Fee Waiver Record

1. This form is intended for the school’s financial records ONLY and should NOT be given to a student or parent/guardian as an application form.

2. The student’s teacher, once the teacher is made aware of the need for a waiver, is responsible for completing the form, and submitting to the principal or designee for review.

3. The teacher may request assistance from the counselor, resource teacher, or administrator to determine appropriate waiver option.

4. Schools should keep all forms on file and keep a record of the total amount of waivers funded by the school for each fiscal year. It is the principal’s responsibility, in collaboration with staff, to determine the appropriate location for this file. Appropriate options may include the school business administrator, school financial specialist, school administrative secretary, and/or other staff as deemed appropriate.

5. The principal may be asked to submit a record of waivers funded by the school per academic semester.

Fee Waiver Record

463 K

English

Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat