Tuition Waiver Form

Tuition Waiver Form
Student Information
Name
First NameLast Name
Student ID
Program/Department
Phone Number
Please enter a valid phone number.
Email
example@example.com
Tuition Waiver Details
Waiver Percentage
Academic Year
Waiver Amount
Reason for Waiver
Terms and Conditions:
I, the undersigned, understand and agree to the following terms and conditions of this tuition waiver:
1. The waiver granted is applicable only to the specified program and academic term or year mentioned above.
2. I am responsible for any additional fees, textbooks, and materials not covered by this waiver.
3. The tuition waiver is subject to compliance with academic progress and any applicable policies of the institution.
4. The waiver may be adjusted or revoked if my status changes or if I fail to meet the specified requirements.
Date
MonthDayYear
Date
Requester's Signature
Clear
Should be Empty: