University of Wyoming
Office of the Registrar
Graduate Student Optional Student Fee Package Petition
Approval of this form will allow graduate students who qualify to purchase the optional student fee package and be considered a full-time
student for the indicated semester for student loan deferment and insurance/government documents. The student benefits package allows
access to Student Health Services, UW athletic events, ASUW membership, and access to Campus Recreation facilities/activities.
The student benefits package is required of part-time students who wish to purchase the UW student medical insurance.
To be eligible, a degree-seeking graduate student must be either an international student enrolled in less than 9.0 credit hours during the
fall or spring semester or a domestic student enrolled in less than 4.5 credit hours during the fall or spring semester and be a:
1. Master’s degree student with 90% of their coursework completed, have a program of study on file with the Office of the
Registrar, be registered for at least one credit hour, and be working full-time on thesis research or a Plan B paper.
2. Ph.D. degree student who has passed their preliminary exams (and have the appropriate paperwork on file with the Office of
the Registrar), be registered for at least one credit hour, and be working full-time on dissertation research (or be a Psychology
Ph.D. student doing an internship).
This form must be submitted to the Office of the Registrar by the last day to add courses for each semester
if the student wishes to have the student medical insurance.
Name:
Student ID#:
Department:
Semester/Year:
U.S.
Citizen?
Yes
No
Hrs. Enrolled this term:
Assistantship:
Yes
Currently registered
through WyoWeb?*
Yes
No
*Failure to be registered at the time this document is submitted will cause significant
delays and perhaps will cause you not to qualify at all.
Graduate Student?*
Yes
No
*The student fee package is available only to graduate students.
Student Signature
Date
Major Professor and Department Head/Chair certification that student meets one of the qualifications listed above:
Major Professor Signature
Date
Dept. Head/Chair Signature
Date
If student is on an assistantship, the “Tuition and Fees Designation” form must be submitted.
If this form is properly submitted and the student is properly registered:
 The student will be coded as full-time by the Office of the Registrar;
 The Accounts Receivable Office will add the charges for the fee package to the student’s account. Also, if the student has
chosen through WyoWeb to purchase the Student Medical Insurance, those charges will also be added to the student’s
account.
This form should be submitted to the Office of the Registrar. If there are questions, please call (307) 766-5272.
Document1
No