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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. Please scan and email the signed form to

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