AUTHORIZATION FOR TUITION WAIVER CLASSROOM TEACHER
NAME___________________________________ SSN_______________________________ SCHOOL/SCHOOL DISTRICT____________________________________________________ CIRCLE THE APPLICABLE TERM
Course Reference
FALL
SPRING
Credit Hours
SUMMER Days/Time
YEAR___________ Course # and Title
I, the undersigned, acknowledge the following: •
• • •
Waiver of tuition and fees will apply to no more than 6 credit hours per term for full time employees by a Florida School District. Waiver shall not include such fees as application, private instruction, independent study or special/lab. Registration will be on a space-available basis only. You may register only during the late registration period as defined in the college catalog. Courses shall be limited to undergraduate courses related to Special Education, Mathematics or Science as approved by the Department of Education. Waiver many not be used for courses scheduled during the school day.
SIGNATURE____________________________DATE__________________________ 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. SUPERVISORS NAME (Please Print)__________________________________________________ SUPERVISORS SIGNATURE_________________________________DATE________ TITLE/DEPARTMENT____________________________________________________
Instruction: After you have registered, present this completed form at your campus Finance Office.