APPLICATION (PUBLIC ACT 90-0282)
Interinstitutional 50% Tuition Waiver for Children of Public University Employees
APPLICATION for 50% Tuition Waiver at (name of university/campus):
Semester and year for which request is made: Fall : Spring:
Summe
r:
Student Name: Birth Date: Email Address:
Student Campus Address: Phone:
Student Permanent Address: City: State: Zip Code:
Student Certification of Registration
Compliance & Acknowledgement of Policies
I hereby declare that the Student Certification of Registration Compliance is true and correct and that I am a child or stepchild who is eligible for the 50% tuition waiver pursuant to
P.A. 90-0282 and related policies/procedures. I request and understand that this information will be verified by accessing university records, and that total partial undergraduate tuition
waiver benefits granted to me may not exceed the 4-year limitation established in P.A. 90-0282. In the event this application contains any false statements, errors or omissions pertaining
to my parent’s service record or in the event total partial undergraduate tuition waiver benefits among eligible institutions exceed the 4-year limitation, I will be responsible for the full value
of any ineligible benefits that I may have received.
I understand that a separate “Tuition Waiver Benefit Utilization Record” must be completed for each institution in which I have been enrolled while utilizing these tuition waiver
benefits, that the tuition waiver benefit utilization record may be subject to verification by the tuition waiver granting institution, and that tuition waiver approval protocols shall be subject to
individual university policies. (See attached policy statement for additional information.)
Application of this waiver serves as both my official notification (unless denied) and my acceptance of this waiver. As an applicant for or the recipient of a tuition waiver award from
Northern Illinois University, I understand that the University has the legal authority to release my name and address, the name of my former high school or college, the name of my award,
and the award amount. This release is valid for the period of time the tuition waiver is in effect. The refusal to accept this agreement will result in a forfeit of the waiver.
Student Signature: _______________________________________________ Date: _____________________________
Parent’s Disclosure/Certification of Illinois Public University Employment
Instructions: Please complete the following information as thoroughly as possible. All items must be completed. Percentage and dates of employment must be
listed for each position claimed. The human resource or personnel office at listed universities may formally confirm the employment record and/or parent/child
relationship through the use of university employment/benefit records at all locations for which employment credit is claimed. Confirmation procedures may require
additional documentation
Employee I.D. # :
Work Phone:
Category: Faculty
Administrative Professional Civil Service:
I hereby d
eclare that this student is my child or stepchild. Employee signature is not required as a condition of student eligibility.
Employee Signature:
Date:
To Be Completed by Applicant/Parent (use additional sheet if necessary)
Institution (branch or location) Inclusive Dates of Employment Percent of Employment
(list current employer first)
FOR OFFICE USE ONLY
Applicant Information Confirmed/Corrected Authorized University Signature & Printed Name Date
Account #: Amount: SFA Initials: Date:
New 01/04
Qualified Employee (Parent) Name:
Employing University:
Email Address:
Co
mpleted applications are due by the following deadlines:
• March 1 - (spring semester)
• July 15 - (summer semester)
• October 1 - (fall semester)
TUITION WAIVER BENEFIT UTILIZATION RECORD
Public Act 90-0282
Instructions: The following information must be completed by the student, certified by the department
responsible for monitoring academic record(s), and attached to the Tuition Waiver Application in the event that
you have (are) already accessed (ing) the 50% tuition waiver benefit at another Illinois public university.
Student Name: Birth date:
Address: City, State, Zip: Local Phone #:
Application for 50% Tuition Waiver at (name of university):
Major:
Expected Graduation Date:
Name of Institution where previously/currently enrolled:
Academic terms during which the 50% tuition waiver benefit was utilized at another Illinois Public University
(specify total credit hours for which the 50% tuition waiver was applicable):
Sem./Year Hours Sem./Year Hours Sem./Year Hours
I have only used the 50% tuition waiver benefit at Northern Illinois University.
I hereby declare that all previous or concurrent academic terms, during which the 50% tuition waiver benefit
was utilized, are accurately accounted for above. I request and understand that this information may be verified
by means of accessing university records and that the total partial undergraduate tuition waiver benefit granted
to me may not exceed the 4-year limitation established in P.A. 90-0282. A separate “Tuition Waiver Benefit
Utilization Record” must be completed for each institution in which the student has been enrolled while
utilizing tuition waiver benefits pursuant to P.A. 90-0282.
Student Signature Date
FOR OFFICE USE ONLY
50% tuition waiver benefit utilization record confirmation (optional as requested by the tuition
waiver granting institution): In accordance with institutional standards for tuition waiver benefit
utilization, the record outlined above is correct.
Name
Authorized signature of record confirmation Date
Employee Records
New 01/04
If you were hired prior to 1-1-99 with between 3 and 7 years of service and your child attends NIU you must read and sign the
following statement.
The undersigned employee of Northern Illinois University states that he/she is a faculty, administrative or status civil service
employee or retiree. The undersigned further states that the above information is correct and that the above named student is a child,
step-child, or adopted child of the employee eligible under the Board of Trustees tuition waiver program. The undersigned
understands that the granting of a tuition waiver is subject to verification as to the eligibility of the employee and the academic
standing of the student. If it is determined that the employee and/or student is ineligible, the employee shall be liable for the amount
of the tuition waiver, which amount may be withheld from the employee’s paycheck.
Date: ______________ Signed: ________________________________________________________ (Employee)
IF YOU ARE AN EMPLOYEE OF NIU WITH 7 OR MORE YEARS
OF SERVICE, CHILD ATTENDING NIU OR ANOTHER STATE
UNIVERSITY - FOLLOW THESE INSTRUCTIONS
P.A. 90-0282 Undergraduate Tuition Waiver for Children of NTU
Employees Attending NIU or Another State University
In accordance with Public Act 90-0282, 50% tuition waivers for undergraduate education have been expanded to include all Illinois senior public universities including the University of
Illinois, Southern Illinois University, Chicago State University, Eastern Illinois University, Governors State University, Illinois State University, Northeastern Illinois University, Northern
Illinois University and Western Illinois University. The 50% tuition waiver will be made available to eligible children of employees of the public universities who have 7 or more years of
total university employment
Waiver - The waiver may be utilized until such time as a total of 4 years of undergraduate 50% tuition waiver
benefits have been expended in accordance with university procedures. The 4-year limitation shall be comprised
of the number of hours or semesters (including summer terms) necessary to complete an undergraduate degree
as defined by the tuition waiver granting university, not to exceed a total equivalent period of 4 years. The
academic terms need not be taken consecutively.
Employment Eligibility - The employee must have completed 7 or more full years (50% or greater basis) of
total (consecutive or non-consecutive) university employment in an appointment status subject to SURS
participation and be employed as of the first day of the academic term or semester for which the tuition waiver
benefit would apply. Employment among different universities shall be cumulative in terms of fulfilling the 7-
year requirement (the Disclosure/Certification Illinois Public University Employment form must be completed).
Child - An eligible child shall include the natural or adopted child or children of the employee as well as
stepchildren.
Student Eligibility Requirements - The employee must be employed at a senior university as of the first day
of the academic semester (in accordance with the academic calendar where the student is enrolled) for which
the tuition waiver benefit would apply.
An eligible child of a qualified employee must be under the age of 25 at the commencement of the academic
year during which the waiver is to be effective (in accordance with the academic calendar where the student is
enrolled). Thereafter, the age limitation must continue to be fulfilled as of the beginning date of subsequent
academic years.
The eligible child must qualify for admission under the same admission requirements, standards, and policies
that the tuition waiver granting university generally applies to applicants for admission to its respective
undergraduate colleges and programs.
The eligible child must continue to maintain satisfactory academic progress toward graduation in accordance
with policies at the tuition waiver granting institution where the student is enrolled.
Eligible Children of Retirees - Retirees must have had 7 or more years of total university employment, prior to
retirement for their children to qualify for a 50% tuition waiver valid only at the university from which they
retired.
Limitations - The tuition waiver benefit may not be used for non-credit or graduate professional academic
programs or certifications.
Procedure for Obtaining 50% Tuition Waiver for Child of NIU Employee who is
Attending NIU or Another State University:
1. An application for a Public Act 90-0282 Inter-institutional 50% Tuition Waiver for Children of Public
University Employees as well as the Disclosure and Certification of Illinois Public University Service
Form may be obtained at any Senior Illinois Public University campus.
2. Employee's with children attending NIU should contact Human Resource Services (815-753-6000)
if there are questions regarding completion of the enclosed forms.
3. The child and employee complete the forms and return them to Human Resource Services.
4. Once the employment history is verified, the forms are forwarded to the Financial
Aid Office at the institution where the child is enrolled. A copy of the application with the
appropriate employment verification signature is also forwarded to the child/parent.
5. The Financial Aid Office verifies student eligibility for the waiver and then forwards the approved
waiver to Bursar's for posting of the waiver.
6. A re-certification or tuition waiver application process may be required at periodic intervals as specified
by the tuition waiver granting universities.
IF YOU ARE AN NIU EMPLOYEE HIRED PRIOR TO 1/1/99, WITH
BETWEEN 3 AND 7 YEARS OF SERVICE, CHILD ATTENDING
NIU - FOLLOW THESE INSTRUCTIONS
50% NIU Undergraduate Tuition Waiver for NIU Employee Children
In accordance with Board Regulations, eligible employees may obtain a waiver of 50% of the tuition accessed
to employee's children until such time as a total of 4 years' undergraduate 50% tuition waiver benefits have been
expended. The 50% tuition waiver is available for eligible children of NIU employees who have three or more
years of NIU employment as of the beginning of the semester for which the tuition waiver benefit would apply.
If you were hired after 1/1/99, you must complete 7 years of employment before dependent is eligible for this
benefit.
Children of NIU Employees Attending NIU
Waiver - The maximum four years undergraduate tuition waiver will be granted for a total of eight semester
hours as a full-time student and not more than four summer terms.
These semesters need not be taken consecutively. The waiver is not applicable to non-credit or
graduate/professional academic programs. A new form must be completed each semester for which the tuition
waiver is desired.
Employment Eligibility - The employee must have completed 3 or more full years (if hired prior to 1/1/99) at a
50% or greater basis of university employment in an appointment status subject to SURS participation and be
employed at the beginning of the semester for which the waiver benefit would apply.
Eligible Children of Retirees - Retirees must have had 7 years of service at Northern Illinois University, prior
to retirement, for their children to qualify for a 50% tuition waiver valid only at Northern Illinois University.
Eligible Children of Deceased Employee - The child/children of an eligible employee who has died while
employed full time (or on educational leave with pay, sick leave, or disability leave) with Northern Illinois
University shall be entitled to 100% waiver of tuition and other eligible registration fees.
Child - An eligible child shall include the natural or adopted child or children of the employee as well as
stepchildren.
Student Eligibility Requirements - The employee must be an NIU employee as of the first day of the
academic term for which the tuition waiver benefit would apply. An eligible child of a qualified employee must
qualify for admission to NIU and be under the age of 25 at the commencement of the academic year during
which the waiver is to be effective. Thereafter, the age limitation must continue to be fulfilled as of the
beginning date of subsequent academic years. The eligible child must continue to maintain satisfactory
academic progress toward graduation in accordance with NIU policies.
Procedure for Obtaining 50% Tuition Waiver
1. Child or parent will call Human Resource Services (815-753-6000) to obtain a tuition
waiver application form or if you have questions about the enclosed forms. There is a section for
both the dependent child and employee to complete and return to Human Resource Services
2. Employment eligibility will be verified in Human Resource Services and an approved copy will be
forwarded to Student Financial Aid Office and also to the employee.
3. The approved 50% tuition waiver should be deducted from the student's bill once processing has
taken place in the Bursar's Office.
4. A re-certification process will occur each semester for all recipients of the waiver.
