Residency (indicated by Banner):
Ohio/Monroe Reciprocity
Non-Resident International
Rank: Masters
Doctoral
Program of Study:
Rocket ID: College: Dept:
Students' Signature: Date:
By accepting this scholarship, I understand I am strongly encouraged to contact the Office of Financial Aid, to determine how this scholarship will
effect my other financial aid and/or student loans. Students who accept this scholarship, are not eligible for any other institutional aid, this includes
but is not limited to Michigan Initiative, employee benefit, graduate assistantship, tuition scholarship.
GRADUATE COLLEGE TUITION SCHOLARSHIP FORM
Students who accept this scholarship, are not eligible for any other institutional aid, this includes but is not
limited to Michigan Initiative, employee benefit, graduate assistantship, tuition scholarship.
Academic Term Years: --
Person Completing Form: Ext:
GPA Requirements: The student has met the minimum Graduate GPA eligibility requirement
of >=3.0 ?
Yes No
Type of Action:
New Change Termination
FOR GRADUATE SCHOOL USE ONLY
Banner Input By:
/
VISA Status Access Input By:
/
Student Name: DOB:
Last Name First Name mm/dd/yyyy
Print Form
Detail Exemption Code:
Reason for Request:
Waiver Term(s) & Hours Waived Per Term:
(Only put terms within the same academic year along with supply hours or
amount to be waived on one form.)
Fall Year
Hours Amount
Spring Year
Hours Amount
Summer Year
Hours Amount
If terminating a waiver, enter "0"on the hours waived line.
Requestor
Date
Ext.
Dean or Business Manager of Requesting College
Date
Ext.
Approvals
Waiver Information Student Information
Department Information
Dean, College of Graduate Studies
Date
Ext.
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