Faculty/Staff Name __________________________________
Department _________Supervisor ______________________
Check all that apply below:
_____ Full-time or permanent part-time employee (full tuition and fees waiver, excluding
registration fee which student must pay)
_____ Active part-time faculty (one class up to 4 credit hours tuition and infrastructure
fee waiver, excluding technology, lab, registration fees which student must
**Hourly employees who are paid from extra help positions are not eligible for waivers.**
To receive this waiver, the signed and dated form must be submitted to NPC
Human Resources Office at the time of registration. If completed form is not
submitted at registration, the student may be dropped from enrollment.
Students receiving the Faculty/Staff Waiver must maintain a 2.0 GPA to keep the
waiver. Students with GPA between 1.0 and 1.99 will be placed on academic probation
and must regain a 2.0 within one semester or will become ineligible for a waiver.
Students below 1.0 will lose the waiver.
Student Name
Student ID #
Relationship to
Staff Member
Immediate family members may be eligible for faculty/staff waivers. Immediate family is
defined as: “the employee, that employee’s current spouse, dependent children, and
other family members who are dependent on the employee for at least 51% of their
support.” The Dependency Section from your latest IRS tax form must be
submitted for verification purposes. If you do not have this documentation,
contact the Assistant Director of Financial Aid. Additional documentation may be
required. Submit waiver form along with tax information to the office of Human
________________________________ _________________________
Faculty/Staff Signature Date
________________________________ __________________________
HR Department Date
For Financial Aid Office Use Only
Waiver Amount $_____________ Processed by: _____________________ Date_________________