KAPLAN-Attn.

: CRYSTAL TANGER
FINANCIAL AID 6301 Kaplan University Avenue Fort Lauderdale, FL 33309 Tel: 866-527-5268 (Toll Free) Tel: 954-515-4700

Graduate Textbook Voucher Additional Expense Form

A. General Information

Last Name First Name Middle Initial

Street Address

SSN

City

State

Zip

Home Phone

Email Address

B. Authorization

I authorize Kaplan University to credit my account with Title IV funds for not only tuition and fees, but also for other charges that I incur for educationally related activities. Examples of potential additional charges are specialized software and/or any additional textbooks. I understand that I have the right to cancel or modify the provisions of this authorization.

Students Signature Date

(Revised 04/07)