Financial Aid & Scholarships
1700 Spartan Drive, Elgin, IL 60123-7193
Location: B156
Phone: 847-214-7360 Fax: 847-608- 5460
Email: financialaid@elgin.edu
2021-2022 ECC Waiver Activation and Private Scholarship Form
_________________________________________________________________________________________
FOR OFFICE USE ONLY:
Amount: ___ __ Term: ______ __ Credits enrolled_____ GPA:_________ Date applied: Staff: _ __________
*Please provide us with your current information. Check off which section applies to you and complete the
corresponding information for that section, then sign and date at the bottom:
Name: _________________________________________________ ECC ID or SS#: ______________________
Address: _______________________________________ City_______________ State______ Zip_______
Phone #: _______________________________________ Email:__________________________________
ESL Waiver: This in-district tuition waiver for up to three credit hours is good for up to one year from the date of successful
completion of the College Transitions for ESL Learners course of the ESL program (ESL 019, ABE 035, or ASE 036) or the intensive
English program at ECC. This waiver is for tuition only. Students may receive this waiver only once. Students completing the
College Transitions for ESL course more than once will not be eligible for additional ESL waivers.
For which course do you wish this waiver to pay for? ______________ Term/year:
HSE Waiver: This in-district tuition waiver of up to three credit hours is valid for one year from the issue date of the Illinois
High School Equivalency transcript. Student must live in-district, successfully complete a High School Equivalency Preparation
(HSE) Class at ECC and pass one of the following approved exams: GED, HiSET, or TASC (must provide a copy of your Illinois
High School Equivalency transcript). This waiver is for tuition only.
When did you pass the GED Examination? (Date) _____
Course Title: __Term: Year: _____
Honors Course Tuition Waiver: You must have completed an Honors course with a grade of “B” or better and have at least a
cumulative 3.25 GPA. This award is for an in-district tuition waiver for the number of hours of the completed Honors course. The
Honors award can be used up to a total of 15 credit hours, and is valid for one year from the time the Honors course is
completed. This waiver is for tuition only.
Honors Course: Term completed: Grade:
Honors Course: Term completed: Grade:
I would like ______ credit hours applied to the ___________term/year for the following Honors Courses:
Honors Course:______________________________ Honors Course:_______________________________
Private Scholarship* (please indicate name) _____________________________
*(Private scholarships: If you have never used this scholarship, please submit letter from the donor).
Donor:________________________________ Scholarship Amount: $_____________
Is this a one-time scholarship?
YES NO
Enrollment Status:
Full-time (12+ credit hours) Part-time (1 – 11 credit hours)
I wish to have funds applied to the following semester(s):
Summer 2021 Fall 2021 Spring 2022
Disclaimer
This form must be completed and submitted to the Financial Aid & Scholarships office on or before May 18, 2022.
Signature: ________________________________________ Date: ____________________
* Electronic Signatures will not be accepted Rev 10/20
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