CSTEP FEE WAIVER REQUEST

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IF YOU ARE NOT A CURRENT OR PAST STUDENT OF BINGHAMTON UNIVERSITY
PLEASE DO NOT FILL OUT THIS FORM

First Name *

Last Name *

If your name has changed since being accepted to the program please include the last name that was on your original application in parenthesis. Sample: Wade (Brown)

Please state your pronouns. *

Phone Number *

Binghamton University E-mail Address *

Undergraduate Major(s) *

Cuurent/Previous Research Title/Topic(s) *

Input N/A if no research experience

Cuurent/Previous Faculty Mentor(s) Name *

Input N/A if no research experience

Cuurent/Previous Mentor(s) Department(s)

Input N/A if no research experience

Binghamton University Graduation Date

for alumni (input N/A if current BU undergraduate student)

Degree(s) Held *

for alumni (input N/A if current BU undergraduate student)

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