http://www.redwoods.edu/Eureka/Housing/PDF/2013-2104%20RH%20Payment%20Plan%
20Wrksht%20REVISED%205-20-13%20ALPHA%20locked%202%20.pdf
RESIDENCE HALLS PAYMENT PLAN WORKSHEET 2013-14
College of the Redwoods – Residence Halls
Please use black or blue ink only!
CR ID#:________________
Name: ______________________________________________
Please Print
(Last, First, MI)
Birthdate: ________________
REQUIRED
Phone#:________________
In order to determine the amount you owe for housing and tuition/ fees you must answer the questions and complete
the budget worksheet below. This worksheet is intended to provide you with information to allow you to make an
informed decision with regard to your costs to attend College of the Redwoods and live in the Residence Halls.
For which term will you be living on campus/ student in the Residence Halls?
□ Full Year Resident (Aug-May)
□ Summer (May-Aug)
□ One Term (Fall)
□ Public Safety Academy (Fall)
□ One Term (Spring)
□ Public Safety Academy (Spring)
I completed my FAFSA (Free Application for Federal Student Aid)
YES or NO
Spring 2014 Yes or No
Summer 2014 Yes or No
Are you registered for classes? Fall 2013 Yes or No
If NO, why not? ___________________________________________________________
Refer to the Cost of Attendance (tuition/fees) and payment plan (see page 2)/ the License Agreement for Use of Housing
Facilities Housing/Food Service cost to complete the budget below. To determine your costs you must reference whether
you will be a Full Year Resident or one term only.
Cost of Housing and Tuition/Fees
Resources for Housing and Tuition/Fees
Be sure to calculate your costs based on whether you are California Resident on Non-Resident, living on campus the full year or one semester
and the total # of units you are/intend to enroll in each term.* If you enroll in more than 12 units per semester; your costs will be higher.
Tuition/Fee: (# of units multiplied by the fee = Cost)
CA Res Per Unit Fee
$46 per Unit X ___Units =
*Non-Res Per Unit Fee $282 per Unit X ___ Units =
*OR Exchange
$112 per Unit X ___ Units =
Books/Supplies:
Housing/Food Service
Transportation
Other
$
$
$
$
$
$
TOTAL COSTS
$
*This includes CA fees which all students pay.
Do you have costs which exceed your resources?
Money from Savings
Money from Parent/Other
Public Benefit
AFDC, SSI, Food Stamps,
General Relief
Scholarships
Federal/State Financial Aid
BOG
Pell Grant
SEOG
CAL Works
Federal Work Study
EOPS
TOTAL RESOURCES
YES or NO
­
If yes, how much? (Total costs $______ – Total resources $ ______ = need $ ________)
­
How will you make up for your unmet need?
$
$
$
$
$
$
$
$
$
$
$
$
Each Housing Payment Plan requires payment of $500 with the completed Student Housing License
Agreement and $1291 upon arrival. All Housing Payment Plans require signature of Guarantor Agreement.
FINANCIAL AID FUNDS ARE NOT AVAILABLE FOR PAYMENT WITH APPLICATION AND PAYMENT UPON
ARRIVAL.
PLEASE CHECK ONE
Payment Plan #1 : PAYMENT IN FULL
Cost: Housing
Fixed Cost, Dining Services
Food Service Credit
Damage Deposit
Total: Due in Full (8-XX-13)
*(Full Year Aug-Dec and Jan- May)
$3680.00
$700.00
$2618.00
$300.00
$7298.00
Payment Plan #2 : Payment by SEMESTER IN FULL (Fall 2013)
Cost: Housing
$2105.00
Fixed Cost, Dining Services
$350.00
Food Service Credit
$1309.00
Damage Deposit
$150.00
Total:
$3914.00
Payment Plan #2 : Payment by SEMESTER IN FULL (Spring 2014)
Cost: Housing
$2105.00
Fixed Cost, Dining Services
$350.00
Food Service Credit
$1309.00
Damage Deposit
$150.00
Total:
$3914.00
Payment Plan #3 FULL YEAR
Due By
Payment
w/Application
$500.00
8/25
10/1
11/4
1/19
3/3
4/1
$791
$1,462
$1,462
$1,462
$1,462
$159
Payment Plan #3 FALL 2013
Due By
Payment
w/Application
$500.00
8/25
10/1
11/4
$791
$1,462
$1,161
1/19
3/3
4/1
$791
$1,462
$1,162
Payment Plan #3 SPRING 2014
Due By
Payment
w/Application
$500.00
Payment Plan #4 : Summer Semester PAYMENT IN FULL
Cost: Housing
$1747.00
Damage Deposit
$150.00
Total: Due in Full (date)
$1897.00
Payment Plan #5 : Public Safety Academy Payment by SEMESTER IN FULL
(Fall 2013)
Cost: Housing
$2,796.00
Fixed Cost, Dining Services
$ 350.00
Food Service Credit
$1,309.00
Damage Deposit
$ 150.00
Total:
$4,605.00
Payment Plan #5 : Public Safety Academy Payment by SEMESTER IN FULL
(Spring 2014)
Cost: Housing
$2,796.00
Fixed Cost, Dining Services
$ 350.00
Food Service Credit
$1,309.00
Damage Deposit
$ 150.00
Total:
$4,605.00
Payment Plan #6 Public Safety Academy FALL 2013
Due By
Payment
w/Application
$732.00
8/25
10/1
11/4
$1,291
$1,291
$1,291
Payment Plan #6 Public Safety Academy SPRING 2014
Due By
Payment
w/Application
$732.00
1/19
3/3
4/1
$1,291
$1,291
$1,291
Residence Halls Payment Plan Obligations and Responsibilities:
By completing this section you are certifying that you understand your responsibilities and obligations of
payment as a student in the residence halls. You are responsible for meeting all applicable deadlines,
reading and understanding all License Agreement Payment information and Residence Hall policy and
procedures. Late or incomplete Residence Hall Payment Plan Worksheet will not be processed, may
delay the review of your application or be returned to you. If all statements are not initialed, your
Housing Application may not be processed. If you do not understand or have question about any of
the statements, you may make an appointment to meet with the Financial Literacy Specialist or
Director of Residence Halls.
Resident Initial each statement:
I understand that Financial Aid funds are not available and that I am responsible for 1st payment and
amount due upon arrival.
I understand that failure to meet all payment plan obligations within 7 days after the payment is due
will result in an inactivation of my meal card and a possible 3 day Removal letter being issued.
I understand the License Agreement Payment Schedule contains all required charges for late
payments or $10 for every day late.
I understand each License Agreement Payment is due no later than 7 days after the payment due
date.
I understand payments received after the 7th day of each month may result in a minimum $10 for
each additional calendar day the payment is late.
I understand that College of the Redwoods Business Office will deduct amounts owed to the District
from all sources that I might receive through the District or funds that have been paid to the District on
my behalf, including but not limited to Financial Aid
I understand that if I receive financial aid and have debt to the college, then costs of tuition/fees will
be paid first with any financial aid I may receive.
I understand that Title 5 Section 59410 authorizes a “hold” be placed on my account. I will be unable
to obtain my transcripts, grades or diploma and I will be unable to register for future terms if I have
unpaid debt.
I understand that the college has an Account Collections Process.
I understand that I or account holder is responsible for paying all fees, charges, and amounts owed
to the College of the Redwoods. Accounts that incur debts over 120 days past due are considered
delinquent. Delinquent accounts are subject to the account collections process. The College of the
Redwoods may take additional actions to collect monies owed on delinquent accounts, including:
1.­ Delinquent accounts may be listed on consumer credit bureaus.
2.­ Delinquent accounts may be sent to the Chancellor’s Office Tax Offset Program
(COTOP)/Franchise Tax Board (FTB) or third party collection agency for collection. The actual fee
charged by COTOP/FTB or third party collection agency plus a $25 processing fee will be added
to the balance owed (as permitted by California Government Code 16583.1).
I understand that if there is a dispute or problem with this agreement then the College will follow
the law of the state of California.
I understand that if I or the account holder leaves College of the Redwoods under any
circumstances with a balance due, they authorize College of the Redwoods and / or its agents, including
attorneys and / or collection agencies, to contact said account holder or student via cellular telephone
and / or all forms of electronic technology (to include text messaging and e-mail) to collect such
outstanding debt, unless the contacting party is notified by a written letter to cease such
communication.
Under penalty of perjury, I certify that the information I have provided on this Residence Hall Payment
Plan Worksheet is true and accurate. I understand that if I give false or misleading information, I may
jeopardize my eligibility for occupancy in the housing facilities of College of the Redwoods. I understand
the College of the Redwoods requires that I remit payment at specified due dates and that failure to do
so may will result in cancellation of my meal card; late fees and or eviction from my campus housing and
or implementation of the Accounts Collection Process. I have read and understand the Community
Guidelines, Residence Hall License Agreement; Student Code of Conduct and all other required and
applicable forms, and college policy and procedures.
Student Signature: ___________________________________ Date: ___________________________