ORANGE COUNTY COMMUNITY COLLEGE
MIDDLETOWN, NEW YORK

FACULTY, STAFF & CHAIRMEN AND ADJUNCT TUITION WAIVER

CREDIT CLASSES
(Limit two (2) per Academic Year)

Self

NON-CREDIT CLASSES ($100 limit each class)
(Limit two (2) per Academic Year)
(Limit one (1) per Academic Year for Adjunct)

			Self					   Dependent/Spouse

										

EMPLOYEE: _____________________________________________________

	    Full time		         Day Adjunct		    Evening Adjunct	

STUDENT: ______________________________________________________

DATES: ________________________________________________________                                     

COURSE/CLASS: ________________________________________________

AUTHORIZED:

Human Resource Officer: __________________________________________

Date: ___________________________________________________________

Non Credit Procedures:
1.	HR Signature
2.	Take blue registration card and this form to Registration

S:\Human-Resources\Forms\waiver facultycredit non-credit.doc