USVI Public Records

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Senior Citizen Waiver Form Revised June 10, 2020 Senior Citizen Education Tuition Program Fee Waiver Form Proof of Status: To be eligible for waiver of tuition and fees, person seeking the Senior Citizen Education Program must meet the following criteria: Be at least 60 years of age, must show senior citizen ID card issued by the Unites Stated Virgin Islands Department of Human Services, and be a resident of the United States Virgin Islands for at least one year. (Undergraduate Catalog 2014-2015, pp. 27-28). SEMESTER (indicate one) Fall Spring Summer Session(s) I or II Year__________ Name of Student: ________________________________________ Student ID Number: _____________ Mailing Address: _______________________________________________________________________ City: _____________________________________________ State and Zip: ________________________ Requested Courses Pre-requisites* 1. _________________________________ ______________________________ 2. _________________________________ ______________________________ 3. _________________________________ ______________________________ 4. _________________________________ ______________________________ 5. _________________________________ ______________________________ 6. _________________________________ ______________________________ *Pre-Requisites may be required for courses. Student Signature: _______________________________________________ Date: _____________ Registrar Office Signature: ___________________________________________ Date: _____________ For Business Office Use Only: Total Credits: ______________ Tuition Amount: _________________ For Registrar’s Office Use Only: Senior Citizen Card ID#_____________________________ Expiration Date: ____________________ Proof of Age: □ yes □ No Degree Student: □ yes □ No Proof of Residence: □ yes □ No Non-Degree Student: □ yes □ No Credit Total: Audit: □ yes □ No Access and Enrollment Services SIGN SIGN