Per Board Policy 5030:
1.
Students in the Peralta Community College District may opt to pay their tuition or enrollment fee through an installment payment plan.
2.
Students are required to pay at least the first $25 of their enrollment fee or non-resident tuition and complete an installment payment plan prior to enrollment in classes.
3.
The payment plan will be interest free.
4.
The payment plan will include the specific amount and due date for each installment. All of the payments will be completed within the term for which the enrollment is made.
5.
Failure to make timely payments will subject the student to the penalties described in Board Policy AP 5035. (Students or former students who have been provided with written notice that they have failed to pay a proper financial obligation shall have grades, transcripts, diplomas and registration privileges withheld until the obligation is satisfied)
Last Name
Street & Number
First Name
City
i.e. 123456789
Zip Code
State
I, , agree to pay my semester tuition fees for
Summer Spring Fall 20 . My current balance will be paid in installments on or before the fifth (5 th ) of each month starting in the month designated by the PCCD Office of Finance and Administration. I realize that failure to fulfill this agreement will affect my future payment plan eligibility.
Applicant’s initials (in lieu of a signature) is required for eligibility.
4/14/2020
 After completing the form, save it for your records and email it to paymentplan@peralta.edu
from the email address registered in your account at
Peralta.
 You will receive an email confirming your payment plan agreement is complete and the information is reflected on Passport with the Peralta
District. If you have any further questions, please let us know.
 Please note that your payment plan will automatically adjust to display your current account balance if you should add or drop any courses from your class schedule. Refer to the list of Peralta District fees at the following link: http://web.peralta.edu/admissions/fees/
 As per district policy, if you do not drop your classes by the appropriate date, you will be billed for your courses. Please consult the academic calendar at the following link: http://web.peralta.edu/admissions/category/academic-calendar/ .
 Finally, as per district policy, students who have a balance on their account and/or payment plan will be unable to order official transcripts until the balance has been paid in full. This will be reflected in a ‘payment plan hold’ on your student account.
APPROVED DENIED Reason for Denial:
Approved/Denied by: Office of Finance & Administration Staff Initials:
Contact Info: Email: paymentplan@peralta.edu
Phone : (510) 466-7372
DUE DATE DUE AMOUNT REMAINING BALANCE
TOTAL
$ -
$ -
$ -
$ -
$ -
Date: 4/14/2020
Revised 9/3/15 JBW