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    Certification For Tuition Waiver Form

    Uploaded by

    Doan Vu

    Copyright:

    © All Rights Reserved
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    Certification For Tuition Waiver Form

    Uploaded by

    Doan Vu
    10 views2 pages

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    certification-for-tuition-waiver-form

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    Certification For Tuition Waiver Form

    Uploaded by

    Doan Vu

    Copyright:

    © All Rights Reserved
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    Certification for Tuition Waiver Form

    See eligibility requirements on the reverse side. For more information, visit www.montgomerycollege.edu/hb104. Bring
    this form to a Social Security Administration Branch, the Railroad Retirement Board, or the U.S. Office of Personnel
    Management, as appropriate, for signature and stamp. Return completed form to the Office of Records and Registration by
    the end of the third week of classes for fall and spring semesters, and by the end of the first week of classes for winter and
    summer terms. Only one form per academic year needs to be submitted.
    This form is valid for the current academic year, which begins in fall and ends at the conclusion of summer II.
    Term/Year Fall ________ Winter ________ Spring ________ Summer I ________ Summer II ________

    Student Name: _________________________________________________________________________________________

    Student ID M- ____________________________ Social Security Number (required): _________________________________

    When did you submit your FAFSA for this academic year? Indicate month and year: __________________________________
    Priority deadlines are: March 1 for fall, November 1 for winter and spring, April 1 for summer
    Note: If you did not submit your FAFSA by the priority deadline for the first semester in the academic year that you wish to register, you will not
    qualify for the disability tuition waiver for that particular semester.

    Major/Curriculum Title _________________________________________________Curriculum Code: ___________________


    If you need to update your major, please fill out a Declaration or Change of Program of Study Form and submit to the
    Office of Records and Registration.
    Social Security Administration, Railroad Retirement Board, or U.S. Office of Personnel Management Official:
    I certify that the above student is out of the workforce as a result of permanent disability and is receiving a social security
    disability benefit (SSDI) or supplemental security income (SSI) as defined by the Social Security Act, Railroad Retirement Act, or in
    the case of a former federal employee, from the federal retirement or pension authority (U.S. Office of Personnel Management).
    Individuals receiving SSI or SSDI benefits as a dependent or survivor of a disabled beneficiary do not qualify for this waiver.

    Name of Social Security/Federal Official: ___________________________________Phone: ___________________________

    Signature: ___________________________________________________________Date: _____________________________


    Affix official address stamp of Social Security Office or Federal Agency here. Or, submit a copy of your most recent benefits verification
    letter from Social Security that is from within the past year.

    By signing this form, I authorize the Social Security Administration, Railroad Retirement Board, or U.S. Office of Personnel
    Management (as applicable) to release information about me; I acknowledge that this form is valid for one academic year and
    must be renewed each academic year; I acknowledge that I must apply for financial aid by the priority deadline; and I
    acknowledge that I will be responsible for charges incurred through registration if I do not qualify for the
    disability tuition waiver.

    Student Signature: ____________________________________________________Date: _____________________________


    Please see page 2 of this form for very important instructions about eligibility and limitations.
    -If you drop a class before the end of the third week of the semester for fall or spring classes, or before the end of the first week
    of classes for winter or summer classes, it will not be included in the Disability Tuition Waiver. You will owe the tuition and the
    fees for that class.
    -In accordance with the Maryland General Assembly guideline, Montgomery College will discontinue the tuition waiver if you
    enroll in a course with less than 10 regularly enrolled students.
    Office Use Only (Initial/Date)

    Ask when submitted FAFSA SSN on File NO Hold Major updated (if applicable) Disability Waiver
    RR 8/26/2022
    Guide for Tuition Waiver for Students with Disabilities

    HB 104 (http://mlis.state.md.us/2011rs/chapters_noln/Ch_576_hb0104T.pdf), enacted by the 2011 Maryland General


    Assembly, redefines the tuition waiver for students with disabilities as those out of the workforce by reason of total and
    permanent disability and entering community colleges. HB 104 supersedes previous legislation and proposes significant
    changes to Section 16-106c of the Education Article, Annotated Code of Maryland.

    Eligibility:
    1. Any resident of Maryland who is out of the workforce because of a permanent disability as defined by the Social Security
    Act, the Railroad Retirement Act, or in the case of former federal employees, the Office of Personnel Management, and
    enrolls in a community college class that has at least 10 regularly enrolled students, may be eligible for a tuition waiver.
    2. The waiver is available for enrolling in up to 6 credits per semester without declaring a degree or certificate program. Any
    further credits, up to 12 credits per semester, will require you to enroll in a degree program, or a certificate program that
    leads to employment. Letter of Recognition and non-credit courses are not eligible for the waiver. *This waiver does not
    cover courses taken for audit.
    3. You are required to apply for financial aid and submit your FAFSA by the priority deadline to receive this waiver (additional
    information is below.)
    4. Individuals receiving SSI or SSDI benefits as a dependent or survivor of a disabled beneficiary do not qualify for this waiver.
    The Student Will:
    1. Complete the Free Application for Federal Student Aid at www.fafsa.gov and submit it to the Office of Financial Aid by
    March 1 for fall courses, November 1 for spring courses, or April 1 for summer courses.
    2. Obtain a Certification for Tuition Waiver form from www.montgomerycollege.edu/studentforms.
    3. Take the form to the Social Security Administration office that serves your area, or, if appropriate, to the Railroad
    Retirement Board or the federal agency from which you retired due to disability to have your form signed and certified that
    you are receiving SSI or SSDI payments and are permanently disabled.
    4. Return the completed Certification for Tuition Waiver form to the Office of Records and Registration by the end of the third
    week of the fall or spring semester, or by the end of the first week of the summer or winter term. Your form should include
    a major/ curriculum title and curriculum code for a degree program or a certificate program if you plan to enroll in more than
    6 credits per semester.
    5. Register for credit classes.
    Adjustments to your account will be made approximately halfway through the semester or term in which
    you are registered or after your financial aid is awarded if you are a late applicant.

    Limitations:
    - If you did not submit your FAFSA by the priority deadline for the first semester in the academic year that you wish to
    register, you will not qualify for the disability tuition waiver for that particular semester.
    - Any student financial aid, other than a student loan, received by the student shall be applied first to pay the student’s
    tuition.
    - Under this exemption, the waiver shall apply to the difference, if any, between the charge for tuition and the financial aid
    award, not including a student loan, that the student receives.
    - The tuition waiver does not apply to fees.
    - You may have up to 12 credit hours covered by the waiver each semester. (The waiver is available for enrolling up to 6
    credits per semester without declaring a degree or certificate program. Any further credits, up to 12 credits per semester, will
    require you to enroll in a degree program, or a certificate program that leads to employment. Letter of Recognition is not
    eligible for the waiver.) *This waiver does not cover courses taken for audit.
    - If you drop a class before the end of the third week of the semester, or before the end of the first week of either summer
    session, it will not be included in the Disability Tuition Waiver. You will owe the tuition and fees for that class.
    - In accordance with the Maryland General Assembly guideline, Montgomery College will discontinue the tuition waiver if you
    enroll in a course with less than 10 regularly enrolled students.
    - This process applies to Maryland residents. Students who reside out of state will not qualify for the disability tuition waiver.
    RR 8/26/2022

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