Senior Citizen Tuition Waiver Application

*Indicates required field

Personal Information

First Name*

Middle Name

Last Name*

Birthdate*

Are you a United States citizen?*

Social Security Number*

If no, what is your country of citizenship?*

Email Address*

Mobile Phone Number

Evening Phone Number

Mailing Address*

Country

Street

City

Region

Postal Code

Demographic Information

Applicants are requested, but not required, to indicate their gender and ethnic background. Failure to respond to this inquiry will not subject you to any adverse action. Husson University will keep all information gathered in this inquiry as strictly confidential.

Sex at Birth

Are you Hispanic or Latino?

Yes

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Course Information

Have you previously taken a course at Husson University?*

Registration Term*

List of course offerings

Using the course offering list please enter course/section # (example PY III 001) you would like to register for.*
Course/Section #

Grading Option*

Applicant Signature

Husson University is pleased to provide a waiver of tuition fees on a limited basis (one fully enrolled Husson University course per semester) for citizens of Maine who have achieved senior status and who desire to further their learning. For the purpose of administering this waiver, “senior citizens” are defined as Maine residents who are, or will become, 65 years of age during the semester for which they are requesting the waiver. The Senior Citizens waiver applies to undergraduate courses offered in non-capped programs on a space available basis. The course may be taken for credit or as an audit. This application for admission is a confidential document. Husson University prohibits discrimination on the basis of race, color, nationality or ethnic origin, religion, sex, marital or parental status, disability, or age in all programs.

I certify to the best of my knowledge that the above statements are true.

Applicant/Student Signature

Programs

Schools & Colleges

Senior Citizen Tuition Waiver Application