OFFICE OF ADMISSIONS AND RECORDS
65+ Senior Citizen Tuition Waiver
SPRIN
G 20 ____ SUM 20 ____ FALL 20 ____
P.O. Box 310 | 1500 Procter Street | Port Arthur, Texas 77641
409-984-6173
Student Name: ______________________________________
Date of Birth: _________________
Student P#: _________________________________________
Telephone #: _________________
Address: __________________________________________________________________________
Email Address: _____________________________________________________________________
Senior citizens, 65 years of age or older, may apply for a tuition waiver if they are (1) 65 years of age or
older, (2) apply for admission and be accepted, (3) register for class(s), (4) provide the Registrar with
proof of senior citizen status (age), and (5) complete the tuition waiver form each term and prior to the
first day of class. The student must stay in Good Academic Standing at LSCPA while using the Senior
Citizen Waiver/Exemption. LSCPA may allow a senior citizen to enroll for credit in up to six
semester credit hours of courses each semester or summer term without payment of tuition if space is
available. Space availability is determined on the last business day prior to the first day of class.
________________________________________
Student Signature
______________________________________
Date
Co
urse:
_______________________
Course: _
______________________
________________________________________
Registrar Approval
______________________________________
Date
