Incidental Fee Review Form
University of North Texas Health Science Center
Office of Student Finance SSC 150
3500 Camp Bowie Blvd.
Fort Worth, TX 76107-2699
(817) 735-2026 / Fax (817) 735-0677
StudentFin@unthsc.edu
Fee Title
Fee Amount
Chart String
Date Reviewed
Purpose of Fee
Fee Description
New Fee
Semester
Change Required?
Yes
No
Fall
Spring
Summer
Yes
No
Approval:
DeptID Holder
Signature
Date
Dean, School (if applicable)
Signature
Date
Provost
Signature
Date
Effective: 09-01-19
Budget Office
Student Finance Office
Signature
Signature
Date
Date
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