University of Wyoming Employees
Application for Tuition Scholarship
at
Laramie County Community College
Scholarship & Financial Aid Ofce
1400 E. College Drive, Cheyenne, Wyoming 82007
Summer
Course information: Year
Fall
Spring
Step 1: University of Wyoming Employee
Applicant’s Name LCCC Student ID#
Address Phone Number
Employee Title Department
Please check the appropriate box:
I am a Full-time beneted employee of the University of Wyoming.
Part-time beneted employee of the University of Wyoming.
Course Name Credit Hours
If approved, tuition and mandatory fees will be waived for the one course up to 3 credit hours for
full-time beneted University of Wyoming employees and 1½ credit hours for part-time beneted
University of Wyoming employees.
Applicants Signature Printed Name Date
Signature of Immediate Supervisor Printed Name Date
Step 2: University of Wyoming Human Resources
The above named applicant has been veried by the University of Wyoming Human Resources
Department to be a:
Full-time beneted employee of the University of Wyoming
Part-time beneted employee of the University of Wyoming
Human Resources Signature Printed Name Date
Step 3: Laramie County Community College Sponsor Charges Ofce
Date Received and Entered AIDE
PRS9370 3/13
