SENIOR CITIZENS GUIDELINES FOR ELIGIBILITY
A. To be eligible for free tuition and fees for credit classes, part-time or full-time, a person must meet the
following criteria and present documentation of each criteria for verification:
1. Be 60 years of age or older
2. Be a legal resident of Virginia
3. Had a taxable income not exceeding $23,850 for state income tax purposes for the year pre-
ceding the year in which enrollment is sought
4. Be admitted to the college as a student
B. To be eligible for free tuition for audit of credit classes or for taking non-credit classes
(not to exceed
three non-credit classes per semester)
a person must meet the following criteria and present documenta-
tion of each criteria for verification:
1. Be 60 years of age or older
2. Be a legal resident of Virginia
3. Be admitted to the college as a student
Information above verified by the Admissions Office Date
JSRCC Form No. 11-0021 Senior Citizens Tuition Assistance form 06/2015
STUDENT TUITION ASSISTANCE AGREEMENT
Date: DOB:
Home Phone#:
Business Phone#:
Campus Business Office Approval Date
This form is to be retained in the appropriate campus Business Office for future reference.
A. I hereby certify that I am qualified for free tuition for credit classes under the Senior Citizens Higher
Education Act--House Bill 580.
B. I hereby certify that I am qualified for free tuition for audit of credit classes or for taking non-credit
classes under the Senior Citizens Higher Education Act--House Bill 580.
Student’s SSN: EmplID:
Last Name First Name MI Jr.,3rd
Street Address City State Zip
SIGNATURE OF STUDENT: DATE:
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