University of Southern Indiana - Graduate Studies: Application Deposit Form

Graduate Studies

Graduate Admission Application Fee Payment

This is a secure site; any information you exchange cannot be viewed by anyone else on the Web.

Please fill in the information below, then press the Submit Information button to securely send your Graduate Admissions Application Fee Payment to the University of Southern Indiana.

Secure Graduate Admission Application Fee Payment

Student ID Number:

Ex. 111223333

Student Name

First Name

M.I.

Last Name

Street Address:

City, State, Zip:

City

State

Zip Code

Student Birth Date:

Ex. mm/dd/yyyy

Credit Card Type:
Credit Card Number:	Ex. 0000111122223333
Expiration Date:	Ex. mmyy
CVV Number:	How to find your CVV number

Cardholder Telephone:	Ex. 3174512258
Cardholder Email Address:

Application Fee:	$40.00 (non-refundable fee amount)

8600 University Boulevard - Evansville, IN 47712-3596 - 812/464-8600