Tuition Waiver Form

RF-HCB 9/09

RESEARCH FOUNDATION GRANT RELATED TUITION FORM

Instructions: Please complete one form for each student who will be entitled to a grant related tuition payment. If tuition is to be waived, the student must pay his/her own fees, or the project director must arrange for the project to pay fees. Fees may not be waived. This form must be approved by the Office of Research Administration before registration. This is the only form that will be accepted for registration purposes.

PLEASE PRINT CLEARLY & ANSWER ALL QUESTIONS

TUITION WILL BE^*: SEMESTER:

WAIVED BILLED FALL SPRING SUMMER ___________

                     CIRCLE ONE                                                                                           CIRCLE ONE                                           YEAR


DEPARTMENT: ____________________________________                 REVISION?:        Yes         No

Circle one

I am a NY state Resident □ or Non NYS Resident □ as defined by Hunter College A revised form should include all

Admissions. Please check a box. Classes covered by the grant.

The grant will pay the out of state Tuition YES □ No□

RESEARCH FOUNDATION ACCOUNT NUMBER: RF#___________________________

STUDENT’S SOCIAL SECURITY NUMBER: __________---____________---______________

STUDENT’S NAME: _____________________ ____________________________

Last name First Name

COURSE NUMBER CODE # CREDITS COST/CREDIT CLASS COST

_________________ ________ _________ $195 (UG) $310 (G) $365 (SSW) _______________

________________ ________ _________ $195 (UG) $310 (G) $365(SSW) ________________

_________________ ________ _________ $195 (UG) $310(G) $365 (SSW) ________________

_________________ ________ _________ $195 (UG) $310 (G) $365 (SSW) ________________

For Office Use Only

Amount Waived ____________

Amount Billed_______________

Student activity fees will be paid by: STUDENT GRANT

Circle One

TOTAL AMOUNT OF TUITION WAIVER/BILLING: $______________

**Tuition can only be waived at the in-state rate.**

I agree that in the even I drop credits, (I.E. Reduce my course-load STUDENT HAS BEEN ADMITTED TO HUNTER COLLEGE? YES NO

Or do not complete the class after the deadline for 100% refund of Is this semester the First Semester for the student? YES NO

Tuition), I will be responsible for all waived and /or billed and fees. If YES, will the grant cover the application fee/? YES NO

Students Signatures: ____________________________________ PI OR DESIGNEE”S SIGNATURE: _____________________________

DATE: DATE:

FOR OFFICE USE ONLY

Research Administration _____________________________________________________ / /
Approval: Signature of Director or Assistant Director Date