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Edm
onds College does not discriminate on the basis of race; color; religion; national origin; sex; disability; sexual orientation; age; citizenship, marital, or veteran status; or
genetic information in its programs and activities. 15-16-ISS-013
Only to be lled if Agency pays for the student’s tuion
AGENCY/ORGANIZATION SPONSORSHIP FORM
Summer 2021
Fall 2021
Winter 2022
Name of organization:
Organization Contact Name:
Contact Email Address:
Student Name:
Student Iden
tification Number (SID):
Effective (first quarter begin) in: Spring 2021
How many quarters will your organization pay
for?
Please indicate billing by checking “Yes” or “No” for each item. Any item not checked will be charged directly
to the student.
REQUIRED FOR ALL PROGRAMS
Yes No
Yes No
Yes No
Yes No
Yes
No
Yes No
Yes No
Yes No
Yes No
Assessment Fee (one time only $50.00)
Bus Pass (First me $36.00, then $26.00 per quarter)
Edmonds CC Health Insurance ($327.99 per quarter)
COLLEGE / HIGH SCHOOL COMPLETION PROGRAM
Tuion (Maximum number of credits paid for per students:
Typical course load is 15 credits. More information at edcc.edu/tuition
Required Associated Student Fees
Lab fee*
Online/Hybrid fees*
IESL PROGRAM
Tuition (Required 20 credits, $3,318.20)
Grammar lab fee ($25.00 per quarter)
Housing fees (price vary, please visit edcc.edu/housing for more informaon)
Print Name and Title
Signature and Date
Edmonds CC scholarships are awarded as tuition waivers. The International Student Services office will adjust your invoice accordingly. There will not be any cash refunded to
students or the agency.
For any questions, please contact us at iss_fiscal@edcc.edu
Assessment/Union Building Fee, Sustainability Fee, Technology Fee, Comprehensive Fee
