Sample Request For Transfer Admission - Application Fee Waiver

Sample Request For Transfer Admission - Application Fee Waiver - Nacac

SAMPLE WAIVER

Request for Transfer Admission

Application Fee Waiver

STUDENT:

Print or type the information requested below. You must personally sign the Certification Statement.

To: Office of Admission at:

Eligible for Pell Grant

Ineligible for Pell Grant

Applicants who are eligible for a Pell Grant

(what is a

Applicants who are not eligible for a Pell Grant but meet

Pell grant?)

are eligible to receive a transfer admission

one of the following indicators of financial need should

application fee waiver. Please sign below to attest to your

self-certify their eligibility for the admission application

eligibility to receive a Pell grant. (Continue to Certification

fee waiver below.

Statement)

q Check here if your annual family income falls

within the Eligibility Guidelines set by the USDA Food

and Nutrition Service (To view USDA Income Eligibility

Guidelines for the Free or Reduced Price Lunch

Program or review FAQs related to this form visit

). OR

q Check here if you are enrolled in a federal, state,

or local program that aids students from low income

families (e.g. TRIO programs such as Upward Bound).

CERTIFICATION STATEMENT: I certify that I understand and meet the eligibilty requirements to request an admission appliction fee waiver.

STUDENT’S NAME

STUDENT’S SIGNATURE

STUDENT’S ADDRESS

CITY

STATE

ZIP

If the institution to which you are applying requires additional documentation, please see page 2.

Sample Request For Transfer Admission - Application Fee Waiver - Nacac