College of Biological Sciences

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First found мар 16, 2016

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College of Agricultural & Environmental Sciences
University of California, Davis
Student Request for Course Material Fee Waiver
INSTRUCTIONS

Students are encouraged to first seek assistance from the Financial Aid Office.

Students who are unable to afford the fee may seek a waiver from the Department offering
the course by completing this form and submitting it to the Department administrative
Office by the 20-day drop date for this quarter.

Only in extreme cases of financial hardship, as of yet unaddressed through financial aid,
can the fee be waived. Attach documentation demonstrating a recently experienced
hardship (e.g., birth certificate for new dependent, job layoff notice). If you are unsure
about what documentation to obtain, please ask at the Department office. Without
appropriate documentation, we cannot consider your request for a waiver.
Student Name
Student ID#
Email
Amount of Fee
Quarter/Year
$________
Circle qtr & add year
Fall
Winter
Spring
20____
Course Name/
Number/Section
I certify that the above statements are true and that I am unable to pay the course material fee.
______________________________
Student Signature
___________________________
Date
Waiver requests must be received in the Department office by the 20th day of instruction.
Approved waivers - fax this completed form to Student Accounting at (530)752-5718
For Department Use
Approved
Denied
__________________________________
Departmental Signature
Student Accounting Use Only:
Exemption number ____________________________________
Detail Code __________________________________________
Exemption Code _________________
________________
Date

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