Please fill out the following information and click the submit button. "*" indicates mandatory fields.

ATTENTION: Please click HERE to see if your country is affected by the Administrative Fee requirement before submitting this form.  If your country is on that list you will need to submit this form to request a Waiver of the fee.  However, if your country is NOT on that list of affected countries, you are automatically exempt and you DO NOT need to submit this form.  Please do not submit this form if you are automatically exempt.  It wastes staff time here at the SLBC offices when unnecessary forms are received because they must be hand-processed.

Thank you,
Dr. Van

*I verify that I HAVE reviewed the "countries affected" list through the HERE link above.
*Your name exactly as it is on your Application form.
User Name (If you are registered with the SLBC Moodle site.)
(If you are not registered with the SLBC Moodle site, please leave the User Name field blank.)
*Verify Email
Why do you want a Fee Waiver?

1000 characters remaining.
*What Is Your Monthly Income in US Dollars?
*What is the amount of your Monthly Expenses in US Dollars?
*What Are Your Source(s) of Income? (separate multiple entries with comma and 1 space)
*Regular Courses or Video Courses
Regular Courses
Video Courses