DEPENDENT OF MILITARY PERSONNEL, POLICE OFFICER, OR FIREFIGHTER WAIVER REQUEST

DEPENDENT OF MILITARY PERSONNEL, POLICE OFFICER, OR FIREFIGHTER WAIVER REQUEST
Provides educational assistance in state-supported colleges and universities for children of certain deceased war veterans, police officers, and firefighters.

Students receiving this exemption must be in good Academic Standing as defined by Delgado Community College and must be enrolled full time through Census day.

Eligible students will receive a Fee Exemption Certificate from the Louisiana Department of Veteran Affairs. You must submit the original certificate (or approved digital copy) to receive the waiver.
STUDENT REQUEST INFORMATION
Student Name (First Last): *
Semester/Year: *
ex: Fall 2020
Student LoLA ID: *
L00000000
Student Email: *

Confirmation Email example@dcc.edu
Waiver Type: *
To be completed by Accounts Receivable
Entered:
Verified By:
Notice of Eligibility:
Academic Requirement:
Status:
Comments/Requirements:
Verification Date:

Month Day Year
Date
Expiration Date: *
WAIVER CERTIFICATE *

Browse Files

Cancel of
Additional Comments:
Optional
STUDENT AUTHORIZATION
Student Certification: *

I hereby certify that the attached EXEMPTION CERTIFICATE is a true and accurate copy of the original which I have in my possession. I acknowledge that I must be enrolled as a full-time student (12 or more credit hours) and be in good Academic Standing as defined by Delgado Community College.
Third Party FERPA Disclosure: *

I authorize Delgado Community College to release necessary financial and educational information, in the manner requested, to the State, Local, or Federal Agency for the purposes of certifying my eligibility.
Terms and Conditions: *

I understand that if it is later determined that I do not meet eligibility requirements, the waiver may be removed from my account and I will be required to pay the full amount due by the published or assigned due date(s). I promise to pay for all fees not covered by this waiver by the published or assigned due date(s). In the event the student becomes delinquent in paying charges or defaults in repaying charges, the debts may be transferred to the State of Louisiana Attorney General’s Office, the Louisiana Office of Debt Recovery, or another external agency for collection. All collection fees incurred shall be at the expense of the student which may be based on a percentage at a maximum of 33 1/3%. If Delgado prevails in a law suit to collect on the student’s financial obligation, the student will be responsible to pay Delgado’s court costs, collection fees and attorney’s fees in an amount the court finds to be reasonable.
Student Signature *

Clear
Type Name *
*Once you enter your name you will not be able to make any changes to this request.
Date *

Month Day Year
Date
Should be Empty:

DEPENDENT OF MILITARY PERSONNEL, POLICE OFFICER, OR FIREFIGHTER WAIVER REQUEST

STUDENT REQUEST INFORMATION

To be completed by Accounts Receivable

STUDENT AUTHORIZATION