Request for Enrollment Deposit Fee Waiver
The $250 enrollment deposit is not an additional fee. It is used as a credit towards your first semester’s tuition
and fees; if we waive your deposit, you will not have this credit.
Student Info: Print or type the information requested below. You must personally sign the Certification
Statement.
_____________________________________________________________________________________________
Student’s Name Z Number
______________________________________________________________________________
Student’s Email Address Date of Birth
Please provide a personal email address that is not affiliated to any school or organization
_____________________________________________________________________________________
Student’s Signature
Certification Statement: I certify that I understand and meet all eligibility requirements to request an enrollment
deposit fee waiver.
Economic Need: The student must meet at least one of the following indicators of economic need.
Student has received or is eligible to receive an ACT or SAT testing fee waiver or
received an application fee waiver.
Student has received or is eligible for the Federal Pell Grant.
Student is enrolled or eligible to participate in the Federal Free or Reduced Lunch
program.
Student’s family income falls within the income Eligibility Guidelines set by the
USDA Food and Nutrition Service.
Student is enrolled in a federal, state or local program that aids students from low-
income families.
Student’s family receives public assistance.
Student lives in federally subsidized public housing, a foster home or is homeless.
Student is a ward of the state or an orphan.
Other request from high school principal, high school counselor, financial aid officer,
community advisor/leader or other official who can attest to the student’s
circumstances.
COVID-19 related income reduction/ job loss
Other financial circumstances where enrollment deposit would provide financial
hardship. Please explain
_____________________________________________________________________________________________
FOR ADMISSIONS OFFICIAL USE ONLY
__________________________ _____________________
Admissions Staff Member Initials Processed Date
click to sign
signature
click to edit
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