UNIVERSITY OF HOUSTON
Student Business Services
9 E Cullen Building
Houston, Texas 77204-2008
Fax: (713) 743-5665
bursar@uh.edu
Fixed Tuiton Plan Selection
Change Form
Student Name (please print) _______________________________________
Student ID _____________________ Term__________________________
I understand by signing this form I am authorizing the University of Houston to update my account in accordance
with my selection above.
Please place an X next to your selection.
______ Fixed Tuition Opt In
Check this option if you wish to participate in the Fixed Tuiton Plan. I have read the
terms and conditions of the Fixed Tuition Plan and understand my tuition and fees will be fixed at the contract rate; however, the
fixed rate is subject to change in accordance with Legistlative approved actions.
______Fixed Tuition Opt Out
Check this option if you do not wish to participate in the Fixed Tuition Plan. I
understand by opting out of the Fixed Tuition Plan my tuition and fees will be assessed at the current variable rate at the time of
my registration.
Please place an X indicating your student status.
______ First Time in College Student (FTIC)
______Transfer Student
Please note that you may not change your selection after August 22, 2016. To cancel participation in the Fixed Tuition Plan, in
future semesters, students must notify Student Business Services in writing prior to enrollment in subsequent semesters and at
least 30 days before the start of the subsequent semester
______________________________________
Student Signature
___________________
Date