"State Employee Tuition Waiver Program Participation Form" - Florida

State Employee Tuition Waiver Program Participation Form is a legal document that was released by the Florida Department of Management Services - a government authority operating within Florida.

Form Details:

  • Released on July 15, 2009;
  • The latest edition currently provided by the Florida Department of Management Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Florida Department of Management Services.

ADVERTISEMENT
ADVERTISEMENT

Download "State Employee Tuition Waiver Program Participation Form" - Florida

Download PDF

Fill PDF online

Rate (4.5 / 5) 16 votes
STATE EMPLOYEE TUITION WAIVER PROGRAM
PARTICIPATION FORM
Name of State University or Community College
By completing this form you are requesting agency approval to participate in this program. You will still need to
complete the appropriate forms of the school you are attending.
Name
People First ID #
Agency
Phone #
Division
Bureau
Address
City
State
Zip Code
Email Address
I am requesting a waiver for
Fall
Spring
Summer
Year
Date of first day of classes (if known)
Name of Courses: List the course number, title and the number of credit hours
Course ID
Please list up to 4 courses, 2 preferred, 2 alternate
Preferred
Preferred
Alternate
Alternate
I, the undersigned, acknowledge the following:
My waiver of tuition and fees will apply to no more than six credit hours per term.
I must register for classes during the State Employee registration period prescribed by the state
university or community college that I plan to attend.
All other charges/fees are my responsibility.
My ability to secure the courses I request depends on space availability.
NOTE: Participating employees should be aware that the school at which you apply may require you to
provide your social security number to verify employment.
Employee Signature
Date
_________________________________________________________________________________________________________
Agency Authorization
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 (FTE).
Supervisor’s name (
)
please print
Supervisor’s Signature
Title
Date
ELT Member name (
)
please print
ELT Signature
Title
Date
Email Form
Print Page
Reset/Clear Form
Save As
Revised 7/15/09
STATE EMPLOYEE TUITION WAIVER PROGRAM
PARTICIPATION FORM
Name of State University or Community College
By completing this form you are requesting agency approval to participate in this program. You will still need to
complete the appropriate forms of the school you are attending.
Name
People First ID #
Agency
Phone #
Division
Bureau
Address
City
State
Zip Code
Email Address
I am requesting a waiver for
Fall
Spring
Summer
Year
Date of first day of classes (if known)
Name of Courses: List the course number, title and the number of credit hours
Course ID
Please list up to 4 courses, 2 preferred, 2 alternate
Preferred
Preferred
Alternate
Alternate
I, the undersigned, acknowledge the following:
My waiver of tuition and fees will apply to no more than six credit hours per term.
I must register for classes during the State Employee registration period prescribed by the state
university or community college that I plan to attend.
All other charges/fees are my responsibility.
My ability to secure the courses I request depends on space availability.
NOTE: Participating employees should be aware that the school at which you apply may require you to
provide your social security number to verify employment.
Employee Signature
Date
_________________________________________________________________________________________________________
Agency Authorization
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 (FTE).
Supervisor’s name (
)
please print
Supervisor’s Signature
Title
Date
ELT Member name (
)
please print
ELT Signature
Title
Date
Email Form
Print Page
Reset/Clear Form
Save As
Revised 7/15/09