Application Processing Fee Verification Form - Larkin University

Larkin University Application Processing Fee Verification Form

(CAS Submission Required)

SECTION I: APPLICANT INFORMATION

Date Name APPLICANT

SECTION II: UNIVERSITY APPLICATION FEE DISCLOSURE

Application Processing Fee: $50.00 USD (Non-Refundable)

This fee is non-refundable except where required by law.
Payment does not guarantee admission or an interview.
Application review begins only after the fee and documents are received.
Fee is separate from tuition and other costs.

SECTION III: PAYMENT INFORMATION

Payment Method: *

Credit Card
Debit Card
EFT Debit Card

Date of Payment *

Transaction/Confirmation Number: *

Name on Payment (if different):

SECTION IV: APPLICANT CERTIFICATION

I certify that all information is accurate and agree to the terms.

Applicant Signature: *

Clear Signature

Date / Time *

Date

Time