If for some reason you cannot submit a TA for the FALL 2010, OCTOBER 4, 2010 complete the form below and e-mail it to the appropriate college representative. *Be sure to sign the e-mail electronically and provide your last four digits of your SSN. I will be financially responsible and obligated for the FALL 2010 session tuition if my Tuition Assistance form for the FALL 2010 session is not approved and sent to TUI University.

Student Name:

Student ID #:

Reason why approved TA cannot be submitted by deadline:

Enter reason here...

Make sure you are going to receive the TA for the FALL 2010 session on a later date before you send a promissory note, otherwise you will have to pay the tuition out of your own pocket in full.

Signature

Last 4 Digits of SSN

Date