COF 145 Lifetime Hours Waiver Request

COF 145 Lifetime Hours Waiver Request

Waiver Request for Institutional Exception to the 145 College Opportunity Fund Lifetime Hours
Student Name*

First NameLast Name
Student ID Number*
Student Email Address*
Daytime Phone Number
Please enter a valid phone number.
Today's Date*

MonthDayYear
The College Opportunity Fund allows all resident, undergraduate students to apply the COF stipend to a maximum of 145 credit hours. Students can use this one-time waiver to apply for up to 3 consecutive semesters of additional COF hours and must be used within that time. Review your COF lifetime “hours used” balance on the College Assist website: http://cof.college-assist.org.
Please indicate term this waiver goes into effect.*
Remaining hours to complete baccalaureate degree at Adams State University (as determined in consultation with academic advisor):*
Enter total remaining credits needed after this current semester.
Reason(s) for requesting an exception to the 145-credit hour limit to receive the College Opportunity Fund through the State of Colorado:*
Academic Advisor's Name

First NameLast Name
Academic Advisor's Email Address
Please enter the correct email address for your academic adviser to process this request. Your advisor's name is in Degree Works and email address can be found at https://ssb.adams.edu/ords/ssb/bwpkedir.P_DisplayDirectory .
Certification Statement:
By signing below,
- I certify that to the best of my knowledge the information included in this waiver request is accurate, true, and unaltered. If false information or falsified supporting documentation is found to have been included, the request will become void and the resultant action will be retroactively nullified.
- I understand if this COF institutional waiver is approved, it is a one-time waiver of the 145 COF lifetime hours limit, and all hours approved must be completed within the semesters specified by the Waiver Committee.
- I understand if I have not received a baccalaureate degree at the end of the waiver period and choose to continue my course work, I must pay full tuition (without COF stipend credit) for all hours in excess of the hours added to my COF lifetime limit.
- and I understand if I have exhausted the institutional waiver, I can apply for a waiver through the Colorado Commission on Higher Education (CCHE).
Student Signature*

Clear
After submission, this form will be routed to your academic advisor and the Office of Academic Affairs for review to determine approval or denial of your request. If approved, the Registrar's Office and Student Business Services will adjust your student record accordingly. For questions, please contact Academic Affairs.

Academic Advisor - Office Use Only
Academic Advisor Password
To be inserted by Academic Advisor. Do not use personal faculty password. Contact Jerah at jadickson@adams.edu, 719-587-7622. Or studentbusiness@adams.edu, 719-587-7728 for assistance.
Do you approve this waiver request?*
Advisor Comments
Advisor Signature*
Type name

Academic Affairs - Office Use Only
Academic Affairs Password
Do you approve this waiver request?*
Academic Affairs Comments
Academic Affairs Signature*
Type name
Should be Empty: