TUITION EXCHANGE APPLICATION INFORMATION E-mail the completed form to [email protected]. Before you e-mail this document, please perform a “SAVE AS” and overwrite your dependent’s last and first names where indicated in the document’s file name (for example… osborn_ethan_teapp_2018_19.doc). Complete and submit extra copies if you have more than one dependent child applying for or renewing a scholarship.

Submission of this completed form signifies that you have read the program overview and rules posted on YCP’s HR website, that you certify you are eligible as a full-time employee, and your dependent child is eligible as a qualifying child per IRS rules.

Upon receipt, the TE Liaison will submit this information to the chosen school(s) using forms provided by the exchange programs. Information submitted may be viewed by the exchange employees and employees of the receiving school.

Dependent Child’s Information: All fields required. Child’s FIRST name Child’s MIDDLE initial Child’s LAST name Child’s SS# (last 4 digits only) xxx-xx- Child’s E-mail Child’s Telephone # Child’s Permanent Address Child’s Date of Birth (Mo/Day/Year) Parent’s Information: Highlight or complete. All fields required. Employment Category FACULTY STAFF Parent’s Name (first, mi, last) Job Title & Campus Location Parent’s E-mail Parent’s Telephone # # of Years Employed Full-Time @ YCP Additional Information: Circle or complete. All fields required. Has your child used TE before? YES NO If Y, how many previous semesters? Are you filing FAFSA? YES NO UNKNOWN Application Status: APPLYING ADMITTED Fall 2018 Class Status: Freshman Sophomore Junior Senior Additional Notes? (Is there any info that the other school should know?) School information: (add lines for additional schools) Member of Name of School, City, & State CIC / TE / Date Admission App Sent Both