Southeast Arkansas College
Employee/Dependent Tuition Exemption Request
Completed form may be faxed to 870-850-3113 or emailed to personnel@seark.edu
Semester
Year
Semester Exemption Requested: (Circle One ONLY) Fall Spring Summer 20___
Employee:
Name: _______________________________Email: _______________________SEARK ID #________
Spouse:
Name: _______________________________Email: _______________________SEARK ID #________
(Attach marriage certificate & tax return)
Dependent:
Name: ________________________Age:____Email: _______________________SEARK ID #________
(Attach birth certificate & tax return)
SEARK Employee/Spouse/Dependent Tuition Exemption Policy:
Upon admission to SEARK College, all full-time SEARK College employees, their spouse, and dependent
children (children under age 24 at the time of registration) may qualify for a tuition exemption for
Southeast Arkansas College academic courses. Employment status on the first day of class determines
eligibility for exemption. SEARK College employees may not attend classes during their scheduled work
hours unless approved annual leave is granted by their Department’s Vice President.
Tuition exemption is based on the in-state tuition rate per credit hour. Required books and fees are not
exemptible.
The last day to apply for admission is the last day to apply for tuition exemption.
A current tax return, marriage license, and birth certificate are required to prove eligibility for spouse
and/or dependent.
A Request for Tuition Exemption form and documentation must be submitted to the Personnel Office prior
to registration each semester. Students receiving the Employee/Spouse/Dependent tuition exemption
must maintain a 2.0 GPA to keep the tuition exemption. Employee, spouse or dependent student may
appeal the individual loss of exemption (in person) to the Vice President for Student Services who may
refer the appeal to committee.
Employee Signature: Date:
Attach Marriage License, Birth Certificate, and Prior Year Tax Return & Forward to
SEARK Personnel Office. Attach Current Transcript for Continuation of Exemption.
Section I (SEARK Personnel Approval)
Verified and approved by:
Signature: Date:
(Personnel or Business Office Employee)
Note: Tuition Exemption Requests are awarded subject to available funding and resources.
Approved by Executive Cabinet 5-23-16
click to sign
signature
click to edit
click to sign
signature
click to edit