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


 

*BILLED MEANS CHARGED DIRECTLY TO THE GRANT.  WAIVED MEANS NO CHARGE TO THE GRANT.  A WAIVER MUST BE PREVIOUSLY APPROVED BY THE CHANCELLOR’S OFFICE.

                                                             * Cost/Credit – (G)   Graduate     (UG) Undergraduate   (SSW) School of  Social Work