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Page 1: AGENCY/ORGANIZATION SPONSORSHIP FORM...REQUIRED FOR ALL PROGRAMS Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Assessment Fee (one time only $50.00) Bus Pass (First

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Edmonds Community College does not discriminate on the basis of race; color; religion; national origin; sex; disability; sexual orientation; age; citizenship, marital, or veteran status; or genetic information in its programs and activities. 15-16-ISS-013

Only to be filled if Agency pays for the student’s tuition

AGENCY/ORGANIZATION SPONSORSHIP FORM

Fall 2020 Winter 2021 Spring 2021

Name of organization: Organization Contact Name: Contact Email Address: Student Name: Student Identification Number (SID): Effective (first quarter begin) in: Summer 2020 How many quarters will your organization pay for? Please indicate billing by checking “Yes” or “No” for each item. Any item not checked will be charged directly to the student.

REQUIRED FOR ALL PROGRAMS Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Assessment Fee (one time only $50.00)

Bus Pass (First time $36.00, then $26.00 per quarter)

Edmonds CC Health Insurance ($327.99 per quarter)

COLLEGE / HIGH SCHOOL COMPLETION PROGRAMTuition (Maximum number of credits paid for per students: Typical course load is 15 credits. More information at edcc.edu/tuition

Required Associated Student Fees

Lab fee*

Online/Hybrid fees*

IESL PROGRAMTuition (Required 20 credits, $3,318.20)

Grammar lab fee ($25.00 per quarter)

Housing fees (price vary, please visit edcc.edu/housing for more information)

Print Name and Title

Signature and Date Edmonds CC scholarships are awarded as tuition waivers. The International Student Services office will adjust your invoice accordingly. There will not be any cash refunded to students or the agency.

For any questions, please contact us at [email protected]

Assessment/Union Building Fee, Sustainability Fee, Technology Fee, Comprehensive Fee

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