National Guard Tuition Waiver Request

NATIONAL GUARD TUITION WAIVER REQUEST
Louisiana Revised Statute 29:36.1 provides a tuition exemption to all members of the Louisiana Army National Guard and Air National Guard who meet all of the following criteria: seventeen years of age or older, domiciled in the State of Louisiana, registered to vote, active member of the Louisiana Army National Guard or Air National Guard at the beginning of a semester and throughout the entire semester for which the exemption is received, not on academic probation or suspension prior to or while receiving the National Guard tuition exemption.

Students must be listed on the Notice of Eligibility for Exemption form approved by the education services officer. Registration and other fees are not covered by the National Guard Fee Exemption.
STUDENT REQUEST INFORMATION
Name*

First NameLast Name
Semester/Year*
Semester/Year:*
Student LoLA ID:*
L00000000
Waiver Type:*
To be completed by Accounts Receivable
Entered:
Verified By:
Notice of Eligibility:
Academic Requirement:
Status:
Comments/Requirements:
Verification Date:

MonthDayYear
Date
Student Email:*

Confirmation Emailexample@dcc.edu
Social Security Number:*
Additional Comments:
Optional
STUDENT AUTHORIZATION
Student Certification:*

I hereby certify that I have verified my eligibility and am listed on the Notice of Eligibility Exemption Form or an approved education services officer sent eligibility verification to Delgado Community College.I understand that the waiver is for tuition only and does not cover legislatively mandated fees, board authorized fees, student or school imposed fees, or any other charges.
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*

MonthDayYear
Date
Please verify that you are human*
Should be Empty:

NATIONAL GUARD TUITION WAIVER REQUEST

STUDENT REQUEST INFORMATION

To be completed by Accounts Receivable

STUDENT AUTHORIZATION