Request for Exemption of Activity Fee

Click here for a printable PDF of the JALC Request for Exemption of Activity Fee form.
Printed forms need to be taken to the Bursar office.

Request *

I request that I be granted an exemption from the activity fee.

Please list semester you wish to be exempted from (Example: Spring 2017) *

Name *

First

Last

Student ID# *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Consideration will be given to students who have no classes on campus and have an unreasonable commute that would preclude them from participation in any of the activities provided. Exemption requests will be considered on a case-by-case basis.

Justification *

Phone

JALC.EDU

Admissions and Records

Request for Exemption of Activity Fee