Paul Quinn: Enrollment Agreement Form- Fall 2023

Commitment Form

Fall 2023
Congratulations on your admission to Paul Quinn! We are excited to welcome you to the Quinnite Nation. We ask that you confirm your intent to register by completing and signing the Commitment Form to reserve your spot in the entering Fall 2023 class. You will be required to submit your commitment deposit at the end of this form.
The Fall 2023 semester has officially closed and the Spring 2024 semeter has opened. Please reach out to us at admissions@pqc.edu if you would like to switch your expected entry term to Spring 2024.
Student Information
Student Name:*

First NameMiddle NameLast Name
Date of Birth:*

MonthDayYear
Date
Student ID : *
This number can be found on your acceptance letter.
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal Email:*
example@example.com
Phone Number*

Area CodePhone Number
Are you a TASFA student?*

YesNoI don't know/I'm not sure
Do you have work authorization?*

YesNoI don't know

Emergency Contact Information
Contact Name*

First NameLast Name
Relationship*
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Email*
example@example.com

Enrollment Information

100% online students will receive communications directly from their advisor over the summer to be registered for courses.
Please select your expected entry term:*
Please select your enrollment type:*

100% Online
Classification*

First-Time FreshmanTransferFormer Student
High School Graduation Date*

MonthDayYear
Date
High School Name*
Are there any special circumstances that will affect your ability to attend Summer Bridge from June 12th to July 21st?
Campus Housing

This is not your housing contract. Complete this section to indicate your housing plans. **Please note that at this time, housing is full. If you request housing, you will be placed on a waitlist and will be given housing as it becomes available. HOUSING IS NOT GUARANTEED**
Please select your housing needs for Summer Bridge (June 12, 2023-July 21, 2023):*

I am under the age of 23 and am requesting housing.I am over the age of 23 and am requesting housing due to special circumstances.I will not need housing.
Please select your housing needs for Fall (Aug 14, 2023-Nov 22, 2023) :*

I am under the age of 23 and requesting housing.I am over the age of 23 and requesting housing due to special circumstances.I will not need housing.
Medical Condition/Physical Impairment/Allergies which may affect housing assignment (please provide written documentation)
Registration Fee

The $200 non-refundable Registration Fee supports general operations of the registration process. However, you may begin a payment plan of your deposit starting at $25.

Payment Information*

USDYou can pay the total non-refundable $200 deposit or begin a payment plan of your deposit starting at $25.

Payment Methods

Credit Card

Apple Pay

Confirmation
By signing this form, I am formally stating my intent to register at Paul Quinn for the term in which I applied for. By signing this form, I am agreeing to the following:
- I am entering a formal agreement to attend Paul Quinn College;
- I understand that this agreement is not valid without the accompaniment of a non-refundable registration fee of $200 (payment plan available);
- I understand that this fee reserves my spot in the entering class
Signature

Clear
Should be Empty:

Commitment Form

Student Information

Emergency Contact Information

Enrollment Information

Campus Housing

Registration Fee

Payment Methods

Confirmation