Arizona University Application – Fill Out and Use

REQUEST FOR WAIVER OF APPLICATION FEE

For Arizona residents for whom payment of the admission application fee would be a financial hardship. This fee is required of all Arizona residents applying for undergraduate admission to Arizona State University, Northern Arizona University, or the University of Arizona.

∙Counselors: by signing this form you are certifying a student’s need for a fee waiver.

∙If your student has already submitted an on-line application, please send this form to the appropriate address at the bottom of this page.

∙If your student plans to submit a paper application, please attach this form to the application.

∙The application fee must be waived or received prior to any application priority deadline.

Student’s Last Name___________________ First Name_________________ MI ___

Date of birth_______________________

Street Address__________________________________________________________

City________________________________ State_______ Zip Code______________

Semester and year for which student is seeking admission______________________

High School Name_______________________________________________________

Counselor’s Signature_______________________________ Date________________

Counselor’s Name Printed ________________________________________________

Student’s Signature__________________________________ Date _______________

Please send completed forms to the Office of Undergraduate Admissions at the appropriate school: