Updated 3/22/2019 (HR/aba)
Tuitio
n Waiver Policy Link: http://www.svsu.edu/operationsmanual/humanresources/employeetuitionwaiverauthorization210-1/
Employee Name:
Employee ID Number:
Employee Group:
Choose One
Full-time Employee (Administrative Professional, Faculty & Support Staff)
Benefit Eligible Part-time Employee
SVSU Retiree
Other Full-Time Employees (Aramark, Barnes & Noble)
*Eligible children - include sons, daughters, stepsons, stepdaughters and legally adopted sons and daughters under age 30
during the entire academic semester enrolled.
Name of the
Individual to Receive
the
Waiver/Scholarship
Student ID Number
the
Employee/Retiree
(self, spouse, or
child*)
If child, please
enter date of birth
indicate
whether
tax
dependent
____/____/________
Yes
No
I have read the SVSU Employee Tuition Waiver policy and understand that some or all of this benefit
**THE COMPLETED FORM MUST BE FORWARDED TO HUMAN RESOURCES FOR APPROVAL**
HUMAN RESOURCE AUTHORIZATION
Approved by: Date:
For Office Use Only:
Office of Scholarship &
Financial Aid
Award Code
Processed by: Date:
Payroll Office
Processed by: Date:
Please select the semesters/years in which the Tuition Waiver/Scholarship Authorization is requested:
A new waiver form must be complete each semester on or following the date noted below:
☐ Fall 20___
Winter 20___
Spring 20___
Summer 20___
Request for
Employee
Tuition
Waiver/Scholarship Authorization
