The purpose of this form is to expedite consideration of tuition and fee waiver requests by providing a similar format to request the waiver(s) and to secure internal approvals from department/unit heads and deans.
INSTRUCTIONS: Submit the completed form to the Office of Grant and Contract Services (OGCS) Grant and Contract
Administrator (GCA) assigned to your unit; OGCS will forward the request to the Vice President for Research (VPR) for review and decision. The following documents must be included with this request: proposal abstract, detailed budget, budget justification.
The Office of Grant and Contract Services is located in Suite 240, ARD Bldg. #56, Flagstaff, AZ 86011-4130. Please contact your GCA or OGCS at 928-523-4880 or via e-mail to ogcs@nau.edu
for assistance in completing this form.
Date:
Proposal Deadline:
Principal Investigator:
Project Title:
Sponsor:
Program:
F&A rate % and base (MTDC, TDC, other) allowed by the Sponsor
1.
Is this a NEW waiver request or a request for CONTINUATION/RENEWAL of waivers for an existing sponsored project? If this is a continuation request, list the NAU Account Number:
2.
Are tuition and fees allowable charged to this grant proposal? If allowable, explain and justify why a waiver of one or both is being requested. What university, school, or departmental interest(s) are served by waiving the direct costs of tuition and/or fees that are allocable for this project?
Tuition Allowed by Sponsor
Tuition Requested from Sponsor
Difference (Amount to be waived)
= $ Fees Allowed by Sponsor
= $ Fees Requested from Sponsor
=
=
= $ Difference (Amount to be waived) =
$
$
$
3.
Provide the following information for each course:
Course # Semester # of credit hrs Tuition $/hr. # of Students
Total value ($) of Tuition Waivers
Total Cost per Course
$
4.
What academic fees, if any, are included in the request?
Fee Cost
Tuition and Fee Waiver Request Form
# of Students
Total value ($) of Academic Fee Waivers
Total Cost per Fee
$
08/2013

Principal Investigator/Project Director (PI/PD) Certification: I certify that the information provided above and in the attached documents is accurate to the best of my knowledge.
______________________________________
PI/PD Date
Department/Unit/College Endorsement: Waiver of the requested tuition and/or fees is in the best interests of the department/unit/college for the reasons described above, and we endorse this request.
______________________________________
Department Chair/Director Date
______________________________________
Dean/Director Date
APPROVED:
_______________________________________
William P. Grabe, VP for Research Date
Tuition and Fee Waiver Request Form 08/2013