<= span style=3D'color:#094477;text-decoration:none;text-underline:none'> &nbs= p; = &nb= sp; WALLACE STATE COMMUNITY COLLEGE

&nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; HANCEVILLE, ALABAMA

&nbs= p; &= nbsp; EMPLOYEES' AND DEPENDENTS' TUITION WAIVER APPLICATION

EMPLOYEE
Employee's Name_____________________________SSN_________________= _________

Dependent's Name____________________________SSN__________________= ________

Relationship to Emplo= yee ( )Spouse ( )Unmarried Child ( )Unmarried Step-Child

Does the Dependent li= ve with you? ( ) Yes ( ) No &nb= sp; Your former spouse? ( )Yes ( ) No

Institution to Attend= if other than Wallace State Community College – Hanceville _____________= __________________

Has the student used a tuition waiver at any other institution? ( ) Yes ( ) No

Employee's Position/Title_______________________ &n= bsp; = ; &n= bsp; Term ____________=

Reference # ___________ Course# ___________________&nbs= p; Time _____________ Credit Hrs. _______

Reference # ___________ Course# ___________________ Time _____________ &nb= sp; Credit Hrs. _______

Reference # ___________ Course# ___________________&nbs= p; Time _____________ Credit Hrs. _______

Courses changed after Financial Aid Office certification must be approved by the Financial Aid Office

Step 1 _____________________________________ &= nbsp; &nbs= p; ___________________________________
&= nbsp; Employee's Signature = &nb= sp; Date = ; &n= bsp; = ; Supervisor's Signature = &nb= sp; Date

Employer &= nbsp;

_______________= __________________________________________________ = &nb= sp; = &nb= sp; =
College &n= bsp; = ; Contact Phone Number (If not WSCC-Hanceville)

Step 2 = FINANCIAL AID OFFICE
I certify= that the above employee/dependent has maintained a 2.0 GPA and has not previously registered for this class.=

Financial Aid Officer: ___________________________ Date: ________ Code: __________

Amt. Entered: _________

Step 3 = BUSINESS OFFICE
Full-time Employment Date:____________________ = Percent of Tuition Waiver: ( ) 33% ( ) 66% (= ) Full

Retirement Date: __________    Account #: _________  Business Manager: _________________     Date: ______________
Step 4        =    PRESIDENT'S OFFICE
I hereby certify that the above named employee is an eligible emplo= yee of the Alabama College System and is entitled to receive all benefits grant= ed under the Employees' and Dependents' Tuition Waiver Program.

President: __________________________ Date: _____________________

Step 5 Complete Registration and P= ay Fees in the Cashier Office

STEPS IN COMPLETING THE EMPLOYEES'/DEPENDENTS' TUITION WAIVER

1. = Complete all information

2. = Complete Dependent information if requesting the tuition waiver for a spouse/dependent.

3. = Sign and date the request.

4. = Supervisor must sign and date the waiver.

5. = Financial Ai= d Office must = verify prior courses and then the waiver will be forwarded to the Business Manager.

6. = The Business Manager will forward the request to the President's Office for approval.

7. = When the tuition waiver has been approved the Financial Aid Office will enter the award in t= he computer.

8. Any course changes after step 5 will require additional approval/form from the Financial Aid Office.

9. = It is the employees’/dependents’ responsibil= ity to complete the registration process and pay all required fees.

QUALIFICATIONS FOR RECEIVING THE TUITION WAIVER

1. = Must be a full-time employee.

2. = Must have completed one full year of service with Alabama community college syst= em before the first day of class.

           One year of service will re= ceive a 33% waiver.
           Two years of service will receive a 66% waiver.
           Three or more years of service will receive a 100% waiver.

3. Employee or spouse/dependent must follow the same procedures as a non-tuiti= on waiver student in regards
to hours taken each semester.

4. All transcripts (inclu= ding high school and ALL colleges attended) must be accepted in the Admissions Office before Tuition Waiver will be processed.

DEFINITIONS

Employee Depend= ent includes tuition waivers to t= he spouse of any full-time employee, the unmarried (never married), natural or adopted children of any full-time employee, residing in the household of th= e employee or the employee's former spouse; the unmarried stepchildren of any full-time employee residing in the household of the employee.

Form Page = ; Updated 17, November 2008<= /o:p>