KENTUCKY STATE UNIVERSITY
Office of Bursar, 400 East
Main Street, Frankfort, KY 40601
Telephone (502) 597 6278,
Facsimile (502)597 5936
FEDERAL WORK STUDY CHECK
hereinafter also referred to as Student, hereby authorize
hereafter referred to as School, to credit my Federal Work Study check from time
to time to my Student Account No.
at the School for payment of institutional charges including, but not limited
to, tuition, fees, room, and board. To accomplish this I waive check endorsement
rights and authorize the School to deposit my work-study check into the School
General Fund after the credit entry to my account. This
authorization will remain in effect until the School receives written notice of
termination from the Student. I have retained a complete copy of this
Authorization for my record.
agree that above information is correct.