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BOISE STATE UNIVERSITY HUMAN RESOURCE SERVICES (Boise State University)

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Human Resource Services | benefits@boisestate.edu | 208-426-4429 | 2225 W UNIVERSITY DR. CAPITOL VILLAGE #3 BOISE, ID 83725-1265
BOISE STATE UNIVERSITY – HUMAN RESOURCE SERVICES
Reciprocal Fee Waiver Request
Student ID#: _________________________________ _______________ _______________
Semester Year
Student’s Name: ____________________________________________________________________________________
(Please Print)
Subject &
Catalog Number
Ex: ENGL 101
University
Attending*
(ex. BSU)
Title of Class
Number of
Credits
Time of Class
(MWF 11:40-12:30)
*Complete a separate fee waiver for each institution you are attending.
Employee Signature: _________________________________________________ Date: ___________________________
Print Employee Name: _______________________________________________ ID#:____________________________
Department: ________________________________________________________ Phone Number __________________
Supervisor’s Signature: ________________________________________________ Date: ___________________________
Required if employee is attending Idaho State University)
Dean or Director’s Signature: ___________________________________________ Date: ___________________________
Required if employee is attending Idaho State University)
State Board Affiliate Agency: ________________________________________________________________ Phone Number: _____________________
Spouse’s Fee Waiver: ( ) Yes ( ) No
Supervisor’s Signature or Affiliate Approver: ____________________________________________________________ Date: _____________________
It is your responsibility to provide ALL of the above information. Failure to do so will delay processing of the fee waiver.
HRS OFFICE USE ONLY: Approved _____________ Disapproved _____________
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BOISE STATE UNIVERSITY HUMAN RESOURCE SERVICES (Boise State University)

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Completed 17 August 2020

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