OHIO NORTHERN UNIVERSITY
Tuition Exchange Re-Certification Application Form 2016-17
I.
Personal Data
1. Student’s Name
Last 4 digits of SS#
2. Email Address
3. Permanent Address
4. College Attending (Fall 2015)
5. Intended Major Program of Study
6. Parent's Name
Telephone
7. Parent’s Email Address
II.
I certify that all of the above information is correct. The Tuition Exchange Selection Committee may
seek additional verification.
Signature of Applicant
Date
Signature of Parent
Date
(Parental signature affirms applicant is a dependent eligible under University policy for tuition remission
status and hence eligible for Tuition Exchange certification by ONU.)
Pleas return this application by November 1, 2015 to:
Mrs. Tammy Everhart, Academic Affairs, Ext. 2033