Third Party Contract Form

Please complete this form if your course(s) will be covered by a Third Party vendor. This form MUST BE completed every semester payment will be made by a third party vendor. Please read each statement very carefully and check all statements ONLY if you are in full agreement with the statement. For more information about visit the Third Party Billing website at https://www.westga.edu/student-services/studentaccounts/third-party-billing.php


If you have any concerns or questions about this form please contact the Office of Student Accounts and Billing Services by email - studentaccounts@westga.edu or by phone at 678-839-4737.

 
 
 
 
 
 

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Type your full First and Last name as it appears on your student record if you are in AGREEMENT with ALL above statements. If you have any concerns or questions about this form please contact the Office of Student Accounts and Billing Services by email - studentaccounts@westga.edu or by phone at 678-839-4737.