Refundable ASCC Student Activity Fee Waiver
I choose not to take advantage of the Student Activity Fee for the ___________________
semester.
By signing this form I understand that
A credit of $5.00 will be applied to my college account.
Printed name: Student ID# _______________
Signature: Date: ____________________
Submit or fax this form to Columbia College
Business Office Sequoia Building
FAX: 209.588.5368
Form must be submitted within the first two weeks of
the semester!
Student Activity Sticker Fee $5 (refundable)
Contact the Student Senate Office for further details at
588.5270
Fee refusal/waiver
2-10-2014