis, or treatment for cancer at the time coverage begins. Additional information on Peace of Mind is provided in the terms and conditions. The nonrefundable annual fee for this benefit is $12 per FACTS agreement. If you elect to enroll, the Peace of Mind fee will be added to your FACTS Enrollment Fee. If applicable, you will be automatically reenrolled in the Peace of Mind plan each consecutive year you have a FACTS Automatic Tuition Payment Agreement.
___ Yes, please enroll me in the FACTS Peace of Mind Protection Plan.
Please sign and date below that you agree to all terms and conditions of your FACTS Tuition Payment Agreement
______
Print name Date
______
Signature
Payments:
The standard 10 month Tuition Schedule is August-May. If you choose the 12 month plan, there is a 1.5% Administrative Fee on total balance.
Monthly Amounts based on UnSubsidized Tuition.Please check the appropriate boxes below:
_____ 10 month plan_____ 12 month plan + (1.5% Administrative Fee)
UnSubsidized TuitionUnSubsidized Tuition
1 Child – $527.001 Child - $445.75
2 Children - $991.002 Children - $838.22
3 Children - $1476.803 Children - $1249.13
4 Children - $1892.004 Children - $1600.32
_____Subsidized Tuition_____ Subsidized Tuition
1 Child – $474.301 Child - $401.18
2 Children - $885.602 Children - $749.07
3 Children - $1318.703 Children - $1115.40
4 Children - $1681.204 Children - $1422.02
_____YES, please add these Fees to my Tuition Total:
Maintenance/Technology _____Workbooks ______Food Services _____
Building Fund Assessment _____Aftercare _____
_____NO, I do not wish to have Fees added to my Tuition. (Fees must be paid by August 1, 2017. If not paid by due date, fees will be added to FACTS account and spread out over your chosen payment plan.)
*Past due aftercare/lunch bills will be added to your final FACTS draft at the end of school year*
Bank Information (United States Bank Accounts Only)
* Bank Name ______* City ______* State ______
* Bank Routing Number ______* Bank Account Number ______
* Account Type: ______Checking______Savings
Choose the date you wish to have your payment made:
_____5th of the month_____ 20th of the month * Check both for Bi-monthly payments
All information on this document will remain confidential.
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For Office Use Only
Date Rec’d:______Date Completed on FACTS: ______By:_____