DEPENDENT CHILD REMISSION FORM
REMINDER: Form must be filled out annually for each academic year tuition remission is requested.
Once this form is complete, please submit to the Human Resources office located in the Lehr Memorial Building.
Please contact the HR office with any questions regarding this form at 419-772-2013.
Employee Information
Name: ___________________________________________ Class: ____________ ID#: __________________
Department: ______________________________________ Title: ___________________________________
Semester (select ALL that apply):
Summer
Fall
Arts & Sciences
Business
Pharmacy
College:
Spring
Engineering
If non-ONU employee, how many years have you been employed? __________ Date of Hire: ______________
Have you applied for any other forms of scholarships, grants, or financial aid (excluding loans) before making
this request?
Yes
No
Dependent Child Information
Name: _______________________________________ ID#: ____________________ DOB: _____________
_________________________________ __________
Employee Signature
Date
________________________________ __________
Dependent Child Signature
Date
Note: All dependent children under the age of 25 (including legally adopted children) and spouses of full-time University employees are entitled to
full remission of tuition for undergraduate level educational courses offered at the University. Benefits are available only for undergraduate level
educational courses offered at the University. Students will be charged and are responsible for additional administrative credit hour fees, the
semester technology fee, and applicable course fees. Administrative fees are nonrefundable after the first day of class.
The completion of this form is for tuition remission requests only. This form alone will not register you for your semester courses.
Registration for classes will continue to follow the current process of a traditional undergraduate student.
OFFICE USE ONLY
HR Director: _______ Employment Validation: _______ Performance Status: _______ Affiliate%: _______ Date: ____________
Registrar: _____________ Add Course: _____________ Date: _______________
Financial Aid: _____________ Process Aid: _____________ Date: _____________