MIME-Version: 1.0 Content-Location: file:///C:/34466512/TuitionWaiver.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" LAWRENCE UNIVERSITY

 

 

LAWRENCE UNIVERSITY

Employee/Dependent (Spouse/Partner/Child) Tuition Waiver

Application Form

Name of Employ= ee:

 

Name of Studen= t:

o<= /span>=   Employee       o Spouse/Partner       &nbs= p;

 

o<= /span>=   Child       &nbs= p;      Grade:  __________

Department:

 

 

o<= /span>=   Full-time    =   o<= /span>=   Part-time    =   ____ hrs/week

Course Name:

 

# of Unit(s)

For Academic Year:       &nbs= p;       o<= /span>=   Term I       &nbs= p;       o<= /span>=   Term II       &nbs= p;       o<= /span>=   Term III

 

Please complete the following:

&n= bsp;

1.  Will you be taking the class for=     o  Credit  or  o Audit ?

 

2.  Have you previously attended clas= ses at Lawrence?   If yes, when: _________________________  &nb= sp;

     o<= /span> YES:=   You must contact the Registrar’s Office and be reinstated as= a student before you

     will be eligible to register for classes.

     o<= /span> NO:    You must apply for admission as a student.  Applications for admission are available

     from t= he Admissions Office or Human Resources.

3.=       If applicable, have you discussed this with your supervisor and worked out a satisfactory

     work schedule?    o  Yes      o No      =

5.=       If a hi= gh school student, have you applied for other financial assistance such as P= ost Secondary Enrollment Option?

 

o&= nbsp;     Yes = 211; Result:  ___________________= _________________________________________

 

o&= nbsp;     No R= 11; Why not? ___________________________________________________________=

 

I understand that courses taken for credit mus= t be completed satisfactorily in order to maintain eligibility for the program.  Courses involving = direct outlay of money on the part of the university may not be taken as part of this program.  This form, application and registration must be completed in advance of the start of classes.

 

Signature of Dependent:  ________________________________________      Date:  ________________

 

Signature of Employee:     ________________________________________     Date:  ________________

 

Signature of Supervisor:    ________________________________________     Date:  ________________

(where appropriate)

 

HR Approval:       &nbs= p;           ________________________________________     Date:  ________________

 

 

cc:        Admissions, Financial Aid, Student Accounts, Registrar, Personnel File

        &= nbsp;   Employee/Student        &= nbsp;           &nbs= p;         &= nbsp;           &= nbsp;           &= nbsp;           &nbs= p;            &= nbsp;          &= nbsp;           &= nbsp;           &nbs= p;           =     8/05