Fillable REQUEST FOR MILITARY FEE EXEMPTION (Northwestern State University)

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REQUEST FOR MILITARY FEE EXEMPTION (Northwestern State University)

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NORTHWESTERN STATE UNIVERSITY
A Member of the University of Louisiana System
Natchitoches, LA 71497
REQUEST FOR MILITARY FEE EXEMPTION
To Qualify for This Exemption, You Must Be:
Active Duty Service Member, Retiree, Reservist, or Qualifying Military Dependent
COMPLETE ONE OF THE FOLLOWING FOR CURRENT MILITARY STATUS VERIFICATION
Military Status Verified by the DEERS Representative at Your Current Duty Station
Name: First___________________________________ Last___________________________________
Current Duty Station: __________________________ Branch of Service: _________________________
Military ID DOD#:_____________________________________________________________________
Signature of DEERS Official: ____________________________________ Date: ___________________
OR
Military Status Verified by NSU Official
Name: First__________________________________ Last___________________________________
Student ID# _____________________ Military ID DOD# (if applicable): _________________________
Verification Document: _________________________________________________________________
Date of Separation/Expiration: ____________________________________________________________
Branch of Service: ______________________________________ DoD#__________________________
Signature of NSU Official: ______________________________________ Date: ___________________
Semester:
Fall______________________ Spring _______________________ Summer ___________________
* Current Military students MUST be verified prior to the start of each semester. Retirees must only provide
verification documentation at the time of initial enrollment. Return Form to NSU Barksdale (barksdale@nsula.edu
)
or NSU Leesville/Ft. Polk (nsuleesvilleftpolk@nsula.edu) Offices.
**Required verification documentation may include providing current military ID, DEERS registration form, Status
Form from Mil.connect, DD 214, LES (Leave and Earnings Statement), military orders, and/or active duty Tuition
Assistance form. It is the responsibility of the student to provide the requested military affiliation documentation.
Inability to verify military affiliation renders automatic disqualification of discounted tuition.
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REQUEST FOR MILITARY FEE EXEMPTION (Northwestern State University)

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Completed 23 July 2020

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