California Community Colleges 2015-16 Board Of Governors Fee Waiver Application Form printable pdf download

California Community Colleges 2015-16 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





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

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

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



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

DEPENDENCY STATUS

The questions below will determine whether you are considered a Dependent student or Independent student for fee waiver eligibility and whether parental information is

needed. If you answer “Yes” to ANY of the questions 1-10 below, you will be considered an INDEPENDENT student. If you answer “No” to all questions, you will be

considered a Dependent student thereby reporting parental information and should continue with Question 11.

Were you born before January 1, 1992?



Yes



2. As of today, are you married or in a Registered Domestic Partnership (RDP)? (Answer "Yes" if you are separated but not divorced or have not filed a termination notice to

dissolve partnership.



Yes



3. Are you a veteran of the U.S. Armed Forces or currently serving on active duty for purposes other than training?



Yes



4. Do you have children who will receive more than half of their support from you between July 1, 2015 - June 30, 2016, or other dependents who live with you (other than your

children or spouse/RDP) who receive more than half of their support from you, now and through June 30, 2016



Yes



5. At any time since you turned age 13, were both your parents deceased, were you in foster care, or were you a dependent or ward of the court?



Yes



6. Are you or were you an emancipated minor as determined by a court in your state of legal residence?

Yes

7. Are you or were you in legal guardianship as determined by a court in your state of legal residence?



Yes



8. At any time on or after July 1, 2014, did your high school or school district homeless liaison determine that you were an unaccompanied youth who was homeless?



Yes



9. At any time on or after July 1, 2014, did the director of an emergency shelter or transitional housing program funded by the U.S. Department of Housing and Urban

Development determine that you were an unaccompanied youth who was homeless?



Yes



10. At any time on or after July 1, 2014, did the director of a runaway or homeless youth basic center or transitional living program determine that you were an unaccompanied

youth who was homeless or were self-supporting and at risk of being homeless?



Yes



 If you answered "Yes" to any of the questions 1 - 10, you are considered an INDEPENDENT student for enrollment fee waiver purposes and must provide income

and household information about yourself (and your spouse or RDP if applicable). Skip to Question #13.

 If you answered "No" to all questions 1 - 10, complete the following questions:

11.

If your parent(s) or his/her RDP filed or will file a 2014 U.S.

Income Tax Return, were you, or will you be claimed on their tax return as an exemption by either or both of your parents?

 

Will Not File

Yes





12.

Do you live with one or both of your parent(s) and/or his/her



RDP?

Yes

 If you answered "No" to questions 1 - 10 and "Yes" to either question 11 or 12, you must provide income and household information about your

PARENT(S)/RDP. Please answer questions for a DEPENDENT student in the sections that follow.

 If you answered "No" or "Parent(s) will not file" to question 11, and "No" to question 12, you are a dependent student for all student aid except this enrollment

fee waiver. You may answer questions as an INDEPENDENT student on the rest of this application, but please try to get your PARENT information and file a

FAFSA so you may be considered for other student aid. You cannot get other student aid without your parent(s’) information.