Student ID#:

First Name:

Last Name:

Email Address:

Verify Email:

Phone #:

Number of cards requesting?

PLEASE READ

• I understand that each meal card is worth ten meals and costs $71.74.
• I authorize the meal card to be charged to my student account with Cowley College.
• I acknowledge that I am responsible for paying this amount, along with all other charges on my student account in accordance with Cowley College’s payment policy.
• I authorize the use of Federal grants and loans to pay the meal card on my student account.
• I understand it may take 2-3 business days to process this request.
• I understand that meal cards carry over from semester to semester but not year to year.

I have read and understand the statement above:

Digital Signature (Type your name.):

Today's Date: