Spouse Remission Form
REMINDER: This form must be filled out for each semester 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):
College:
Summer
Arts & Sciences
Fall
Business
Spring
Pharmacy
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
Spouse Information
Name: _______________________________________ SSN: ____________________ DOB: _____________
_________________________________ __________
Employee Signature
Date
________________________________ __________
Spouse Signature
Date
____________________________________ __________
Instructor Signature
Date
(If auditing a course, the course instructor’s signature is required)
Note: All 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.
CRN
Subject
COURSE REGISTRATION
Course
Section
Credit HRS
Office Use
Total Credit HRS: _________
Office USE ONLY
HR Director: _______ Employment Validation: _______ Performance Status: _______ Affiliate%: _______ Date: ____________
Registrar: _____________ Add Course: _____________ Date: _______________
Financial Aid: _____________ Process Aid: _____________ Date: _____________