APPLICATION FOR ADMINISTRATIVE FEE WAIVER
Please fill out the following information and click the submit button. "*" indicates mandatory fields.
*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.)
*Country
United States
Australia
Canada
UK
Other
Other:
*Email
*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)
Verify Authentication Code: