Confirmation of Enrollment Form

Biographical Information

I am a:*

First Year Student

Transfer Student

Returning Houghton Student

Hidden: $300 due for FY/Transfers

Hidden: $100 due for Returners

Hidden: Total Amount Due

How many years of college have you completed?

Student Contact Information

Student Mailing Address:*

Country

Street

City

Region

Postal Code

Student Cell Phone* (it is important to list the student's cell phone and not a parent/guardian phone number)

Student Email Address*

Emergency Contact Information

Please enter contact information for 2 emergency contacts. When applicable, emergency contacts should include a parent(s) or legal guardian(s).

Emergency Contact 1

First Name*

Last Name*

Phone Number*

Email Address*

Relation to you*

Emergency Contact 2

First Name*

Last Name*

Phone Number*

Email Address*

Relation to you*

Residential Information

I will be a...*

Resident (living in a residence hall)

Commuter (not living in a residence hall but attending classes in person)

Full Time Student

Full Time

Part Time

Houghton Gift!

You get to pick which Houghton gift you would like!

$25 Bookstore Gift Card

Baseball Hat

Mittens

Winter Hat

Enrollment Deposit Payment

The deposit is refundable* until May 1 and goes directly toward the cost of attendance.

*With the exception of Honors at Houghton students. Deposits for Honors at Houghton students are non-refundable, as their deposit secures their spot in Houghton's Honors Program.

Payment Preference

Pay online from a checking/savings account or credit card

Pay online through PayMyTuition or Flywire (for Canadian and International students)

Mail a check to Houghton University

Pay enrollment deposit:

Amount Due
Transaction Fee	Dependent on selected payment type
Total	Dependent on selected payment type
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Amount Due

Transaction Fee

Dependent on selected payment type

Total

Dependent on selected payment type

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Pay your deposit now with one of the below choices:

Mail check to:
Admission Office
Houghton University
PO Box 128
Houghton, NY 14744

In the "Memo" area, indicate the name of the student and enrollment deposit (example: Enrollment Deposit for John Smith).

Confirmation of Enrollment Form

Houghton University
1 Willard Avenue
Houghton, NY 14744

+1-800-777-2556
+1-585-567-9200
admission@houghton.edu

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