It is the policy of Galveston College to provide equal opportunities without regard to age, race, color, religion, national origin, gender, disability, genetic information, or veteran status.
ELIGIBILITY REQUIREMENTS
• Student must be classified as a Texas resident.
• Preceptor must be a registered nurse who serves at least one day a week as a clinical preceptor.
• Preceptor must serve as a clinical preceptor during the term the exemption is requested – or – preceptorship must have ended
less than 1 year ago.
• Students must meet GPA limit Satisfactory Academic Progress (SAP) requirements in accordance with Galveston
College Financial Aid policy to be eligible for this award. Students may appeal if denied this award due to SAP
requirements – see Financial Aid for details.
• Students may not take a number of hours considered excessive under Texas Education Code 54.014. All official
transcripts must be on file before eligibility can be determined.
AWARD AMOUNT
• Preceptor: $500 or tuition (whichever is less); Child of Preceptor: $500 or tuition (whichever is less) for up to 10 semesters.
INSTRUCTIONS
• Complete and return this form to the Admissions Office.
• Student must verify Texas Residency with the Admissions Office.
• Student must complete the Preceptor Exemption Form and obtain a letter from the Nursing department where the
preceptorship is occurring. The exemption form and letter must
accompany this form.
Student ID Number: __________________________ Date of Birth: ______________________________
Last Name: ______________________________ First Name: ___________________________ MI: _____
Address: _______________________________________________________________________________
Street/PO Box City State Zip
Phone: ____________________________ Email: _____________________________________________
I have a Bachelor or higher-level degree
I have attended a Texas private or an out-of-state institution
I am seeking an exemption of tuition and applicable fees under Texas Education Code 54.356 – Preceptors for
Professional Nursing Education Programs. I understand that I must make Satisfactory Academic Progress, as
defined by Galveston College Financial Aid policy, to continue to receive this award. I am eligible under the
conditions in Texas Education Code 54.356 to receive this award and certify all the information provided on
this form is accurate and true.
___________________________________________ __________________________________
Student’s Signature Date
***STAFF USE ONLY***
All transcripts on file
Student is eligible for exemption/waiver
Student is not eligible for exemption/waiver due to:
GPA
Excessive Hours under TEC 54.367
___________________________________________ __________________________________
Director of Admissions/Registrar Date
Exemption for Clinical Preceptors
and Their Children
Admissions Office Use Only
Date Entered: __________________
By: ___________________________
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