Tuition Voucher Online Form

* required fields
Employee Information

First Name:* Last Name:*
ID/SSN:* Phone:*
Email:* Address:*
City:* Zip:*

If you want to use the hours for someone besides yourself, please supply the following student information.

Student Information

First name: Last name:

Terms & Conditions

  • Student must be maintaining Satisfactory Academic Progress (SAP) as outlined on
    Satisfactory Academic Progress (SAP) standards

  • LSEC and Non-credit classes are not eligible.

  • Resident tuition is paid for online classes.

  • Recipients of the employee tuition scholarship will not be eligible for the Over 65 or Silver Cougar Club tuition discount.

  • Eligible dependent children for the full-time staff and full-time faculty categories are defined as those children claimed on the employee’s or, in the event of divorce, dependents of the employee and their ex-spouse at the time the two were married and claimed on either parent’s most recently filed federal tax return. Misrepresentation of a qualifying dependent will result in the permanent loss of the Tuition Scholarship benefit.

To help keep spammers from using our forms you will have to type Barton below before submitting

I certify that to the best of my knowledge the information on this form is true and complete without evasion or misrepresentation. I understand that if found to be otherwise, it is sufficient cause for rejection.*

By checking this box you have created an electronic signature as legally binding as your handwritten signature.

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