TTU Request for Fee Discount for Spouse and/or Dependent
This is to request a fee discount for undergraduate courses only in accordance with Tennessee Tech
Policy 631, Educational Assistance for Spouse and Dependents of Tennessee Tech Employees.
Instructions: Please complete Section I below and forward the original white copy of this form to the TTU
Human Resources Office at least two weeks prior to registration for timely processing. Your credit won’t
show up on your student account until after you have registered.
I. EMPLOYEE SHOULD COMPLETE THIS SECTION
__________________________________________________________ ______________________
Employee’s Name Tech T#
______________________ _____________________
TTU Campus Box TTU Phone or Cell #
_________________________________________________________________ ________________________
Spouse/Dependent’s Name T# or last four digits of SSN
Relationship: ( ) Spouse ( ) Dependent Child If Child: ______________ _______________________
Age Birthday
Institution where enrolled _________________________________________________________________________
______________________________ ______________________________ ________________________
Term Enrolled Anticipated Number of Credit Hours Value of Discount
EMPLOYEE CERTIFICATION:
I hereby certify that the above information is correct and that I am currently a TTU employee with employment of 50%
time or more. I also certify that I and my spouse or dependent meet the eligibility requirements for a fee discount in
accordance with Tennessee Tech Policy # 631, Educational Assistance for Spouse and Dependents of Tennessee Tech
Employees.
I will notify the Financial Aid Office of any Title IV financial aid, as this benefit may require an adjustment of financial
aid received. I understand that Title IV aid includes national direct student loan, college work study, supplemental
educational opportunity grants, Pell grants, and other student aid programs administered by TTU.
___________________________________________________________________
________________________
Signature of Employee/Retiree/Dependent of Deceased Employee
Date
APPROVAL FROM UNIVERSITY OFFICES
Date of Regular Employment ___________________________ Percent Full-Time ________________
Date of Retirement/Death ______________________________
Human Resources/Approved _____________________________________________
Financial Aid Office/Post Credit __________________________________________
______________________________
Account Code
Date: _______________
Date: _________________
