Confirmation and Deposit Form

Confirmation and Deposit Form

Deposits are non-refundable and will be applied toward your tuition when classes begin.
Name *

First Name Last Name
Email *
example@example.com
Phone Number *
Last 4 Digits of Social Security Number *
Birthdate *

Month Day Year
Date
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Signature *

I confirm my enrollment intention at Saint Mary-of-the-Woods College Clear

Deposit/Order -Select your course of study and applicable fee (if any) below: *

Indiana 21st Century Scholar Scholarship -Fee Waived

Free

Campus Program Temporarily Waived

Free

Online Program Waived

Free

Graduate Program

$ 100.00

Total

$ 0.00