Employee / Dependent Tuition Waiver Request

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Please correct the field(s) marked in red below:

Directions: Please complete this form for each term in which you are requesting a waiver for you or your qualified dependent. Use a separate form for each person. Denied request will be returned to employees. 

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Tuition Waiver Request is for: 
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Tuition Waiver Request is for:
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Classified Employees Only: By Checking the box below I certify that I have received acknowledgement from my supervisor for classes scheduled during my work hours. 
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Employee Information:
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Employee Information:
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Employee Classification
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Dependent Information:
Dependent Information:
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School Term:  Select the term and provide the year for the waiver request. 
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School Term: Select the term and provide the year for the waiver request.
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 Course Information:
Course Number# Course Name Credits
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By checking the box below, I acknowledge it is my responsibility to pay any balance due.
 *

Please allow two weeks for processing


Waiver eligibility per contracts, memos, and employee hand book. 

1. Distance Education fees are not covered by this waiver. 

2. Waiver includes tuition & fees (other than Distance Education) 

  • Exception Exempt techs with less than 5 years of service are eligible for tuition only. 

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Human Resources Use Only:
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Eligibility
Eligibility
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Financial Aid Use Only:

Financial Aid Use Only:
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Business Office Only:
Business Office Only:
  1. To receive a copy of your submission, please fill out your email address below and submit.