SPECIAL REQUEST FOR OUT-OF-STATE TUITION AWARD

FOR GRADUATE ASSISTANTS

Use this form for the following claims only (please use a separate form for each type)

* department is paying the out-of-state tuition for a GA who is NOT on a permanently budgeted line.
* Academic Common Market support.
* Capstone International Program Center students sponsored by Academic Affairs.
* Law School sponsored students.
* National Student Exchange Program students approved by NSE coordinator.
* Summer out-of-state tuition support where GA appointment held in previous spring semester.
* Funding agency policy provides only in-state tuition.
* Graduate fellowship or scholarship under Academic Affairs with awards equivalent to at least 0.25 FTE.

Code 1
Code 2
Code 3
Code 4
Code 5
Code 6
Code 7
Code 8

Division:

Fall

Department/Area:

Spring

Date prepared:

Interim

Prepared by:

Summer 1

Type (code #):

Summer 2

Student Number

Name (Last, first, MI)

FTE

Contract & Grant Accounting Approval

Does the contract or grant contain a cost of education allowance?

Yes

Is budget limited to in-state only?

Yes

Account number to charge OOS tuition:

Approval

Graduate School Approval

Approval

Account number