Who is eligible to receive this tuion waiver? Choose the opon that best describes your situaon:
“First‐Dollar” Waiver ‐ Central Oregon Community College (COCC) will provide a “ﬁrst‐dollar in” tuion
waiver to the spouse and children age 23 and under (including adopve and step‐children) of members
of all branches of the United States Armed Forces or United States Coast Guard who: a) Died while on
acve duty; or b) Died as a result of a military service‐connected 100% disability.
“Last‐Dollar” Waiver ‐ COCC will provide a “last‐dollar in” tuion waiver to the spouse and children age
23 and under (including adopve and step‐children) of members of all branches of the United States
Armed Forces or United States Coast Guard who: a) Is 100% permanently disabled as a result of a mili‐
tary service‐connected disability as cerﬁed by the U.S. Department of Veterans’ Aﬀairs; or b) Died as a
result of less than a 100% disability as connected to military service; or c) Meet criteria “a” or “b”
above, but also received the Marine Gunnery Sergeant John D. Fry Scholarship.
Addional eligibility requirements:
You must be an in‐district resident of the COCC district at the me of applicaon for the waiver.
If you are a spouse of the fallen service member, you must iniate the request for a waiver within ten
years of the determinaon of death or 100% disability. The spouse will lose eligibility upon remarriage.
You must be seeking a credit level cerﬁcate of degree program.
The beneﬁt applies to tuion only; other fees are not covered.
You must meet COCC’s sasfactory academic progress requirements.
You must submit this form once annually by the tuion due date of the term for which you wish to re‐
ceive a waiver. The tuion waiver cannot be applied retroacvely to any prior tuion charges.
For “last‐dollar” waivers, students must also submit a Free Applicaon for Federal Student Aid (FAFSA)
and complete the requirements necessary to determine aid eligibility.
Veterans Cerfying Oﬃcial
541‐383‐7264 • fax: 541‐383‐7506
2600 NW College Way, Bend, Oregon 97703
Student name (print) COCC ID number
Student signature Date
I cerfy that I understand the details and condions of this waiver and will supply documentaon to establish
eligibility if requested.