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Student Representation Fee Waiver Application
(Please Print)
Term_________________________________________________________ Student ID_____________________________________________
Name________________________________________________________ Today’s Date __________________________________________
Address ______________________________________________________ Telephone ____________________________________________
City/State/Zip__________________________________________________
__________________________________________________________________________________________________________________
Student Signature
Fax the completed request to 760-384-6372 or mail to
Cerro Coso Community College, Attn: Business Office, 3000 College Heights Blvd., Ridgecrest, CA 93555
Students may request a waiver of the $2.00 student representation fee for religious, political,
nancial or moral reasons. This request must be made for each semester enrolled.
If this waiver results in a credit balance on the student account, a refund will be processed.
Rev. 01/16