International Student Promissory
Note Form – Fall 2022
To be considered for a Promissory Note, you must:
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Be in the final year of your studies
Be facing an exceptional1 or extraordinary circumstance2
Have paid a minimum of $5,000 deposit
Get charged a $30.00 Administrative Fee
Be in good academic standing with the College (minimum 2.0 GPA)
Provide support documentation to support your claim
Have settled any older debt and have honoured all previous payment
Agree to the terms and conditions of the Promissory Note Agreement (i.e. interest charges)
Students off model route in the program and/or not meeting conditions for a promissory note
also can apply and will be reviewed on an individual basis.
How can a Promissory Note affect you?
• Delay in registration
• Interest charges
• Defaulting on your Promissory Note:
a) Will result in your account being sent to a collection agency which can damage your credit
score and your future in Canada.
b) Prevents you from being able to register for the following term, participate in graduation
ceremonies or receive academic documents (diplomas, transcripts, letters of permission,
official confirmations, etc.) until your account is paid in full.
When can you apply for a Promissory Note?
From 17/Aug/2022 to 13/Sep/2022.
How to apply for a Promissory Note?
How to apply for a Promissory Note? Go to myCentennial > Student > Registration > CASS> Click on
the link to complete a CASS Request Form> Select Promissory Note in the listing of services. This
service will not be available until 17 August 2022.
I confirm that I have read the instructions and I agree with the terms for promissory note
Exceptional circumstances: unforeseeable circumstances not existing at commencement of studies, that are beyond your
control and which make it impossible for you to pay your tuition and fees by the published deadline dates. (i.e. Delay in receiving
funds or loan distribution; A delay or disruption in the transfer of fees from a financial institution, scholarship, sponsorship, or
from another educational institution).
1
Extraordinary circumstances: Documented medical conditions which occurred after commencing studies and adversely affect
the student’s ability to pay fees. Significant traumatic event which impacts student ability to pay their fees such as death of parent
or sponsor.
2
Student ID#:
Email:
First Name:
Phone:
Last Name:
Country
of Origin:
Address:
IMPORTANT: email, telephone and address above must be identical to the information
available on your Mycentennial Account http://my.centennialcollege.ca
Are you studying inside Canada?
YES
NO
Your program of study (name and code):
I need promissory note for semester:
Do you have a minimum 2.0 GPA?
YES
NO
Have you paid a minimum of $5000 deposit?
Insert
GPA here:
YES
NO
If you answered NO,
how much deposit have you paid?
Have you settled any previous debt and honoured all previous
payment commitments owed to the College?
YES
If no, what is your outstanding tuition balance?
Why are you unable to meet the payment
requirements by the specified due date?
How will you pay the balance of your
fees if this application is approved?
Student Signature:
Date:
FOR OFFICE USE ONLY
C12_02_JUL22
NO