SPRING 2023: Graduate Student Payment Memo Submission Form
Please submit your Graduate Student payment memos and/or fellowship letters through this form for processing to student accounts.
I am a...
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Student
Staff/ Faculty Member
Staff/Faculty Member Name
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First Name
Last Name
Email
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example@example.com
Department
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Student Name
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First Name
Last Name
UA ID
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Student Email
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example@example.com
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Payment Memo Details
This memo includes:
Tuition
Fees/Surcharges
Graduate Student Health Insurance
TUITION: Total Credits or Total Amount Awarded
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EX: 9 credits or $4851.00
FEES: Check all that apply:
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All Fees (excluding late fees, parking, P.O. Box, and housing fees)
Surcharges (CEM/CBSM)
Late Payment Fees (Excludes late rental payments)
Notes to Graduate School:
(i.e. to be used for specific classes, requirements for reward, etc.)
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Payment Details
Exemption Code
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Detail Code
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Upload your Memo
Upload Document:
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Browse Files
(PDF copies only)
Cancel
of
Upload Document:
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Browse Files
(PDF copies only)
Cancel
of
Memo Submission Agreements
I understand that my student loans or other federal aid may be reduced as a result of the tuition and/or fee support in this memo and its impact on my cost of attendance.
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I Agree
I understand that I am fully responsible for any balance due and/or any late fees that are accrued for failure to pay the balance by the fee payment deadline.
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I Agree
Submit
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