OFFICEOF SPONSORED PROJECTS

POBox4130

1395SouthKnolesDrive

Flagstaff,Arizona86011

ARDBuilding#56Suite252

Phone(928)523-4880/Fax(928)523-1075

Sponsored Project Tuition and Fee Waiver Request Form

The purpose of this form is to expedite consideration of tuition and fee waiver requests by providing a similar format to request the waiver(s) and to secure internal approvals from department/unit heads and deans.
INSTRUCTIONS: Submit the completed form to the Office of Sponsored Projects (OSP) Grant and Contract Administrator (GCA) assigned to your unit; OSP will forward the request to the Vice President for Research (VPR) for review and decision. The following documents must be included with this request: proposal abstract, detailed budget, budget justification.
Please contact your GCA or OSP at 928-523-4880 or via e-mail to for assistance in completing this form.

Date:

Proposal Deadline:

Principal Investigator:

Project Title:

Sponsor:

Program:

F&A rate % and base(MTDC, TDC, other) allowed by the Sponsor

  1. Is this a NEW waiver request or a request for CONTINUATION/RENEWAL of waivers for an existing sponsored project? If this is a continuation request, list the NAU Account Number:
  2. Are tuition and fees allowable charged to this grant proposal? If allowable, explain and justify why a waiver of one or both is being requested. What university, school, or departmental interest(s) are served by waiving the direct costs of tuition and/or fees that are allocable for this project?

Tuition Allowed by Sponsor / = / $ / Fees Allowed by Sponsor / = / $
Tuition Requested from Sponsor / = / $ / Fees Requested from Sponsor / = / $
Difference (Amount to be waived) / = / $ / Difference (Amount to be waived) / = / $
  1. Provide the following information for each course:

Course # / Semester / # of credit hrs / Tuition $/hr. / # of Students / Total Cost per Course
Total value ($) of Tuition Waivers / $
  1. What academic fees, if any, are included in the request?

Fee / Cost / # of Students / Total Cost per Fee
Total value ($) of Academic Fee Waivers / $

Principal Investigator/Project Director (PI/PD) Certification: I certify that the information provided above and in the attached documents is accurate to the best of my knowledge.

______

PI/PDDate

Department/Unit/College Endorsement: Waiver of the requested tuition and/or fees is in the best interests of the department/unit/college for the reasons described above, and we endorse this request.

______

Department Chair/DirectorDateDean/DirectorDate

REVIEW BY OSP: The GCA is responsible for reviewing the request in relation to the associated proposal or funded project and making a recommendation.

GCA Recommends: Approval DisapprovalInitials

Reasons for the recommendation:

OSP Director Recommends: Approval DisapprovalInitials

Reasons for the recommendation:

REVIEW BY ASSOCIATE VICE PRESIDENT FOR SPONSORED PROJECTS:

OSP AVPR Recommends: Approval DisapprovalInitials

Reasons for the recommendation:

REVIEW BY VICE PRESIDENT FOR REASEARCH:

VPR Recommends: Approval DisapprovalInitials

Reasons for the recommendation:

Rev. 01/24/20171