Contract or Grant Funded Course Arrangements "*" indicates required fields Step 1 of 5 20% Process Overview This form must be used if you are arranging a course that is fully or partly funded by a grant, a contracted third party, or, if you are requesting an executive waiver of charges from student accounts due to authorization by a dean of your department. The Bursar's Office does not continuously track whether students are registered for a particular course that requires charges to be charged to a grant, a third party, or waived. Therefore, we urge you to inform students that it is possible they may receive a bill for the relevant courses at least up through add/drop period. Please remember, the bulk of students must be registered for the course before charges can be moved off student accounts or waived. Since we bill on a weekly basis through the last day to drop classes, in order to limit the occurrences of participating students receiving bills, the Bursar's Office must receive the student information as soon as possible as new registrations occur via this online request form. Upon receiving your completed online request, the Bursar's Office will process the data provided by moving the relevant charges from student accounts to the third party account or by waiving charges per your request. Once the Bursar's Office completes processing of your online request, you will receive an email notification that your request was processed along with a link to this site to obtain the completed file report. This will serve as confirmation that your request has been completed. If an in-house grant is paying student charges, the person assigned that duty from the relevant department must submit a payment request voucher to Accounts Payable (Jim Connelly) for payment of student charges to the Bursar's Office. If a third party contractor is paying student charges, the Bursar's Office will send a copy of the completed Contract Training Agreement along with an invoice for payment, if applicable, to the third party/agency. Requestor name* First Last Requestor email* Enter email Confirm email Extension* Authorizing division*The dean of this division will automatically be copied on this request. Academic Affairs Administrative Services Enrollment Services Nursing Workforce Development & Community Education Other Person responsible for obtaining authorized signatureOnly select "Someone else" if someone other than you or your dean is responsible for obtaining signature, e.g., if you are completing this form on behalf of a colleague or faculty member Me and/or dean Someone else Name of responsible person* Email* Enter Email Confirm email Signatory authority*Name of dean or supervisor authorizing this request Email* Enter email Confirm email Choose your course arrangement* Contract funded course Grant funded course Executive course waiver Executive course waiver: Per a dean or other official who is authorized to approve the waiving of tuition and/or fee charges for specific students or all students in a specific course. Typically this is not a third party contract or grant arrangement. In these instances, the instructor’s salary and fringe costs are part of the instructor’s normal workload and the full costs of student account tuition and fees are to be waived.Term for which this arrangement applies*202401202405202407202409202501 Contract coursesName of contracting party* Billing address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contact name* Contact phone and extension* Contact email* Enter email Confirm email Brief description of contract performance*For those responsible for setting up contract courses remember, a Contract Training Agreement must be signed between GCC and the third party. The Contract Training Agreement replaces the State Standard Contract previously in use. When your department has negotiated a contract course with another agency, the Contract Training Agreement must be completed. The agency/third party will sign the agreement first, then, it should be returned to GCC for a signature. A new payroll account code was created for the third party credit course contracts. Use this new code going forward. Please don’t change anything already submitted this year. The code to be used is 11500 2030 C01F 10. You no longer need to use the Day/DCE payroll account code. Unless other arrangements have been approved by an authorized signatory, third party contracts for credit courses will be billed out at a flat rate of $1,500 per credit ($4,500 for a 3 credit course). If other arrangements are approved, please be sure those arrangements are clearly stated in the Contract Training Agreement. A completed Contract Training Agreement must be provided to the third party/agency to be signed and dated prior to obtaining a signature from the GCC Authorized Signatory. Once the agreement is reviewed and approved by the GCC Authorized Signatory, he/she must sign and date it. The agreement must be ready to upload at the same time you are completing your online contract course request via this form. You will be unable to complete this online request unless you have the completed agreement ready to upload. Complete a Contract Training Agreement Pre-existing contract*Is there a previously signed Contract Training Agreement that remains in effect for this request that has already been submitted to the Bursar's Office? Yes No HiddenFund/Org/Account #s Upload contractSigned contract is required in order for this office to bill. Please scan and upload document complete with signatures. PDFs accepted only.Accepted file types: pdf, Max. file size: 8 MB. Grant-funded course arrangementsGrant/project name* Fund/Org/Account #s* Grant/project coordinator* Extension* Email* Enter email Confirm email Executive course waiversCourse/student/billing informationHow is the instructor's salary paid?* Part of normal workload By grant By third-party contractor Other Arrangement applies to* All students in a specific class Select students in different classes Select students in a specific class Select students for a specific number of credits Charges for this arrangement are* Waived Paid by grant or third-party contractor Partly billed to third-party or grant, and/or partly waived, and/or partly billed to student Does arrangement cover special program and course fees?* Yes No Notes or additional informationProvide details*HiddenBusiness Office — Upload spreadsheetOptional - upload spreadsheet here if you are not completing any of the fields below Drop files here or Select files Accepted file types: xls, xlsx, csv, doc, docx, pdf, xlsx, Max. file size: 8 MB. All students in a specific classCourse information*CRNCode, num, section Add RemoveSelect students in different classesStudent/course informationNameID#Subj/Course#/SectCostBilledWaivedBilled to studentNotes Add RemoveSelect student(s) in a specific classCourse information*CRNSubj/Course#/Sect Add RemoveStudent informationNameID#CostBilledWaivedBilled to studentNotes Add RemoveHiddenTotalsCostBilledWaivedBilled to studentNotes Add RemoveSelect student(s) for a specific number of creditsStudent informationNameID#CreditsCostBilledWaivedBilled to studentNotes Add RemoveOptionally upload a spreadsheetIf you have a long list of students, you may prefer to upload a spreadsheet insteadAccepted file types: xls, xlsx, csv, txt, Max. file size: 8 MB.