CERTIFICATION FOR TUITION WAIVER
(Form must be completed each semester and returned to the Director of HR)
Waiver for:
Employee
Semester/Year : Fall
Spouse
(year)
Dependent Child
Spring:
(year)
Undergraduate Center for Lifelong Learning Course(s):_________________________________
Employee Name: _____________________________ Employee ID Number: ______________
Department: _________________________________ Title: ____________________________
Phone: ______________________________________ Email: ___________________________
Circle one:
Employment Status:
Home
Cell
Full-time Faculty
Full-time Staff
Student Name: _______________________________ Student ID Number: ________________
(if different from employee name)
Credit Hours to be taken: ___________ Dependent’s Date of Birth: _____________________
Dependent’s Marital Status: _________________________ (Single, Married, Divorced)
********************************************************************************************
I have read and understood all provisions of the tuition waiver policy (See overview on page 2 of form and Staff
Manual Section 604 and Faculty Manual Sections K.7 and N.3). My signature affirms that all information provided
on this form is complete and true to the best of my knowledge. I hereby acknowledge my responsibility to inform
Human Resources, in writing, of any change in enrollment, employment status, or dependent marital status. I
understand that the tuition waiver is for tuition only and does not cover books, supplies or any fees or charges such
as, but not limited to, graduation fees, broadband fees, nursing fees, private music licenses, testing fees, student
teaching fees, online technology fees.
Employee Signature: ___________________________________ Date: ____________________
Spouse Signature: _____________________________________ Date: ____________________
Dependent Signature: __________________________________ Date: ____________________
Supervisor’s Approval: _____________________________________ Date: ______________________
(for employee tuition waiver only)
Director of HR Approval: _______________________________ Date: ____________________
Credits Approved: _______________
OVERVIEW
1. Regular full-time employees may enroll in one university course each term during
employment and receive full scholarship assistance (tuition waiver) for tuition charged.
2. DEPENDENTS (as defined by IRS guidelines) and SPOUSE of regular full-time
employees will receive full waiver of undergraduate tuition (does not include masters
or doctoral programs). No retroactive credit will be given for students of employees
hired during the current academic term if the employee currently has family members
enrolled.
3. The amount of tuition waiver will be reduced by the amount of grants, scholarships, or
governmental assistance received for all commuter students.
4. Dependents, who are campus residents, may use outside scholarships to offset room and
board charges. In all cases, grants and governmental assistance must be used to offset
tuition charges, not room and board charges.
5. Enrollment is subject to the normal entrance requirements of the University and is on a
space available basis, with scholarship assistance contingent upon verification of
eligibility by the Director of Human Resources.
6. The employee must remain employed through completion of the course in order to
receive the full tuition waiver for themselves, their spouse, and their dependents. A prorated charge of costs will be made in the event of separation of employment.
7. For EMPLOYEES, course work is expected to take place during non-work hours.
Enrollment in a course that is available only during working hours is subject to approval
of the employee’s supervisor and is limited to one course (maximum 5 credit hours) per
term. Time taken during work is taken without pay in the absence of alternative
scheduling approved by the supervisor. (It may not be possible for some departments to
provide such approvals because of operating requirements and staffing considerations in
the department.)
8. Tuition waivers apply in the case of DEPENDENTS until they complete a baccalaureate
degree, attain the age of twenty-five or become married, whichever occurs first.
9. Summer School tuition, Interim Class(es) tuition, and Overload fee do not qualify for a
tuition waiver.
10. Undergraduate courses offered through the Center for Lifelong Learning and RN to BSN
are eligible for the standard tuition waiver assuming that the minimum number of regular,
tuition paying students for said course has been met.