Program You are Completing(Required)Choose your programABE- Adult Basic Education (GED, HS+)ESL - English as a Second LanguageName(Required) First Last BC Email(Required) Quarter:(Required)Please select the quarter you are applying the WAIVER for. We are no longer able to accept waiver requests for previous quarters. Winter 2024Spring 2024Bellevue College Student Identification (SID) Number or ctcLink ID(Required) I am requesting a waiver at this time for the $25 tuition for my ESL/ABE/HS+/GED® because I have at least one of the documents listed in the box below. I understand my name must be on the document and the document must be clear. HiddenCheck all that apply; L & I does NOT apply(Required) Working Connections ChildCare (WCCC) Award/Change letter HUD Housing Award letter for public housing Letter requesting waiver (on letterhead) from a church, community organization, Salvation Army, etc. The letter must address the student’s need re: low income Check all that apply; L&I does NOT apply(Required) Select All A letter documenting your QUEST/EBT (Electronic Benefits Transfer) benefits Apple Health/Medicaid Plan Public assistance (DSHS, SSI, TANF, WIC Coupon, etc) Employment Security Benefits Statement My child(ren) get free/reduced lunches at school(s) Working Connections ChildCare (WCCC) Award/Change letter HUD Housing Award letter for public housing Letter requesting waiver (on letterhead) from a church, community organization, Salvation Army, etc. The letter must address the student's need re: low income Other (Please describe below) Other: Proof of waiver eligibility (Picture of Apple Health, WIC, copy of Quest benefits letter, etc...)(Required)Your image or file must be clear, current, and have your name on it. Max. file size: 5 MB.Attendance Statement: Attendance is very important for your success. If you do not maintain regular attendance in your classes, you will NOT be eligible to receive a waiver when you register for the following quarter. I verify that the above information is correct and true.Bellevue College does not discriminate on the basis of race, color, national origin, language, ethnicity, religion, sex, sexual orientation, including gender identity or expression, disability, or age in its programs and activities. Please see policy 4150 at www.bellevuecollege.edu/policies/. The following people have been designated to handle inquires non‐discrimination policies: Title IX Coordinator, 425.564.2641, Office C227, and EEOC/504 Compliance Officer, 425.564.2266, Office R‐130.Student Electronic Signature(Required)Include first name and last name upon agreement. Date(Required) MM slash DD slash YYYY Last Updated May 30, 2023
