Fee Waiver Follow-Up Questionnaire
Please complete this questionnaire to provide updated information regarding your fee waiver application.
Applicant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference Number for Original Fee Waiver Application (if available)
Have you previously been granted a fee waiver?
*
Yes
No
Please indicate your current employment status
*
Employed full-time
Employed part-time
Unemployed
Student
Retired
Other
Monthly Household Income and Expenses
*
Rows
Amount (USD)
Total Monthly Income
Total Monthly Expenses
Have there been any significant changes to your financial situation since your original fee waiver application?
*
Yes
No
If yes, please describe the changes to your financial situation
Please upload any supporting documents (such as pay stubs, benefits letters, or other proof of financial situation)
Upload a File
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Choose a file
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Please share any additional information that may help us review your fee waiver request
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