2017 Hurricane Tuition Waiver Request Form for Kansas City Kansas Community College
This form is designed for individuals who are displaced academically due to 2017 Hurricanes.
Prior to the submission of this form, you should complete an online application for admissions to KCKCC, the application can be found at kckcc.edu.
Complete the questions listed on the form, once submitted, the form will be reviewed by the KCKCC Hurricane Relief Committee.
Please allow 8-10 business days after submission for review.
Once the KCKCC Hurricane Relief Committee has reviewed your request, you will be notified via email once the process has been completed.
First Name: *
Last Name: *
KCKCC Student ID number:
Date of Birth: *
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Residency Address: *
Residency City, State, Zip Code: *
Email Address: *
Phone Number: *
Indicate if you are an international student studying in the U.S. on a student VISA: *
Are you a U.S. citizen: *
Name of institution attended when hurricane affected your studies: *
Location (city and state) of the institution attended when the hurricane affected your studies: *
I intend to use federal financial aid and will add KCKCC's school code (001925) on the 2017-2018 FASFA: *
Anticipated start semester of attendance at KCKCC: *
I understand that I must submit documents (class schedule, enrollment verification, etc.) to provide proof of dislocation due to a 2017 Hurricane to Tina Church Lewandowski, Director of Admissions and First Year Experience (tchurch@kckcc.edu or Kansas City Kansas Community College, Admissions Office, 7250 State Ave, Kansas City, Kansas 66112). *
Type your name below to certify that the information provided is true and accurate to the best of my knowledge. *
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