California Community Colleges 2016-17 Board Of Governors Fee Waiver Application Form printable pdf download

California Community Colleges 2016-17 Board of Governors Fee Waiver Application

This is an application to have your ENROLLMENT FEES WAIVED. If you need money to help with books, supplies, food, rent,

transportation and other costs, please complete a FREE APPLICATION FOR FEDERAL STUDENT AID (FAFSA) or the California Dream

Application (for eligible AB 540 students) immediately.

The FAFSA is available at and the Dream Application is available at https://dream.csac.ca.gov. Contact the Financial Aid

Office for more information. IMPLEMENTATION OF Assembly Bill 1899: Victims of Trafficking, Domestic Violence and other Serious

Crimes

AB 1899, chaptered in September of 2012, provides for a non-resident enrollment fee exemption for “Victims of trafficking, domestic violence and

other serious crimes”. In addition, the legislation allows these students to apply for and, if eligible, receive financial aid from programs administered

by public postsecondary institutions or the state of California. Finally, the legislation provides that enrollment fees shall be waived for these students

who apply for and are eligible to receive Board of Governor enrollment fee waivers.

This FEE WAIVER application is for California residents, eligible AB 540 students, and eligible AB 1899 students, as determined by the Admissions

or Registrar’s Office. If you have not had your California residency or eligibility status determined by the Admissions or the Registrar, please see one

of those offices to obtain the valid determination. Fee waiver eligibility cannot be determined until your status has been verified.

Has the Admissions or Registrar's Office determined that you are a California resident?

Yes No



If no, has the Admissions or Registrar's Office determined that you are eligible for a non-resident tuition exemption as an AB 540 student?

Yes No

If no, has the Admissions or Registrar's Office determined that you are eligible for a non-resident tuition exemption granted as a result of you residing

in the United States with a “T” or “U” visa (immigration status under Section 1101(a)(15)(T)(i) or (ii), or Section1101 (a)(15)(U)(i) or (ii), of Title 8 of

the United States Code)?

Yes No

Name:

Student ID #

Last

First

Middle Initial

Email (if available):

Telephone Number: (______)

Home Address: ________________________________________________ Date of Birth:

_______/_______/_________

Street

City

Zip Code

IMPLEMENTATION OF THE CALIFORNIA DOMESTIC PARTNER RIGHTS AND RESPONSIBILITIES ACT

The California Domestic Partner Rights and Responsibilities Act extends rights, benefits, responsibilities and obligations to individuals

in domestic partnerships registered with the California Secretary of State under Section 297 of the Family Code. If you are in a

Registered Domestic Partnership (RDP), or legal same sex marriage, you will be treated as an Independent married student to

determine eligibility for this Enrollment Fee Waiver and will need to provide income and household information for your domestic

partner. If you are a dependent student and your parent is in a Registered Domestic Partnership, or legal same sex marriage, you will

be treated the same as a student with married parents and income and household information will be required for the parent’s domestic

partner. Note: These provisions apply to state student financial aid ONLY, and not to federal student financial aid.

Are you or your parent in a Registered Domestic Partnership with the California Secretary of State under Section 297 of the Family Code? (Answer

“Yes” if you or your parent are separated from a Registered Domestic Partner but have NOT FILED a Notice of Termination of Domestic Partnership

with the California Secretary of State’s Office.)

Yes No

If you answered “Yes” to the question above, treat the Registered Domestic Partner as a spouse. You are required to include your

domestic partner’s income and household information or your parent’s domestic partner’s income and household information in

Questions 4, 11, 12, 13, 14, 15, 16, 17.

Student Marital Status

Single

Married

Divorced

Separated

Widowed

Registered Domestic Partnership

California Community Colleges 2016-17 Board Of Governors Fee Waiver Application Form

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