UB ePay

1. Personal Information
(Please complete the following information)

Student First Name:	* M.I.:

Student Last Name:	* Suffix (Jr.,etc.):

Student Person Number
or Social Security
Number:	*

Student Gender:	*

Student Birthdate:
(use 4-digit year)	* Month: Day: Year:

Phone Number:	*

Your E-Mail:	* (for e-mail receipt)

Apply to Semester:	*

Program Name & Location:	*

* - Required

(Please verify that this is the correct payment item.)

Study Abroad Semester Program Deposit ($500.00)

Site for payment of program deposits for participants in semester-long UB study abroad and student exchange programs.

PARTICIPANTS IN SUMMER OR WINTER PROGRAMS SHOULD PAY PROGRAM DEPOSITS AT SUMMER/WINTER DEPOSITS

PARTICIPANTS IN SHORT-TERM NON-CREDIT ROTATIONS SHOULD PAY DEPOSITS AT SHORT-TERM ROTATION DEPOSIT SITE

Study Abroad Semester Program Agreement

I verify that I have received an offer of admission to a semester-long UB Study Abroad or Exchange Program from UB's Office of Study Abroad Programs. I hereby confirm my intent to participate in the listed program through payment of this program deposit. I understand that if I withdraw from this study abroad program, this program deposit will not be refunded. I also understand that my participation in the program is contingent upon my acceptance of the terms and conditions of participation, as they are described in materials forwarded to me in the Study Abroad Program acceptance package.

Credit Cards / eChecks Accepted

UB currently accepts eChecks, Visa, MasterCard, AmericanExpress and Discover.

Debit Cards with Visa or MasterCard logos are accepted.

Daily limits on these cards vary, please contact your bank.

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