Pacific University Student Account Authorization Form I Authorize Pacific University to charge my student account and use financial aid funds which can include IV loans, grants, scholarships, or other institutional, federal, or state funds to pay any nonstandard charges assessed to my student account. These charges may include, but are not limited to the following: assessment tool and equipment check outs. ______________________________________ Student Name ______________________________________ Student ID # ______________________________________ Signature _____________________________ Date Provided by the Society for Human Resource Management. This is a sample template. Please consult with your legal counsel before adopting any new policy.