NON-WORK RELATED
TUITION WAIVER APPLICATION
Traditional Undergraduate Only
Instructions for completing application:
1.
Tuition waiver application for full-time undergraduate students must be completed once
per academic year and submitted to Human Resources one (1) month prior to registration.
2.
Applications for courses less than full-time must be completed and submitted to Human
Resources one (1) month prior to the start of each term. Do not complete this application until the
student has been pre-registered.
3.
Make sure to complete the total number of courses being taken, the term and year, and
sign the application.
********
Employee's Name _____________________________ Date______________________
Department _________________________________________
Person for whom application is made ____________________________________
ID#____________________
Relationship to Employee _________________
Dependent for Tax Purposes?  Yes
 No
Birth date of student ____________________________
Term/Year ______________
Academic Program (check one): Full-time _______ Part-time __________
Open Enrollment ____________
Number of units to be taken (if Not full-time)
__________
Summer Semester: list course name and number____________________
Specify
___________________________________________________________
NOTE: Summer session travel courses are NOT eligible for tuition remission
Accepted?  Yes
 No
Preregistered?  Yes
 No
Signature of Employee ___________________________________________
Human Resources Approval ________________
Waiver % _____________
Business Office Approval __________________
Part-time: Term_____________
Amount _______________
Full-time: Year_____________
Amount_______________
TUG Waiver Form
Rev. 4/2013
Conditions of Tuition Waiver:
Tuition Waiver Benefit
After one year of employment, full-time employees and their eligible dependents are eligible
to take advantage of attendance in most Saint Mary’s College courses, with reduced or fullywaived tuition, subject to certain limitations summarized in this section, and described more
fully in the Tuition Waiver Policy available in Human Resources and on the HR website.
Requirements and Limitations:
A partial list of tuition waiver requirements and limitations applicable to employee, spouse
and children of employees includes (please read the policy for a full list of requirements and
limitations):
1. Employees must have completed one (1) year of full time employment with the College
to be eligible for tuition waiver for themselves, spouses or eligible (dependent) children.
Eligible children must begin their program prior to attaining age 21.
2. An applicant for tuition waiver must meet the normal application and admissions
requirements of the College and of the academic program for which application is being
made.
3. Tuition waiver for any one student, including employees and their dependents, and near
relatives of Christian Brothers, may be received for a maximum of four (4) academic years
and may be applied only to courses undertaken in a single degree or certificate program.
4. All employee tuition waiver benefits must be approved by Saint Mary’s Human
Resources department.
5. Application for a waiver shall be made to Human Resources at the time application for
admission to the College is made. Renewal applications for full time enrollment shall be
made to Human Resources on or before the beginning of each academic year. Renewal
applications for part time enrollment shall be made before the beginning of each term.
6. This plan may be revoked or modified by the Board of Trustees of the College, effective
for current or future participants and commencing with the academic year immediately
following the date of such revocation or modification.
7. The tuition waiver is for tuition only and will not waive course fees (for lab materials,
travel, etc.), mandatory fees (student body fee, health insurance, etc.) or any room and board
fees.
Please note: Tuition waivers for undergraduate courses are considered to be tax exempt per IRS
section #117.
I have read and understand the above requirements and limitations regarding the Tuition Waiver
Benefit:
____________________________________
Employee Signature
TUG Waiver Form
Rev. 4/2013
______________________
Date