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Part 1 Identify yourself (mandatory) Student Number: _______________________Queen's Email: ________________________________________
 

Summary: Part 1 Identify yourself (mandatory)
Student Number: _______________________Queen's Email: ________________________________________
Student Name: _______________________________________________________________________________
Last Name First Name Initial
Part 2 Setup Pre-Authorized Payment Plan (PPL)
This method of Payment is available to students in the School of Graduate Studies only
Attach a void cheque or official document from banking institution (to include: full name of student, bank
number, branch number and account number).
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activity fees, and UHIP. Please select additional fees you would like to include:
Residence Meal Plan Other: _______________________________
Part 3 Important Information
This authorization will be in effect for the Fall, Winter, and Spring/Summer terms. Monthly deductions will
continue until the student submits the Change to Pre-Authorized Payment Plan form to discontinue or
payment in full is received*.
The Pre-Authorized Payment Plan is calculated at the beginning of each term. If there is an addition/change
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Deductions take place on the 5th day of each month, for eleven consecutive months (October to August)

  

Source: Abolmaesumi, Purang - School of Computing, Queen's University (Kingston)

 

Collections: Computer Technologies and Information Sciences