Student Sponsorship Agreement - Northwest Iowa Community College

Student Sponsorship Agreement

Northwest Iowa Community College must receive an updated agreement each school year or when the most current agreement expires. If there are any changes the NCC Business Office must be notified either to negotiate a new agreement and/or to terminate the affected agreement. All agreements must be received within the first 14 days of class or classes. All agreements must be sent directly from the sponsor via email or mail.

Student Information

Student Name:

Student ID #:

Address:

City/State/Zip:

Phone #:(Home/Cell) ( )- - (Work) ( )- - Email: Billing Information (Must be completed by the Sponsor)

Sponsor Name:

Contact Person:

Address:

City/State/Zip:

Contact Phone #: ( )- -

Contact Email:

Please indicate the terms being sponsored and/or the expiration date of the agreement

Term (indicate year): Fall 20

Spring 20

Summer 20

Expiration Date of Agreement: / / Expenses Covered (Please indicate the dollar amount or percentage covered for each item)

Tuition & Fees

Housing

Books/Supplies

Computer and/or Tools (if applicable)

Other (please list any other items covered here):

If the amount being sponsored is more than what is needed, the student may be refunded the difference. YES NO

By signing below I agree that we, the sponsor listed above, will pay for the tuition, fees, books, and other charges as stated above. If the student withdraws from NCC for any reason and in accordance with the College's refund and withdrawal policy all remaining tuition and other charges are immediately due and payable by the above sponsor. It will be the sponsor's responsibility to collect from the student, if applicable.

By signing below I agree that this sponsorship is not dependent on grades received or GPA of the student. Whether the student passes or fails we, the sponsor listed above, will pay for all charges as stated above.

By signing below, I agree that if we, the sponsor, decide to no longer sponsor the student we will still be held responsible for payment of the student's charges to NCC and will need to collect from the student, if applicable.

Sponsor Signature

Date

By signing below, I, the student, waive my rights under the Family Educational Rights and Privacy Act (FERPA) by authorizing Northwest Iowa Community College to share requested student records with the above listed sponsor.

Student Signature

Last updated February 2022

Date

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