Confirmation and Deposit Form

Confirmation and Deposit Form

Deposits are non-refundable and will be applied toward your tuition when classes begin.
Name

First NameLast Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Last 4 Digits of Social Security Number
Birthdate

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature

I confirm my enrollment intention at Saint Mary-of-the-Woods College

Indiana 21st Century Scholar

Scholarship -Fee Waived

Free

Campus Program

Temporarily Waived

Free

Online Program

Waived

Free

Graduate Program

$100.00

Music Therapy Equivalency

$100.00

Total

Credit Card - Online \Graduate

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country