Bursar Forms



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Bursar Forms

Address Change Form
Change your local, billing, and/or permanent address and fax it directly to us.

Correction of SSN (Form W-9S)

To correct a student's Social Security Number, complete this form and return it to the
Bursar's Office. Proper verification in the form of a social security card will be required to initiate the correction.

Refund Deposit Form

Have your Bursar Refund Check directly deposited into your checking/savings account
or on to your Saluki Cash Card. Simply complete this form and return it to the Bursar's Office.

Revocation Form
Have your direct deposit stopped by filling out this revocation form.

Customer Survey
Let us know how we are doing.

Automatic Payment Authorization Form
Your monthly payment can be processed automatically on the date indicated on your monthly
statement by using your credit/debit card or your checking/savings account.

Credit Card Fax Form
To pay on an account by credit card (card holder's signature required on payment form)
complete and fax this form directly to us.

Perkins Loan Forms
Find the Perkins Loan Deferment Forms and Cancellation Forms here.

Student Insurance Refund Forms
Find the Student Health Insurance Refund Form here.

Collection Report

Bursar Deposit Correction Form

Click for these forms.

Customer Survey
Let us know how we are doing.

Southern Illinois University is an equal opportunity employer and will not discriminate against
any person on the basis of race, religion, national origin or sex in violation of Title VII.