FEE WAIVER FORM
FOR MINISESSION/FLEX COURSE
Semester/Year : ___Fall 20____ ___Spring 20____
___Summer 20____
Name________________________________________________ Date____________________
(Last) (First) (M. I.)
Student ID:___________________________
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Course & Number Section Number Hours
_____ WAIVE FEE ___________________________ ________________________ ______________
______________________________________________ __________________
Student’s Signature Date
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Comments/Justification:
______________________________________________ __________________
Registrar’s Signature Date
______________________________________________ __________________
Bursar’s Signature Date
It is the student’s responsibility to take this form to the Bursar’s Office in order to have the fee waived.
Form 1412/007 (2/08)