
REQUEST FOR WAIVER OF APPLICATION FEE
For Arizona residents for whom payment of the admission application fee would be
a financial hardship. This fee is required of all Arizona residents applying for
undergraduate admission to Arizona State University, Northern Arizona University,
or the University of Arizona.
Counselors: by signing this form you are certifying a student’s need for a fee
waiver.
If your student has already submitted an on-line application, please send this
form to the appropriate address at the bottom of this page.
If your student plans to submit a paper application, please attach this form
to the application.
The application fee must be waived or received prior to any application
priority deadline.
Student’s Last Name___________________ First Name_________________ MI ___
Date of birth_______________________
Street Address__________________________________________________________
City________________________________ State_______ Zip Code______________
Semester and year for which student is seeking admission______________________
High School Name_______________________________________________________
Counselor’s Signature_______________________________ Date________________
Counselor’s Name Printed ________________________________________________
Student’s Signature__________________________________ Date _______________
Please send completed forms to the Office of Undergraduate Admissions at the
appropriate school:
Arizona State University Northern Arizona University University of Arizona
PO Box 870112 PO Box 4084 PO Box 210073
Tempe, AZ 85287-0112 Flagstaff, AZ 86011 Tucson, AZ 85721-0073
Fax: 480.965.3610 Fax: 928.523.0226 Fax: 520.621.9799
Arizona State University Northern Arizona University University of Arizona