Draft: Florida State University Graduate Waiver Receipt Form

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FLORIDA STATE UNIVERSITY

GRADUATE WAIVER RECEIPT FORM


(Return to your academic department representative)
If you have applied to the FSU Office of Financial Aid for financial assistance, you must contact that office so they may discuss how
accepting this award impacts other sources of financial aid. Our department has notified the Office of Financial Aid of this award.

Student Name: Mr Jorge Luiz De Oliveira


Employee ID: 200550167

In-State: Hours Covered – 12 Amount – 4842.12

Out-Of-State: Hours Covered – 0 Amount – 0

Semester: 2019 Fall Waiver Year: 2019

TUITION WAIVER FINANCIAL LIABILITY AND POLICY ACKNOWLEDGEMENT

AFT
1. I acknowledge tuition waivers cover only the tuition portion of the cost associated with taking classes.

2. I acknowledge that if my waivers are canceled or if I withdraw from the University, drop below the required academic load, or my
assistantship or fellowship is terminated my waivers will be revoked and I will be financially liable for the dollar amount(s) listed
above. If any University authority terminates the assistantship upon which the waiver is based or cancels my enrollment I will be
financially liable for the dollar amount(s) listed above. Waivers will not cover any dropped classes.

3. I acknowledge that if I officially withdraw from the University and my petition is approved, a refund can only be provided if the
refund or withdrawal request is submitted within six months after the end of the semester in which the withdrawal occurred. If
financial aid is received during the term in which the refund is granted, state and federal regulations may require that the refund
be returned to the aid source.

4. By allowing this waiver to pay for my tuition in the Student Financial (OMNI) system I am accepting the policies stated in
Graduate Student Waiver Manual.
DR
5. Waivers can cover only courses related to the student's academic degree. Waivers cannot be used for Sponsored Institute
courses.
Student Fees

Tuition waivers cover only the cost of tuition. Students are responsible for all other fees associated with attending the university.
For detailed information on fees, visit: http://controller.vpfa.fsu.edu/Student-Financial-Services/SFS-For-Students/Tuition-Rates/Main-
Campus

I have read the above information and understand the waiver policies.

Student Signature________________________________________________Date________________________________________

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