BROAD-BASED FEE WAIVER REQUEST FORM

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91�� Fee Waiver Requests
Couper Administration Building, Business Office
fees@binghamton.edu

To be eligible for a waiver of 91�� Broad Based Fees, all courses in the academic term must be taught via distance learning.

DEADLINE FOR SUBMISSION: END OF 2ND WEEK OF CLASSES EACH TERM

If the above criteria is met, the student may be considered for a waiver of the broad based fees listed below. A new fee waiver request form must be submitted for each academic term.

Academic Support Fee
Campus Life Fee
Career Resource Fee
ID Card Fee
Intercollegiate Athletic Fee
Recreation Fee
Student Health Services Fee
Transportation Fee
Undergraduate Activity Fee (summer only)

kovachk@binghamton.edu

Email *

Record kovachk@binghamton.edu as the email to be included with my response

Date *

Date

B-Number *

Last Name *

First Name *

Address *

City *

State *

Zip Code *

Phone Number *

BU Email Address *

Term for which you are requesting waiver *

Reason for Request *

Please note: If we cannot determine whether the course(s) are taught exclusively via distance learning, we will notify you via email requiring that you obtain verification of instructional method from the instructor of the course(s) before your waiver can be processed

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