Tuition Waiver Request

Tuition Waiver Request Form

After form is submitted it will be routed to your supervisor for approval.
Submission Date

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

First NameLast Name
Employee's E-Mail*
example@oregoncoast.edu
Person taking class will be:*

EmployeeDependent
Dependents Name:*

First NameLast Name
Relationship:*
Classes Requested

Classes Requested*

Total all Credits
Total all Tuition
Send to this person for approval:*
To be Approved by Supervisor:

The person requesting this tuition waiver is a current, active employee in good standing at OCCC and is eligible to receive a waiver of tuition for themselves or their dependent. Fees and book are still the participants responsibility. Please pay online through your student portal or contact Laura at Laura.Rosborough@oregoncoast.edu or (541) 867-8551.
ApprovedDisapproved
By typing my name I acknowledge that I have reviewed this request.
Date Signed

MonthDayYear
Should be Empty:

Tuition Waiver Request Form