This form should be used to request tuition/fee waivers to be paid by department and/or grant index.
Please allow 3-5 business days from date received in Bursar's Office for processing requests. Please check the Bursar's Web site for the fee payment deadlines for each term. Completed form can be faxed to 901-678-0288 or e-mailed to firstname.lastname@example.org. (Form should be scanned & attached to email.) For best results, printing should be done with landscape format.
Requester Phone #:
Approver Phone #:
(This person must be
listed as an Authorized Signature for the org, and approver must sign in order for this form to be processed by Bursar's Office)