VETERAN/DEPENDENT OUT OF STATE TUITION WAIVER PROGRAM
I, the undersigned, acknowledge the following:
My waiver of tuition will only be applied to eligible out of state fees; I understand a portion will still be owed.
Signature (Student)
FOR PALM BEACH STATE COLLEGE INTERNAL USE ONLY
Palm Beach State College shall waive allowable fees for each recipient who is eligible for a Veteran or Veteran Dependent where:
(a) Student does NOT have 3
rd
attempt courses waived.
(b) Student has submitted appropriate documentation to the Registrar's Office.
i) Form DD-214.
ii) They have been honorably discharged.
iii) They physically reside in Florida.
OR
(c) Student is entitled to and uses educational assistance provided by the United State Department of Veterans Affairs.
Last Name:
Student ID:
First Name:
Fall
I am requesting a waiver for:
Spring Summer
Name of Courses: List the course number and reference number
Course ID Reference Number
Date
Signature (Registration Rep.)
Date
MI:
Registrar's Office:
Verified (FSS 1009.26):
Cashier's Office:
Customer Number: 2317 Veteran (Out of State)
NoYes
Registration Rep. Name (Printed)
Year
Veteran (Out of State)
Select one:
Veteran Dependent (Out of State)
Contract:
Receipt Number:
Customer Number: 2495 Veteran Dependent (Out of State)
Contract:
Receipt Number:
