George Mason University Graduate Admission Application Fee

Credit Card Authorization Form

Applicant Information

Date of BirthApplicant's Name

Application Type

Applicants who failed to pay their graduate application fee online, may pay the graduate application fee using this

credit card authorization form. We accept MasterCard or Visa only; we do NOT accept Discover or American

Express.

Credit Card Authorization

Application Term

Fall Spring

Signature Date

I acknowledge that George Mason University graduate application fees are non-refundable and non-

transferrable. I authorize the Office of Admissions to charge the following amount to my credit card (check

one):

MasterCard Visa

Card Type

Billing Address

Street Address

I authorize George Mason University to charge the credit card indicated in this authorization form. This payment

authorization is for the goods/services described above, for the amount indicated above only, and is valid for one

time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with

my credit card company; so long as the transaction corresponds to the terms indicated in this form.

Mailing Addresses

This credit card authorization form must have your original signature. Please mail this form directly to the

college or school to which you are applying:

Email: [email protected]

Graduate Admissions

4400 University Drive MS 5A8

Fairfax, VA 22030

Email: [email protected]

College of Humanities & Social Sciences

Graduate Admissions

4400 University Drive MS 2D2

Fairfax, VA 22030

Email: [email protected]

3351 Fairfax Drive MS 3B1

Arlington, VA 22201

Email: [email protected]

Volgenau School of Engineering

Master's and Non-Degree Applicants:

Volgenau School of Engineering

Graduate Admissions

4400 University Drive MS 3D5

Fairfax, VA 22030

Email: [email protected]

Email: [email protected]