Student Representation Fee Waiver
The Student Representation Fee is a mandatory $1 fee charged to all students each semester for
purposes of providing Associate Student Government representatives the means to represent BCC
students before city, county, district, state, and federal government as well as public agencies.
This fee may be waived for any political, religious, financial, or moral reason. To waive the fee, complete
the following and email the form to the Director of Student Life and Development (Joann Garcia –
jgarcia@barstow.edu) or the President of the Associated Student Government
(asg_president@barstow.edu).
Students must submit the waiver no later than the published fee payment deadline or within one week
of registering for classes if registering in late starting classes. The fee cannot be waived once paid or
after these deadlines.
Section I – Student’s Personal Information
B Number
Name
Email Address
Address
City
State
Zip
Section II – Acknowledgement from ASG (Signature from Director of Student Life and Development or
President of ASG required)
Signature
Date
Section III – A&R Use Only
Date form received
Student Registration Date
Representation Fee Paid: ___Yes ___No
Waiver Submitted Before Payment Deadline: ___Yes ___No
Late Starting Classes Only: Student Submitted Waiver Within One Week of Registration ___Yes ___No
Student Eligible for Waiver: ___Yes ___No