Tpeg Short Term Loan Application And Promissory Note (Page 4 of 4) in pdf

Section E: Student Certification and Promissory Note

, promise to pay to the order of Houston Community college (HCC)

the sum of

(dollars awarded) or any amount I used to finance my tuition, fees and/or books for the Fall

Spring _____.

I promise to repay this loan in full within thirty (30) calendar days from the date of signature on the

Promissory Note or upon the date of my total withdrawal from the Houston Community College, whether

voluntary or involuntary, (whichever occurs first).

I understand a financial aid hold will remain on all my College records until the loan has been paid in full.

I will pay a fifteen dollar ($15.00) service charge if I fail to repay this loan in full within the designated time

frame indicated below.

I will immediately inform the Financial Aid Office and Registrar’s Office at my College if my address,

name or social security number changes during the period of this loan.

I will repay this loan even if: (a) I do not finish my program of study at HCC, (b) I become dissatisfied with

the College and/or instructors, (c) I am unable to get a job when I terminate or complete my studies at HCC

or (d) I am totally withdrawn due to non-payment of my loan within the designated time frame indicated

above.

I understand that if I default on the payment of this loan or on any of the conditions stated in my

promissory note, I may be subject to the following actions:

The entire unpaid balance shall become immediately payable.

Legal action could be taken against me. If this occurs, I agree to pay reasonable attorney

fees, costs, and any other costs and expenses associated with collecting the unpaid

balance.

The outstanding loan amount will be placed on my student account as money owed and all

HCC services/privileges will be withheld.

My account may be assigned to a collection agency. A collection fee may be added to my

student account at the time of assignment.

I understand that I may prepay all or any part of the principal amount of the loan at any time before the due

date.

I understand that my TPEG Short Term Loan will be cancelled if I become totally disabled (unable to

engage in any substantially gainful activity, i.e. employment or school), due to a medically determined

impairment that is expected to continue for an indefinite period of time or result in death. (Please provide

documentation.)

I certify that I have read and understand the information contained in the application. I have read and understand the

TPEG Short Term Loan Policy, and I will adhere to it. I certify that information regarding my rights and

responsibilities have been explained to me. Furthermore, I certify that information provided is true and correct to the

best of my knowledge.

Repayment of this loan is due by the close of business on

Signature:

Date:

Copies of this document should be distributed to the following:

Financial Aid Office

Business Office

Student

Tpeg Short Term Loan Application And Promissory Note Page 4