Dependent Tuition Grant Application
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(Based off drop deadlines according to the office of the Registrar)
September 4, 2020
December 16, 2020
January 25, 2021
May 27, 2021
Term(s) applying for: Fall 2020
Interim 2020
Spring 2021
Summer 2021
*I understand if I miss the deadline to turn in the application, I will not receive the grant for previous terms.
Student Information
Student Name
BEAR # _________________________________ Date of Birth _______________
(An eligible child must be under age 25)
Address ______________________________________________________________________________________________________
City _____________________________________________ State ____________ Zip Code___________________________
Phone Number________________________________ Email _____________________________________________________
Program Level Undergraduate Graduate (An eligible dependent must be admitted and enrolled by 9/1/19)
Degree Program
Study abroad & the MBA program are not covered under the tuition grant
EMPLOYEE Information
Employee name _________________________________________________________________________________________
BEAR # ________________________________
Employee Classification
Faculty Professional Administrative Classified
(If any section is not completed, your grant paperwork will not be accepted)
Is the student your spouse?
(Attach proof of marriage)
Is the student your eligible child under the age of 25? (Attach proof of dependency)
Did the student apply for FAFSA and COF?
(Please apply before completing paperwork)
Did the student apply for the UNC scholarship?
Is the student classified as an in-state Colorado resident? (If not, you understand you are liable
for the out-of-state tuition portion until you apply and are accepted as an in-state Colorado resident).
By signing below, we, the Employee and the Dependent (as listed above), acknowledge that we understand the above
information and guidelines listed in the board policy for receiving Dependent Tuition Grant. We also understand that we
may be subject to taxation under IRS Code section 117 or IRS Code Section 127. (See Payroll website at
http://www.unco.edu/payroll/ for the schedule of taxation.)
Employee’s Signature Date
Student’s Signature Date
To be completed by human resources
Employee FTE DOH _ HR Signature Date
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Dependent Tuition Grant Application
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Dependent definitions
Eligible Dependent: Eligible dependents are specified in statutes, primarily § 24-50-603(5), C.R.S., as modified
or further defined by other state statutes (e.g., Title 10) or federal regulations (e.g., Affordable Care Act [ACA],
IRC on taxable income).
A. Current Spouse, including Common Law Spouse and Domestic Partnership
1. Spouse means a spouse as recognized under federal tax law.
2. Common Law Spouse means an adult,
a. Who is at least 18 years of age; and
b. With whom the Employee cohabitates; and
c. Who represent themselves to the community as married to each other; and
d. There is no legal impediment to the marriage.
B. A child include:
a. a biological or natural child;
b. a legally adopted child;
c. a child legally placed for adoption or foster care;
d. a step child as long as the employee and natural parent are married;
e. a child of a partner in a civil union as long as the employee and parent are in a committed
relationship; and
f. a child for whom the employee has a court order granting legal custody or parental
responsibility that specifies the employee is responsible for providing health insurance
Acceptable Dependent Verification Documents
DEPENDENT Required documents
Registered marriage certificate
Spouse/ Domestic
Common-law affidavit OR
Domestic Partnership Affidavit
AND a document dated within the last 60 days
showing current relationship status, such as a joint
household bill or joint bank/credit account, etc.
The documents must be dated and list your
partner’s name at your mailing address.
A copy of the child’s birth certificate or adoption
certificate, naming you or your spouse/Civil
Union Partner as the child’s parent;
OR appropriate custody or allocation of parental
responsibility naming you or your spouse or Civil
Union Partner as the responsible party to
provide insurance for the child.