OFFICE OF HUMAN RESOURCE MANAGEMENT
HOWARD UNIVERSITY · Washington, D.C. 20059

APPLICATION FOR REMISSION OF TUITION FOR DEPENDENT
CHILDREN OF EMPLOYEES, RETIREES, AND DECEASED EMPLOYEES

Note:

 Eligible dependent children may receive Remission of Tuition benefits premised on the policy and guidelines in place as of the effective date of their retirement. Remission of Tuition benefits are subject to the Taxpayer Relief Act of 1997. Benefit recipients are advised to consult with their personal tax experts for assessment of their personal income tax situation.

PART I. EMPLOYEE DATA

  1. Employee/Retiree/Deceased Name:
  2. Social Security No.:
  3. Application Date:
  4. Current or Last Position of Employment (complete Lines A, B, and C):
    1. Title:
    2. Admin Dept, School, or College:
    3. Enterprise (check as appropriate): University Hospital
  5. Type of Appointment (complete Lines A, B and C):
    1. Staff Faculty
    2. Non-Grant Grant/Contract
    3. Full-Time Half-Time Temporary

PART II. APPLICANT DATA

  1. Applicant’s Name:
  2. Social Security No.:
  3. Student ID No.:
  4. I am eligible for benefits as a dependent of a (check one):
    Current Employee
    Retiree
    Deceased Employee
  5. Remission Requested for Undergraduate Studies in the School/College of:
    Arts & Sciences (excl. Voice & Instruments)
     Communications
    Engineering, Architecture & Computer Sciences
    Business
    Education
     Pharmacy, Nursing & Allied Health (excl. Pharmacy Programs)