Request for Transfer Admission
Application Fee Waiver
STUDENT: Print or type the information requested below. You must personally sign the Certification Statement
and send this form to the admission office at the school you are applying to.
To: Ofce of Admission at:
Eligible for Pell Grant
Applicants who are eligible for a Pell Grant (what
is a Pell grant?) are eligible to receive a transfer
admission application fee waiver. Please sign below
to attest to your eligibility to receive a Pell grant.
(Continue to Certication Statement)
Ineligible for Pell Grant
Applicants who are not eligible for a Pell Grant but
meet one of the following indicators of nancial need
should self-certify their eligibility for the admission
application fee waiver below.
q Check here if your annual family income
falls within the Eligibility Guidelines set by the
USDA Food and Nutrition Service (To view
USDA Income Eligibility Guidelines for the Free
or Reduced Price Lunch Program or review
FAQs related to this form.) OR
Check here if you are enrolled in a federal,
state, or local program that aids students from low
income families (e.g. TRIO programs such as
Upward Bound).
CERTIFICATION STATEMENT: I certify that I understand and meet the eligibilty requirements to request an admission appliction fee waiver.
STUDENT’S NAME STUDENT’S SIGNATURE
STUDENT’S ADDRESS CITY STATE ZIP
If the institution to which you are applying requires additional documentation, please see page 2.
Request for Transfer Admission Application Fee Waiver continued...
Additional Documentation Required
Eligible for Pell Grant
If the institution to which you are applying requires
verication of your eligibility for a Pell grant,
you can utilize either of the following options for
documentation.
OPTION 1
Provide a copy of your most recent Student
Aid Report (SAR) from the US Department of
Education. Your Student Aid Report (SAR) is a paper
or electronic document that gives you some basic
information about your eligibility for federal student
aid as well as listing your answers to the questions
on your FAFSA.
If you cannot locate your SAR, you can retrieve
one from the US Department of Education’s Ofce
of Federal Student Aid (FSA). Your SAR can be
downloaded at (https://fafsa.ed.gov/)
OPTION 2
Attestation from a nancial aid ofcer or other
ofcer of your current or most recently-attended
institution of higher education.
AUTHORIZED OFFICIAL’S NAME
AUTHORIZED OFFICIAL’S SIGNATURE
AUTHORIZED OFFICIAL’S TITLE
AUTHORIZED OFFICIAL’S EMAIL ADDRESS AND PHONE NUMBER
NAME OF EDUCATIONAL INSTITUTION
Ineligible for Pell Grant
If you indicated you are ineligible for a Pell Grant, but
self-certied that you meet one of the other criteria
for economic need (with an annual family income
within the income Eligibility Guidelines set by the
USDA Food and Nutrition Service OR enrolled in a
federal, state, or local program that aids students
from low income families), please contact the
admission ofce at the college or university to which
you are applying when additional documentation is
required.