Community Education Tuition Waiver Form

Community Education Tuition Waiver Form

This form will be routed to Human Resources and Billing for tracking purposes, please follow the registration link below to enter into a course.
Submission Date

MonthDayYear
Term:*
Year
Name of Employee requesting Tuition Waiver*

First NameLast Name
Employee's E-Mail*
example@oregoncoast.edu
Phone Number*

Area CodePhone Number
Person taking class will be:*

EmployeeDependent
Dependents Name:

First NameLast Name
Relationship:
Class Registration Form

Go to the community education course page (https://oregoncoast.edu/communityed/), select the course you would like to register into and in the coupon code area enter "employee" to receive the discount.

Classes Requested*

	Course Name	Course Cost	Course Dates (i.e. Jan. 11th - March 1st)
1st Course
2nd Course
3rd Course
4th Course
5th Course

* Please note that certain noncredit courses may be excluded from the employee waiver program, and that some community education and small business development courses fill up quickly.
Total all Costs
Waiver Agreement and Acknowledgement:

I attest that I am an active employee in good standing at OCCC and am eligible to receive a waiver of tuition for myself or my dependent. I attest that this course will not interfere with my normal working hours or that I have received approval from my supervisor if there is a conflict. Fees and books are still the participant's responsibility. For questions regarding registration please reach out to Talaina.King@oregoncoast.edu.
By typing my name I acknowledge that I have reviewed and accept this agreement.
Date Signed

MonthDayYear
Should be Empty:

Class Registration Form