REGIONAL OCCUPATIONAL PROGRAM

ADULT STUDENT FEE WAIVER APPLICATION

 

INSTRUCTIONS:  SUBMIT A COPY OF PROOF OF HARDSHIP WITH THIS APPLICATION.

 

Student Name:

Date:

Class Title:

Class #:

Instructor:

Location:

Semester:

Fall

Spring

Summer

       

 

Fee waived for the following reason:

 

      CalWORKs/TANF

Applicants must meet state and federal regulation requirements to qualify for cash assistance.  Applicants must maintain residency in the state of California to qualify.

      MEDI-CAL, Food Stamps, WIC

Permanent or temporary medical card in student's name, County check warrant, ID card, food stamp authorization, social worker referral.

       Supplemental Security Income (SSI)

SSI documentation.

       Adult Enrolled in High School Diploma Program

Referral from school official.

         Adult Attending Less than 20 hours to Finish Requirements for the Certificate of Completion for a Course

Program referral.

      Other

Requests must be referred to ROP Administration.  Approval will be given to an adult who is eligible for economic public assistance or student aid and/or with income levels below $12,500 for single persons or $25,000 per household with an additional $1,000 per dependent child.

 

ADULT STUDENTS MAY NOT ENROLL IN ROP CLASSES UNLESS FEES ARE PAID OR A WAIVER HAS BEEN GRANTED.

 

ROP Administration Signature:

 

Granted

Denied

Date

Comments:

 

 

 

 

CONFIDENTIAL