Housing Registration Fee

Student Information

First name

Last name

UE ID Number

Payment Information

Card Number

Expiration Month

Expiration Year

Card Security Code

Name On Card

Billing Street Address

Billing Address City

Billing Address State

Billing Address ZIP

Billing Email Address

Billing Phone Number

You authorize the University of Evansville to initiate a charge to the above specified credit or check card. Your credit or check card statement will reference "U OF E BUSINESS OFF" as the payee. You affirm that:

I have read, understand and agree to be bound to the terms of this agreement;
I am authorized to perform transactions using the card information above;
I accept the terms of this agreement and certify, under penalty of law, that the information provided above is correct.

Should this transaction fail for any reason (including invalid account numbers, chargeback etc.) you understand that additional penalties, fees and interest may accrue.

Total payment amount: $75