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Get FIU State Employee Tuition Waiver Program

STATE EMPLOYEE TUITION WAIVER PROGRAM NON-FIU EMPLOYEES TO BE COMPLETED BY THE EMPLOYEE Please type or print form Last Name First Name Title Employing Agency Work Phone Number E-Mail Address I am requesting a waiver For Year M. Courses in the College of Law Executive Cohort programs undergraduate limited access programs dissertation thesis directed individual study directed research courses internships distance learning CAPS Professional Development offerings continuing education courses or other one-to-one instructional courses are not covered. Employee Signature Date AGENCY AUTHORIZATION I authorize the above-named employee to participate in the Tuition Waiver Program. I also certify that the above-named employee holds an established authorized position with a full time equivalency FTE. Supervisor s Name please print Supervisor s Signature Agency Head or Designee please print Once this form is completed with all the appropriate approvals please submit to the FIU Cashier s Office at either campus. I. Fall Panther ID Department Spring Summer List course s for which you desire approval* Include 2 alternatives. Prefix Number Section Course Title Credit Hours Class Day s /Time Preferred Alternate I understand the following o I must be a full time state employee. My waiver of tuition of fees will apply for up to 6 credit hours per semester. I must regis ter for classes between 12 noon and 5 00 p*m* on the last day of the drop/add period during the first week of classes. My ability to secure the courses I request depends on space availability. The waiver will only apply to tuition* All other charges are my responsibility. Courses in the College of Law Executive Cohort programs undergraduate limited access programs dissertation thesis directed individual study directed research courses internships distance learning CAPS Professional Development offerings continuing education courses or other one-to-one instructional courses are not covered* Employee Signature Date AGENCY AUTHORIZATION I authorize the above-named employee to participate in the Tuition Waiver Program* I also certify that the above-named employee holds an established authorized position with a full time equivalency FTE. Supervisor s Name please print Supervisor s Signature Agency Head or Designee please print Once this form is completed with all the appropriate approvals please submit to the FIU Cashier s Office at either campus. I. Fall Panther ID Department Spring Summer List course s for which you desire approval* Include 2 alternatives. Prefix Number Section Course Title Credit Hours Class Day s /Time Preferred Alternate I understand the following o I must be a full time state employee. Prefix Number Section Course Title Credit Hours Class Day s /Time Preferred Alternate I understand the following o I must be a full time state employee. My waiver of tuition of fees will apply for up to 6 credit hours per semester. I must regis ter for classes between 12 noon and 5 00 p*m* on the last day of the drop/add period during the first week of classes.

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