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Student Account Forms: Undergraduates

Guarantor Authorization and Debt Repayment Agreement

This document is used to add a guarantor(s) to an individual student account and is required in order to disclose any financial information to anyone other than the student.

Guarantor Authorization and Debt Repayment Agreement

Third Party Billing

If a third party (i.e. outside agency, corporation or State Prepaid Tuition Plan) will be paying all or part of your tuition and fees, and the third party requires a bill or invoice to be mailed directly from the Office of Student Accounts, a written authorization must be received from the third party thirty days prior to the beginning of classes. Please note: The University requires a Financial Information Release Form completed by each student requiring Third Party Billing.

Third Party Info Release form

Refund Request

Students who have a credit balance on their student account and ARE NOT receiving federal loans may submit a written request for those funds to be refunded to them. If you have requested your Title IV funds to be retained in your student account, you may also request a refund by simply sending an e-mail request to

Student Health Insurance

Students who have previously waived University-sponsored student health insurance can purchase it at any time by submitting an acceptance form. For more information regarding the Vanderbilt University student health insurance plan, click here (undergraduate / international).

Petition to Add Health Insurance

Replace Lost Check

If you need to replace a lost, destroyed, or stale-dated refund check you must complete the replacement form:

Replace Lost Check