I hereby declare that the Student Certification of Registration Compliance is true and correct and that I am a child, adopted or stepchild who is eligible for the 50% tuition waiver pursuant to policies/procedures. I request and understand that this information will be verified by accessing university records, and that total partial undergraduate tuition waiver benefits granted to me may not exceed the 4-year limitation. In the event this application contains any false statements, errors or omissions pertaining to my parent's service record, or in the event total partial undergraduate tuition waiver benefits among eligible institutions exceed the 4-year limitation, I will be responsible for the full value of any ineligible benefits that I may have received.
I hereby declare that all previous or concurrent academic terms, during which the 50% tuition waiver benefit was utilized, are accurately accounted for above. I request and understand that this information may be verified by means of accessing university records and that the total partial undergraduate tuition waiver benefits granted to me may not exceed the 4-year limitation.
I understand that a separate Tuition Waiver Benefit Utilization Record must be completed for each institution in which I have been enrolled while utilizing these tuition waiver benefits, that the tuition waiver benefit utilization record may be subject to verification by the tuition waiver granting institution and that tuition waiver approval protocols shall be subject to individual university policies.
Application of this waiver serves as both my official notification (unless denied) and my acceptance of this waiver. As an applicant for or the recipient of a tuition waiver award form Western Illinois University, I understand that the University has the legal authority to release my name and address, the name of my former high school or college, the name of my award and the award amount. This release is valid for the period of time the tuition waiver is in effect. The refusal to accept this agreement will result in a forfeit of the waiver.