Online Purchase Order Submission Form

3rd Party Name*
Organization ID Number*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Name*
First Last
Contact Phone*
Contact Email*
Invoices may be emailed to the email address listed above?*
- Yes
- No
Term*
Year*
3rd party will be paying ALL tuition and associated fees for the following students*
- Yes
- No
Please visit the following website for current tuition rates and associated fees: https://umaine.edu/bursar/tuition-and-fees/*
Please visit the following website for current tuition rates and associated fees: https://umaine.edu/bursar/tuition-and-fees/
Student ID# Student Name Course(s) Covered Amount Covered
Notes

Anticipated Resources must be entered by each student on their MaineStreet account in order to avoid late fees and communicate that there is a 3rd party paying their bill. Step-by-step instructions can be found here: https://umaine.edu/bursar/resources/

Due to FERPA regulations, we are not able to discuss account details without written authorization. Such details include charges, enrollment, grades, attendance, etc.

Please direct any questions to:
Nancy Bergerson
3rd Party Billing Specialist
Tel: 207.581.1530
umbursar3rdpartybilling@maine.edu

Student ID#	Student Name	Course(s) Covered	Amount Covered