Application for Employer Deferral Program

Group

Subgroup

Eligible Programs

BS in Leadership (BILS), MS in Organizational Leadership, MS in Health Informatics, Health Informatics Certificate, Organizational Leadership Graduate Certificate, or Heider College of Business Graduate Programs
(all other University programs are excluded)

Purpose

To request a deferment of your tuition due date up to 45 days after the end of your class(es).

Requirements

You must adhere to the following in order to qualify for this program:
This application must be submitted each semester in which the student intends to defer the portion of tuition covered by reimbursement. If you are registered for two eight-week terms in one semester you only need to submit the form once, by the start of the first eight-week class or classes.

Tuition is due in full (no later than 45 days after the final day of your classes).
This form must be completed in full by the employee and submitted by the original tuition due date.
All payments made to your account from another source (e.g. student loans, scholarships, etc.) will be applied to your unpaid tuition first. These funds will not be refunded until your tuition has been paid in full.
Deferred balances may not be included as part of a monthly payment plan.
If you are a degree seeking candidate, all invoices must be paid in full before diploma or certificate are issued.
A late payment fee will be assessed, and a hold may be on be placed on your account, if payment is not received by the tuition deferred date.
The University withdrawal policy applies to both the student and employer's share of tuition. Even if your employer has committed to paying all or a portion of your tuition, the charges are on your account and you are responsible for making sure the account is paid in full.
If the entire balance is not paid in full within 45 days from the last day of your class(es), the University may take and or all of the following steps:
- Offset any financial aid refund that may have been or will be received without further notice.
- Report the delinquency to the credit bureau(s)
- Refer the tuition account to a collection agency or law firm for the full amount due, plus all associated collection fees (not to exceed 40%) and legal fees.

Program of Interest

Term

Beginning Date

# of weeks

Student First Name

Student Last Name

Student Email Address

Have you ever applied to or been enrolled as a student at Creighton?

Yes

No

If you know your NetID, please enter it here.

Birthdate

Employer Name

If other, please give the name of your company

Employer Address

Country

Street

City

Region

Postal Code

Employer Email

Your Signature

Your digital signature in this block authorizes your employer to view your Creighton account information in compliance with the Family Educational Rights and Privacy Act of 1974 (as amended). You additionally authorize your employer to make payments toward your account balance.

Please note: If your employment status changes or your employer rescinds your tuition funding, you are responsible for the tuition and fees accrued at Creighton University.

I have read the guidelines for Employer Tuition Deferral. By signing below I understand that I am fully responsible for the timely payment of my tuition.

Signature (type your full name)

Date

Payment

Amount Due
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Amount Due

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