New Orleans Police Officer & Firefighter Waiver Request (A)

Submission ID
ACTIVE NEW ORLEANS POLICE AND FIREFIGHTERS WAIVER REQUEST
Accessibility Statement

Delgado Community College is committed to digital accessibility. This form is designed to be compatible with assistive technologies and follow accessibility standards. If you encounter any barriers or need an alternative format to provide your signature, please contact us by emailing the Bursar's Office at bursaroffice@dcc.edu.
Authorized by the College’s former governing board in 1989, the Board of Trustees for State Colleges and Universities, Delgado continues to offer waivers of tuition for active City of New Orleans Police Officers and Firefighters, as published in the Delgado Community College Catalog.

Eligible students will receive a Fee Exemption Certificate from the New Orleans Police/ Fire Department Training Divisions. You must submit the original certificate to our office to receive the exemption.
STUDENT REQUEST INFORMATION
Student Name (First Last):*
Semester*
Student LoLA ID:*
L00000000
Student Email:*

Confirmation Emailexample@dcc.edu
Waiver Type:*
To be completed by Accounts Receivable
Entered:
Verified By:
Eligibility Certificate:
Status:
Comments/Requirements:
Verification Date:

MonthDayYear
Expiration Date:*
WAIVER CERTIFICATE*

Cancelof
Additional Comments:
Optional
STUDENT AUTHORIZATION
Student Certification:*

I hereby certify that the attached EXEMPTION CERTIFICATE is a true and accurate copy of the original which I have in my possession.I understand that the tuition waiver is for tuition and course fees 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 understand that the tuition waiver is for tuition and course fees only and does not cover legislatively mandated fees, board authorized fees, student or school imposed fees, or any other charges.
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.
Type Name*
*Once you enter your name you will not be able to make any changes to this request.
Date*

MonthDayYear
Signature* Student: Please sign by clicking the signature line and signing this form.
Please verify that you are human*
Should be Empty:

ACTIVE NEW ORLEANS POLICE AND FIREFIGHTERS WAIVER REQUEST

STUDENT REQUEST INFORMATION

To be completed by Accounts Receivable

STUDENT AUTHORIZATION