TEXAS TUITION REBATE APPLICATION (UNDERGRADUATES ONLY)

Section 54.0065 of the Texas Education Code authorizes a tuition rebate for certain students who are receiving a bachelors degree from a public institution in Texas. Complete the checklist of eligibility on page 2. If you believe that you will qualify for this tuition rebate, then please complete this form legibly and submit to the Office of the Registrar prior to the published deadline on the Comet Calendar. Name: ________________________________ ___________________________
(Last) (First)

_____
(M.I.)

UTD ID:

UTD Email Address: ____________________________

Address: ___________________________________ Daytime Phone: _________________ City: ________________________________ State: ______ Zip Code: ________________ Semester and year that you are applying to graduate: ______________________________ Major: ______________________________________

Please list all colleges or universities you have attended in the United States and abroad, including The University of Texas at Dallas. (1) _________________________________ (2) _________________________________ (3) _________________________________ (4) __________________________________ (5) __________________________________ (6) __________________________________

I understand that by submitting this form to the Office of the Registrar that my student record will be reviewed to determine final eligibility. I have completed the checklist on page 1 of this form and believe that I am eligible based on criteria outlined by 13.82 of the Texas Higher Education Coordinating Board Rules and Regulations. ___________________________________________ Student Signature _____________________ Date

Rev. 05/2013

TEXAS TUITION REBATE CHECKLIST Are you eligible for the Texas Tuition Rebate? This checklist will help you determine your eligibility. Please read the requirements on this checklist carefully before you complete and submit the Tuition Rebate Request Form. You must meet all the requirements below. If you cannot confidently place a checkmark in the box beside each statement, please consult your academic advisor. I enrolled for the first time in an institution of higher education in the Fall 1997 semester or later.* If you enrolled for the first time at UTD or any other institution of higher education in or after Fall 2005, you must be graduating within four calendar years of your first enrollment.

I am receiving my first bachelors degree. (If you are receiving a second bachelors or a graduate degree, you are not eligible for the rebate.) I am a resident of Texas and have been eligible for resident tuition in Texas at all times while pursuing my bachelors degree. I have attempted no more than three hours in excess of the minimum number required to complete the degree under the catalog under which I am graduating (see NOTE below). Please consult your academic advisor if you have any questions about the required hours for your degree. NOTE: o Attempted Hours includes: Earned hours Unearned hours (courses completed for non-passing grades) All attempted transfer credits Course credit earned exclusively by examination (the first 9 hours are excluded from attempted hours) Courses dropped after the official census date (withdrawn courses that appear as a W on the transcript) For-credit developmental courses Vocational/Technical courses taken at other institutions Optional internship and cooperative education courses Repeated courses o Attempted Hours do not include: Course credit taken to satisfy ROTC requirements that are not required to complete the degree program Courses dropped for reasons that are determined by UTD to be totally beyond the control of the student You must submit your application for the Texas Tuition Rebate before the day of the commencement ceremony for the semester in which you will graduate. It is your responsibility to ensure that the form is received in the Office of the Registrar, Student Services Building, First Floor. If you qualify, you will be notified by mail approximately four to six weeks after degree conferral. If you do not qualify, you will be notified via your UTD email address. If you qualify and have student loans with the State of Texas, your rebate will be applied to your student loans. Upon final review by the Office of the Registrar, Financial Aid, and the Bursars Offices, your check will be mailed to the address specified on your Texas Tuition Rebate application approximately four to six weeks after UTDs degree conferral. Processing may be delayed due to the fall holiday break. Visit the UTD graduation website at www.utdallas.edu/records/graduation for additional information.
Rev. 05/2013