Skip to content Home Billing Collections/Delinquent Accounts For Faculty and Staff Deceased Student For Parents and Families 1098-T Authorized User Parent Plus Refunds For Students 1098-T Questions Authorized User Financial Responsibility Third Party Billing Forms Payments/Payment Plans Payment Plan – Employer Deferred Payment Plan - Military Benefit Deferred Payment Plan – University Third Party Payments Veterans Policies Refund Disclosures Refunds Tuition Charge Appeal Directory Contact Us Third-Party Authorization Please review the Third Party Payments policy before completing this form. Third Party Payments Policy Authorization For (required) Single Student Multiple Students Authorization Type (required) Traditional Dual Enrolled Academically Talented Youth Program (ATYP) State approved EMC Authorized Reimbursement / Covered Charges Charge Tuition Percentage Dollar Amount Mandatory Fees Percentage Dollar Amount Room and Board Percentage Dollar Amount Other Percentage Dollar Amount Other Percentage Dollar Amount Enter either a percentage or a dollar amount for the charges to be covered. These apply to all students listed unless otherwise noted. Student Information Student name Student email Student WIN Your nine-digit WMU Identification Number. Semester - None -Fall 2025Spring 2026Summer I 2026Summer II 2026 Course Number / Title Credit Hours Third-Party Sponsor Information Organization name (required) Address Address (required) Address 2 City/Town (required) State/Province (required) - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code (required) Counselor email Invoicing email (required) Required for invoicing. Billing Guidelines and Acknowledgements I want the third-party to be billed before scholarships or grants are applied. This will allow students to receive refunds of excess aid. WMU applies any scholarships or grants to a student’s account before billing the third-party. Students can only receive financial aid up to their total cost of attendance. I acknowledge that our organization has discussed with the student and guardian that they are responsible for any charges incurred by the student that are NOT covered by the organization. I have read the Western Michigan University Third Party Billing Policy and agree to the terms. I am authorizing Western Michigan University to bill for the specified tuition and related fees for the term(s) indicated for this student or cohort. Authorized Signature (Sponsor) (required) Date (required) Attachments Multiple student list Upload Must be in Excel or CSV format with Last Name, First Name, WIN, Semester(s), and Course Info columns. If the amount varies by student, include the total number for each student.One file only.100 MB limit.Allowed types: csv, xls, xlsx. Additional documentation Upload Maximum 9 files.100 MB limit.Allowed types: txt, rtf, odf, pdf, doc, docx, csv, xls, xlsx. Submit Leave this field blank
