Fillable FORM MUST BE FILLED OUT COMPLETELY IN ORDER (City College of San Francisco)

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FORM MUST BE FILLED OUT COMPLETELY IN ORDER (City College of San Francisco)

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The FORM MUST BE FILLED OUT COMPLETELY IN ORDER (City College of San Francisco) form is 1 page long and contains:

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  • 2 check-boxes
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File type: PDF

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City College of San Francisco
Tuition and Fees Office
Request to Reverse $7 Student Activity Fee
FORM MUST BE FILLED OUT COMPLETELY IN ORDER TO BE PROCESSED
To: City College of San Francisco
Attn: Tuition and Fees Office
Student Name (print)
Last First MI
Student I.D # Date of Birth
Email
Phone
I, the above named student, do not agree to pay the Student Activity Fee for
Check Semester: Fall Spring Year:
Explain below why you are requesting to reverse the Student Activity Fee:
Please reverse this charge in my student account as soon as possible.
Student’s Signature Date:
AUTHORIZATION TO REVERSE ABOVE FEES:
Dean of Student Activities
Signature (Required)
Date
Phone #
Tuition and Fees Representative
Signature (Required)
Date
Phone #
Remarks:
Received by: Processed by: Date:
Copies: White: Tuition and Fees, MUB 130 Yellow: Student Activities, SU205 Pink: Student Tuition & Fees Form – 11/2019
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FORM MUST BE FILLED OUT COMPLETELY IN ORDER (City College of San Francisco)

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Completed 13 April 2021

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