Completion of this Payment Agreement Form is required as part of the admission process. Please complete this form in addition to the application. If you have not filled out the application, click here to download and print.

Section I: Applicant Information

 
Last Name*
First Name*
 
Country*
 
Address 1*
 
Address 2
 
   State*    Zip*
City*
 
 Home   Cell   Office      
Primary Phone*
 
 Home   Cell   Office      
Secondary Phone
 
Email*

Section II: District Information

 
I work in the following State:
 
I work in the following District:
 
District Name (If Other):
 
Your CPS Employee ID:
CPS Employee ID is a 9 digit number beginning with "000" and can be found on employee's paystub above your earnings for that period.
 
District Name (Optional):

Section III: Degree Program

 
I have applied for admission into the following Program
 
Specify Start Date
 
Payment Type

CPS Payroll Processing Fee: $300

I acknowledge that the Board of Education of the City of Chicago (the Board) will withhold and remit tuition payments on my behalf to American College of Education (ACE) in connection with my enrollment in the College. I authorize the Board to withhold and remit the tuition obligation on my behalf to American College of Education (ACE) in accordance with the deduction schedule below. Additionally, I authorize the Board to withhold non-refundable payroll processing costs of $300 (in two deductions of $150 each) payable to Chicago Public Schools associated with payroll withholding services. These deductions will commence with the first payroll period after approval of this application and enrollment into the College and will be followed by tuition deductions payable to ACE.
Number of DeductionsProgram Tuition CostProcessing FeesTotal Program Cost & Processing FeesMaximum Program Cost Deduction per Paycheck
36$6,950$0$6,950$194

The fees below do not include application fees, graduation fees or fees for services (ie. Transcripts). Such fees are paid seperately and directly to the College.

Number of DeductionsProgram Tuition CostProcessing FeesTotal Program Cost & Processing FeesMaximum Program Cost Deduction per Paycheck
39$6,950$300$6,950$186
Number of DeductionsProgram Tuition CostProcessing FeesTotal Program Cost & Processing FeesMaximum Program Cost Deduction per Paycheck
36$6,950$300$6,950$202
Number of DeductionsProgram Tuition CostProcessing FeesTotal Program Cost & Processing FeesMaximum Program Cost Deduction per Paycheck
18$6,950$300$6,950$403

Please agree to the following payroll deduction authorization.

I authorize the Board to withhold the amounts indicated above for the program selected from my gross wages or salary commencing with the first payroll period after approval and processing of this application. I understand that deductions 1 and 2 represent payment of the processing fees and the related payroll withholding fees. I further understand that deductions 3 through 38, where applicable, represent tuition payments to ACE.

In the event that I resign, terminate or retire before the entire tuition and the administrative cost obligation is fully paid I authorize the Board to withhold the entire obligation outstanding from any vacation or sick leave payouts due me at resignation, termination or retirement. I agree that the Board will not be required to take any other action to commence the withholdings authorized by this paragraph. I also agree that the Board may institute an action in any court of competent jurisdiction to obtain a judgment against me or my heirs for any program obligation not satisfied by the payroll withholding or deduction from my final wages authorized by this paragraph.

Please note: The Chicago Public Schools may cease payroll deductions only upon notification from the American College of Education (ACE). Participants should contact ACE at 1-800-280-0307 or studentservices@ace.edu to submit a Drop request form. Participants will be notified by ACE when the request to terminate payroll deductions is submitted to Chicago Public Schools Department of Human Resources. Please note that deductions will cease upon fulfillment of tuition obligation to ACE.

I have authorized my employer to withhold the amount specified above on the stated schedule, and to remit such amount, on my behalf, to American College of Education.

In the event, that I cease my employment with my employer for any reason prior to payment of outstanding tuition and any related fees, I authorized my employer to the extent permitted by applicable law to withhold the entire amount of tuition then owed the College net of any refund from any vacation, sick leave, severance or regular wage payouts due to me at termination unless I have made arrangements with the college for an alternative payment plan.

Section IV: Payment Method

Payment is due FIVE CALENDAR DAYS prior to the course start date, after you have been accepted to the program, via the following methods:

Method 1: Credit Card

Payments by credit card can be made online in your MyACE student portal account:
An email will be sent to you with your username and password for access to your "MyAce" student portal account. Once you have received this email, you will need to visit http://www.ace.edu/ and click on the "Current Students" tab along the top of the screen, then click on the "Login to MyACE" icon on the right side of the screen. You will be asked for your username and password (if you have questions about your login information, email studentservices@ace.edu). Select the "My Finances" menu and the "Make a payment" link after logging in.

ACE Business Office is available to process tuition fees at 800-280-0307.

Method 2: Checks or money orders payable to American College of Education

All tuition checks or money orders should be mailed to:
Overnight mail delivery not available to P.O Box. Use different address for overnight mail.
American College of Education
P.O. Box 678564
Dallas, Texas 75267-8564

Overnight payment address only:
Northbrook Services
Attn: American College of Education (678564)
8711 Freeport Parkway N
Irving, TX 75063

IMPORTANT: Admission documents should NOT be sent to the payment addresses above. Transcripts, teaching certificates, etc. sent via regular or express mail should go to : Pearson/ACE 1900 East Lake Ave, Glenview, IL 60025. ATTN: Enrollment Support

Enrollment Agreement

By checking this box, I acknowledge a binding agreement between American College of Education and myself. I acknowledge that if admitted to the College, I will be enrolled in a degree program at the College; that I am financially responsible for payment of the required tuition and fees; and that I have read and agree to accept all of the College's rules and regulations, including refunds, cancellations, and grievance procedures, as specified in the current edition of the college catalog, which can be found at the following address: http://ace.edu/documents/Graduate_School_Catalog_2009-2010.pdf. I acknowledge that if I no longer wish to be enrolled at the College, it is my responsibility to submit a Student Status Change Form (available at www.ace.edu under the Current Students tab) in order to enact my withdrawal.
By checking this box, I acknowledge that once I am enrolled in my degree program by American College of Education, I will be able to access the Student Portal, which can be found at: https://myace.ace.edu/ immediately after receiving my username and password from the university; and have access to both the courses and the total quarter hours required for my program of study.
By checking this box, I acknowledge that there may be State certification requirements that must be met, beyond the scope of the College's admission and program requirements. I understand that my State is the source for the most accurate and up-to-date information on certification requirements and that it is my responsibility to remain informed about my State's requirements. I understand that State requirements will affect the applicability of my program in specific States, and I take responsibility for meeting these requirements. I have reviewed and understand the State certification requirements specified in the College Catalog, which can be found at the following address:
http://ace.edu/documents/Graduate_School_Catalog_2009-2010.pdf

The College reserves the right to terminate a Student's enrollment for failure to maintain satisfactory academic progress, failure to pay tuition or fees by applicable deadlines, disruptive behavior, posing a danger to the health or welfare of students or other members of the College community, or failure to abide by the College's policies and procedures. The College can discontinue a student's enrollment status, not issue grades, and deny requests for transcripts should a student not meet all of his/her financial and institutional obligations.

Electronic Signature

By typing my name below and clicking the 'Submit' button, I acknowledge that I am providing an electronic signature for this document. In doing so, I attest that all of the information submitted on this form is true and accurate and that I have read and understand all parts of this document.

 
Please type in your name: