Sample Authorization Letter Your Letterhead Lansing Community College 7120-Student Finance PO Box 40010 Lansing MI 48901-7210 Ph: 517-483-1272 Fax: 517-483-9858 LETTER OF AUTHORIZATION DATE: / / accepts the financial obligation of the employee student as indicated below. _______________ (Your Company Name Here) We understand that our company is responsible for payment of tuition and fees even if the employee/student drops classes during the time that LCC offers only 50% refund or during 0% refund. STUDENT NAME: STUDENT BIRTHDATE: or LCC STUDENT # INSTITUTION: Lansing Community College SEMESTER: Fall AUTHORIZED and/or Spring Summer (please circle one) Year COURSES: AMOUNT: $ Choose one of the following billing options for sponsored employees/students who may be eligible to receive financial aid: _____Bill our company first for our student’s tuition and/or fees. _____Bill our company first if a student is receiving loans only (money that must be repaid). _____Bill financial aid first if a student is receiving grants and/or scholarships (gift aid). PLEASE SUBMIT BILLING TO: Your Contact Person: Your Street Address: City: Your Phone Number: State: ( ) Zip: - *PAYMENT WILL BE DUE WITHIN 30 DAYS OF RECEIPT OF INVOICE AUTHORIZED SIGNATURE: ______________________________________________________________________ AUTHORIZED NAME/TITLE: ____________________________________________________________________ TIN (tax id number): __________________________