09/11/19 rev
Eligibility to participate in the Tuition Exchange Scholarship Program is determined under Guidelines
adopted by Daemen College. Certification of the applicant’s eligibility does not guarantee acceptance
into the TE Program of the institution the applicant seeks to enter. Member colleges/universities are
generally able to offer only a limited number of scholarships. Accordingly, the application process
should be initiated in a timely manner. Further, the employee must keep the Liaison officer/Employee
Engagement Department at Daemen College informed of the applicant’s intention to attend a
particular college/university as soon as the decision is finalized. New applications for scholarship must
be received by the Employee Engagement Dept. no later than October 31
. Students must complete
the Tuition Exchange on-line application on the Tuition Exchange Website: In addition, students must also apply annually, by January 15
, for
re-certification of any scholarship awarded. You may be required to provide proof of dependent status
for an eligible student.
Student Information
Name of Applicant: ___________________________________________________________________________
Last 4 SSN: ______________ Date of Birth: ____________ Relationship to Employee: ____________________
Home Address: ____________________________________________________________________________
Home Telephone: __________________________ Student E-Mail: ____________________________________
Employee Information
Name of Employee: ____________________________________ Date of Hire: ___________________________
Address (if different from student/applicant) _______________________________________________________
Employee Signature: _________________________________________________ Date: ___________________
Years of Service at Daemen: ________________________________ (5 years full time employment is required)
Names of TE Colleges or Universities applying to and course of study at each (attach separate sheet if
1. _____________________________________________________________________________________
2. _____________________________________________________________________________________
3. _____________________________________________________________________________________
4. _____________________________________________________________________________________
5. _____________________________________________________________________________________
At beginning of next academic year, applicant will be a COLLEGE:
Freshman__ Sophomore__ Junior__ Senior__
Has applicant received a TE scholarship previously: ___Yes ___No
If Yes
Is this an application for a __new or __renewed scholarship?
Name of the college/university attended? ___________________________
Year(s) that the scholarship was held: ______________________________