Enrollment Form

The Graduate University of America

The Globe’s Leading Virtual University

If you have questions, please contact us at 888-506-1106

Copy and Paste this Enrollment Form into an email

Name: ____________________________________________________________________________________________________

Program/Degree/Selection: __________________________________________________________________________________

Mailing Address: ___________________________________________________________________________________________

Email Address: _____________________________________________________________________________________________

Phone Number: ____________________________________________________________________________________________

Occupation: _______________________________________________________________________________________________

Prior Education/Degrees/Certifications: _______________________________________________________________________

___________________________________________________________________________________________________________

Payment Information for Credit Card or Debit Card

Name on Card: _____________________________________________________________________________________________

Address of Card Holder: _____________________________________________________________________________________

Credit or Debit Card Number: ________________________________________________________________________________

Expiration Date on Card: ____________________________________________________________________________________

Three Digit Security Code from Back of Card: __________________________________________________________________

I authorize payment of $98 for the Enrollment Fee. Please initial here ________

I authorize GUA to charge my credit card, debit card. Please initial here ________

I authorize GUA to charge my credit/debit card for the $250 graduation fee upon completion of my program _______

Bachelor: $ 9,389 - $5,000 = $4,389 ______

Master: $11,389 - $5,000 = $6,389 ______

Doctor: $13,389 - $5,000 = $8,389 ______

Enrollment Fee of $98 is in addition to tuition.

Graduation Fee of $250 is in addition to tuition.

Cancellation Policy

There are no tuition refunds. Once the Proprietary Executive Summary and Catalogue have been released

to the student, there are no refunds. I agree with the above terms and conditions. Please accept my enrollment

as a member of GUA.

_______________________________________ Date: ____________________________

Type Your Name as Your Signature

Enrollment Form