Request for Tuition Rebate

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Completed by Student

Section 54.0065 of the Texas Education Codes

In order for a student to be eligible for a rebate under this program, they must have attempted NO MORE than three hours in excess of the minimum number of semester credit hours required to complete the degree, under the catalog, under which they graduated, which includes: any hours attempted, any transfer credits, developmental coursework, pass, failed or repeated coursework, drops after Census Day, withdrawals, credit by exam over 9 hours and optional internship and cooperative education courses.

*Note: If you have outstanding student loans, the university may choose to apply your refund to the outstanding balance.

Student Name*

First Name

Middle Name

Last Name

Lamar Email*

Student Data

Date Submitted*

Current Graduating Semester*

Expected Graduation Date*

LU ID Number*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

First semester enrolled in ANY Texas Institution of Higher Education:*

List ALL Higher Education Institutions Attended including Dates Attended:*

High School Graduation Date*

Were you ever co-enrolled?*

Yes No

In a high school and a University, at the same time

List Co-Enrolled College/University including Dates Attended

How many hours?

Short Answer

Have you ever taken AP/CLEP Exams?*

Yes No

AP/CLEP Exam Hours (Only the first 9 credit by exam hours do not count.)*

3 6 9

Have you been enrolled in an ROTC program?*

Yes No

Short Answer

Degree Sought*

Double Major (Optional)

Personal Email*

Signature*

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Use your mouse or finger to draw your signature above

Registrar's Office

Verification/Approval:*

[clear]

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Hours needed for LU Degree:

Total numbers of hours ATTEMPTED:

(RO)Student Eligible for Rebate:*

Yes No

Registrar’s Office Comments:

Reason for Denial

Too many hours Did not graduate within 4 years Too many hours and did not graduate within 4 years. Did not graduate Not an Undergraduate Not graduating in the current semester

Fiscal Office

Verification/Approval*

[clear]

Use your mouse or finger to draw your signature above

(FO)Student Eligible for Rebate:*

Yes No

If YES, rebate amount:

Date Approved:

Completed by Student

Please answer the following questions:

Student Data

Registrar's Office

Fiscal Office