Fee Waiver Form

Fee Waiver Form

Your results are what we care most about. If you are unable to afford our services, submit a request to get a portion of your fees waived.
Applicant's Information
Name

First NameLast Name
Address
City, State, Country
When Services are requested
Phone Number
Please enter a valid phone number.
Email
example@example.com
Income Details

Help us determine how much of your fee we can waive.
Household income & Size
When Services are requested
Income, Monthly, Expenses. Also please email your most recent W2 of three months of a pay stub. If you are currently unemployed, please identify your living situation, ages of members of household, how long you have been unemployed, resume and and desired place of employment.
Terms and Conditions:

I, the undersigned, understand and agree to the following terms and conditions of this fee waiver:
1. The waiver granted is applicable only to the specified program and term or year mentioned above.
2. I am responsible for any additional fees, books, and materials not covered by this waiver.
3. The tuition waiver is subject to household income capabilities and supporting documents will be sent to support@femmu.org.
4. The waiver may be adjusted or revoked if my status changes or if I fail to meet the specified requirements.
Date

MonthDayYear
Date
Requester's Signature

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Applicant's Information