Fillable Military Tuition Waiver Form printable pdf download

Office of the Registrar

Print Form

ATTN: Tuition Classification Officer

Carter Hall 3002, Campus Box 50

Greeley, CO 80639

(970) 351-4315 (970) 351-1870 FAX

MILITARY TUITION WAIVER FORM

Indicate the term for which you are requesting the Military Tuition Waiver:

TERM

YEAR

Attention: Certification of waiver must be signed and submitted to the Office of the Registrar no earlier than 30 days prior to the first day

of classes and no later than the first day of classes. Failure to submit this form by the first day of classes may result in non-resident

tuition classification for the semester without right to appeal. Note: Unless the student meets the requirements for Colorado

residency, this eligibility expires the first term following military retirement, military discharge or loss of dependent status.

Last Name

First Name

Middle Name

Street

City

State

ZIP

UNC Bear Number

Date of Birth

Email Address

Daytime Phone Number

Sponsors Information (If not the student)

Last Name

First Name

Middle Name

Street

City

State

ZIP

Daytime Phone Number

Relationship to Student

Email Address

Military member please check the correct response below. If one of the next 3 statements does not apply to the military member please do not complete

this form.

My dependent child listed above as the student was born to or legally adopted at the time I was stationed in Colorado – provide copy of birth

certificate or adoption certificate

My spouse listed above as the student was my legal spouse at the time I was stationed in Colorado and we are currently still legally married –

provide copy of marriage certificate

I am the military member requesting the Military tuition adjustment for myself as the student.

Military member please check the correct response below. If one of the next 2 statements does not apply to the military member please do not complete

this form.

Military member is currently stationed in Colorado, complete Part 1 and Part 2 and attach a copy of your current orders stationing you in Colorado

along with military and dependent ID’s.

Military member is not currently stationed in Colorado but was stationed in Colorado within12 years of the first day of the semester I am requesting

this adjustment. Complete Part 2 and attached a copy of your military orders stationing you in Colorado and orders transferring you out of Colorado

along with military and dependent ID's.

Part I - To Be Completed by the Base Education Officer

I certify that (Name) ___________________________________ is an active duty member of the U.S. Armed Forces and q has permanent duty

station (PCS) or q is on temporary assignment to duty (TDY) in Colorado at (name of military installation __________________________________

and that (name of dependent) _______________________________ is a legal dependent of this member. I further attest that the information certified

above q will q will not remain in effect as of the first day of classes for the semester listed above at the University of Northern Colorado.

Certifying Officer: Name _______________________________________________

Title: _________________________________________________

Office or Command: _____________________________________________________________________________________________________________

Signature of Certifying Officer: ______________________________________________________________ Date:________________________________

Military Tuition Waiver Form

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