Tuition Waiver Request Form
After form is submitted it will be routed to your supervisor for approval.
Submission Date
-
Month
-
Day
Year
Date Picker Icon
Term:
*
Please Select
Summer
Fall
Winter
Spring
Year
Please Select
2020-21
2021-22
2022-23
2023-24
2024-25
2025-26
2026-27
2027-28
2028-29
2029-30
Name of Employee requesting Tuition Waiver
*
First Name
Last Name
Employee's E-Mail
*
example@oregoncoast.edu
Person taking class will be:
*
Employee
Dependent
Dependents Name:
*
First Name
Last Name
Relationship:
*
Please Select
Spouse/Significant other
Child
Parent
Classes Requested
Classes Requested
*
Rows
Course #
Course Credits
Course Name
Course Tuition
1st Course
2nd Course
3rd Course
4th Course
5th Course
Total all Credits
Total all Tuition
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 Isaac at Issac.Kinion@oregoncoast.edu or (541) 867-8551.
Send to this person for approval:
*
Please Select
Robin Gintner
Kristina Holton
Joy Gutknecht
Sharon Hahn
Ben Kaufman
Kellianne Parker
Dave Price
Marshall Roache
Chris Rogers
Carla Schubiger
Spencer Smith
Sarah Whiteford
Type a question
Approved
Disapproved
By typing my name I acknowledge that I have reviewed this request.
Date Signed
-
Month
-
Day
Year
Date Picker Icon
Submit Form
Should be Empty: