Fillable APPLICATION FEE WAIVER VERIFICATION REQUEST FORM (University of South Florida)

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APPLICATION FEE WAIVER VERIFICATION REQUEST FORM (University of South Florida)

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Ofce of Graduate Admissions | 4202 E. Fowler Ave., SVC 1036 | Tampa, FL 33620 | P: 813-974-3350 | F: 813-974-9689 | E: admissions@usf.edu | usf.edu/admissions
APPLICATION FEE WAIVER
VERIFICATION REQUEST FORM
INSTRUCTIONS
Please complete all the prospective student information below. Please request the program director to ll out the bottom section and email it to
GradAdmissions@usf.edu. Once this form is approved, visit our website www.usf.edu/admissions to submit an Online Graduate Application.
In order to waive the application fee, this form must be signed by Program Director / Designee.
LEGAL NAME ____________________________________________________________________________________________________________________________
LAST NAME FIRST NAME MIDDLE NAME
STREET ADDRESS/APT# ____________________________________________________________________________________________________________________
CITY, STATE, ZIP CODE ______________________________________________________________________________________________________________________
EMAIL ADDRESS__________________________________________________TELEPHONE NUMBER (please include area code) _____________________________________
UNDERGRADUATE MAJOR__________________________________________________UNDERGRADUATE INSTITUTION _________________________________________
PROSPECTIVE STUDENT’S SIGNATURE___________________________________________________________________DATE ____________________________________
INSTRUCTIONS
Please verify that the above student participated in one of the following programs. Please email this form to the University of South Florida Graduate
Admissions email at GradAdmissions@usf.edu
PROSPECTIVE STUDENT INFORMATION
DIRECTOR INFORMATION
APS Bridge Program
(American Physical Society Bridge Program)
RISE Program
(Research Internship in Science Education)
MARC U-STAR
(Maximizing Access to Research Careers Undergraduate
Student Training in Academic Research)
LEADERSHIP ALLIANCE CONSORTIUM
FAMU Graduate Feeder Scholars Program
(Florida Agricultural and Mechanical University)
McNair Scholars Program
(Ronald E. McNair Scholars Program)
FGLSAMP
(Florida-Georgia Louis Stokes Alliance for Minority Participation)
EDUCATION USA OPPORTUNITY FUNDS PROGRAM
NATIONAL GEM CONSORTIUM
SIGNATURE_________________________________________________________________________________________DATE _________________________________
DIRECTOR / DESIGNEE / UNIVERSITY EXCHANGE COORDINATOR
EMAIL ADDRESS__________________________________________________TELEPHONE NUMBER (please include area code) _____________________________________
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APPLICATION FEE WAIVER VERIFICATION REQUEST FORM (University of South Florida)

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Completed 29 July 2020

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