Updated 12/11/18
OFFICE USE ONLY
Senior Tuition Waiver and
Course Audit Form
Students aged 65 years or older before the start date of the term are eligible for a senior tuition waiver to audit approved
courses. In order to prioritize space for students who are earning credit and paying full tuition, senior tuition waiver
course registration starts on the Monday of the week prior to the start of the term. This completed form must be
submitted in order to receive the senior tuition waiver.
ELIGIBILITY
Must be 65 years or older and a resident of Oregon at the start of the term in which the course is offered
Course must be a lower-division college credit course (100- or 200-level, e.g. ART 101, SPN 101, WR 227)
Some courses have pre-requisites, which must be completed prior to registration or waived by the instructor
Waiver may only be applied to a maximum of 8 credits per term
Course must be audited, meaning that grades and credit will not be granted upon completion, nor will audited classes
satisfy graduation requirements, veteran’s certification requirements, or most financial aid requirements
Must have submitted an application for admission to the college prior to registration: www.clackamas.edu/apply
IMPORTANT NOTE: The senior tuition waiver only waives the cost of tuition. Students are responsible for any fees
associated with the course, as well as any general student fees.
STUDENT INFORMATION *Indicates required field
Student ID Number or SSN* ___________________________________ Birthdate* ______________________________
Name* ___________________________________________________________________________________________
First Middle Initial Last
Address* _________________________________________________________________________________________
Street City State Zip
Phone* ______________________________ Email* ______________________________________________________
COURSE INFORMATION
Term*: Fall 20______ Winter 20______ Spring 20______ Summer 20______
Course
Number
(e.g. PSY 201)
Course
Section
Number
(e.g. 01)
Course Title
(e.g. Psychology as a Natural Science)
Instructor Signature
(required for each course)
Payment is due at the time of registration. By signing this form, you agree to all CCC policies and procedures including financial liability. If you fail to pay on time and CCC refers your
account(s) to a third party for collection, a collection fee of up to 25% of the debt or the maximum percentage allowed by applicable law will be added to your balance due. CCC will add
these fees to your balance due, and they will be due and owing no earlier than 60 days after the date your payment is due and prior to referring your account to a collection agency. You will
be held academically and financially responsible for all classes. Please review the current class schedule for important deadlines.
Signature* ____________________________________________________________ Date _______________________
Submit completed form to:
EMAIL: registration@clackamas.edu
FAX: 503-722-5864
IN PERSON: Enrollment Services, Roger Rook Hall Lobby
MAIL: Enrollment Services, Clackamas Community College,
19600 Molalla Ave, Oregon City, OR 97045-7998
click to sign
signature
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