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    Readmit Application Fee Waiver Request Form

    Readmit applicants to SUNY Plattsburgh who are U.S. Citizens or Permanent Residents, and wish to be considered for a readmit application fee waiver, must submit the following (in addition to this form):

    1. A letter requesting a fee waiver along with proof that you meet the income requirements shown in the table below.

    2. A copy of your most recent signed Federal Tax Return including all business schedules (if applicable) AND W2 from employer(s); OR, proof that you receive Social Service Benefits, Social Security or SSI, unemployment benefits, etc.

    -OR-

    3. If you have an extenuating circumstances* and do not feel that you have the ability to pay the readmit application fee.
    *You must provide a written statement, addressed to the Director of Admissions, describing the extenuating circumstance for which you are requesting a readmit application fee waiver. The "Applicant Section" must be completed to be considered.

    Financial eligibility is primarily determined by the family income guidelines shown in the table below. These are the same guidelines as those used by the SUNY system.

     

    Household Size: 1 Annual Income: $23,107
    Household Size: 2 Annual Income: $31,284
    Household Size: 3 Annual Income: $39,461
    Household Size: 4 Annual Income: $47,638
    Household Size: 5 Annual Income: $55,815
    Household Size: 6 Annual Income: $63,992
    Household Size: 7 Annual Income: $72,169
    Household Size: 8 Annual Income: $80,346

    *Plus, 7,992 for each family member in excess of eight.
    Applicant Section
    Date of Birth
    Date of Birth
    Date
    Date
    I understand this is a legal representation of my signature.
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