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Champlain College - Third Party Funding
My tuition is being paid in part or in whole by:
Employer
Military Tuition Assistance
DoD Civilian Military Tuition Assistance
Department of Veteran Affairs
State Vocational Rehabilitation Agency
Not sure which option to choose, reach out to us by email at
compass@champlain.edu
or text/call 802-992-1474.
Student Information
Student ID Number
First Name
Last Name
Please verify the information in this section. If anything looks wrong, please reach out to
compass@champlain.edu
.
Program Information
Please select the semester you wish to apply third party funding towards.
Academic Semester
If no options appear initially, please begin typing out "Spring", "Summer", or "Fall" to load the available academic periods
x
Enrolled Program for the Selected Academic Semester
Course Information
Once you have selected semester above, please search for the course title you wish to request sponsored billing for by typing in the appropriate field below.
Course Section Number & Title
Start Date
End Date
Course Section Number & Title
Start Date
End Date
Course Section Number & Title
Start Date
End Date
Course Section Number & Title
Start Date
End Date
Course Section Number & Title
Start Date
End Date
Course Section Number & Title
Start Date
End Date
Employer Or State Or Federal Billing Information
Please upload prior authorization file(s) that would allow Champlain College to bill your employer on your behalf for the purposes of covering your tuition costs. (If you have multiple files you may upload additional files by clicking "Add another file" below).
If you do not have a signed billing authorization file, we can generate and send one to the Third Party Contact information listed below.
Yes, I have prior authorization from my employer.
No, I do not have prior authorization for Champlain College to bill my employer.
If your employer or state/federal sponsor included a PO or Voucher number they wish to see on their invoice please include it here.
Failure to include a PO or Voucher number, when provided by your employer, may result in your employer declining payment and passing the cost on to you.
Do you have additional non-course related expenses
that your sponsor has agreed to cover
? (graduation fees)
Yes, I have non-course related expenses I wish to seek sponsorship for.
If your sponsor covers additional non-course related expenses please list them here along with the expense amount. Please be sure to follow any guidelines listed by your employer such as itemizing or date stamping.
This will appear directly on the agreement sent to your employer if you do not have prior authorization.
If your sponsor requires a receipt of non-course related expenses please upload them here.
Are you eligible for Department of Defense Tuition Assistance?
Please select...
Not Eligible or Not Applicable
Uniformed Service Members
DoD Civilian Eligible
If you are eligible and would like to file for DoD TA alongside your sponsorship please let us know by selecting your eligibility type. If you are not eligible or choose not to receive assistance please select "Not Eligible/Not Applicable".
Please select your branch of service or if a civilian employee, the branch to which you are employed
Please select...
Air Force
Air National Guard
Army
Army National Guard
Coast Guard
Marines
Navy
U.S. Air Force Reserve
U.S. Army Reserve
U.S. Coast Guard Reserve
U.S. Marine Corps Reserve
U.S. Navy Reserve
Scholarship Information
Scholarship Organization
Scholarship Award Name or Program
If applicable
Award Amount
Scholarship Billing Contact
Please select...
Organization
Bill Me Directly
Proof of Scholarship
If applicable
Third Party Funding Details
Search for your Employer, State/Federal Entity, or Scholarship Provider below. If no results are found, please enter the name of the Organization.
Organization
blank field
Third Party Payer Contact Phone #
Third Party Payer Contact First Name
Third Party Payer Contact Last Name
Third Party Payer Email Address
If you don't have an email address, please leave this field blank.
Amount Requested
Third Party Payer
Mailing Address
Note, this can be general address for the organization.
Desired Payment Method
Debit or Credit Card, 2.85% fee, on TouchNet (Student must make payer an authorized user on TouchNet)
Wire Transfer (Must include student name and ID number)
Check (Must include student name and ID number on check)
Please Confirm
I am liable for scholarship funding if payment is not received. In the event that I withdraw from course(s) or the College, and payment arrangements are not made at that time, any tuition costs due are my responsibility.
Yes, I understand that I may become responsible for course costs.
I understand that in the event that payment is not received within 45 days of billing, I am liable for charges. In the event that I withdraw from course(s) or the College, and payment arrangements are not made at that time, any tuition costs due are my responsibility.
Yes, I understand that I may become responsible for course costs.
Digital Signature Affirmation
I understand that by checking this box, the above signature field constitutes a legal signature.
Hidden
Academic Profile ID
Salesforce Contact ID Number
Program of Interest ID
Course 1 ID
Course 2 ID
Course 3 ID
Course 4 ID
Course 5 ID
Course 6 ID
Organization ID