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Request for Waiver of Charges Form
Request for Waiver of Charges Form
Request for Waiver of Charges
Name
*
First
Last
EagleOne Card Number
*
Email
*
Phone
*
Affiliation
*
Freshman
Sophomore
Junior
Senior
Graduate
Faculty/Staff
Guest Patron
Please provide a title or some other identifier for the item(s) in dispute.
*
Why do you believe your charge(s) should be waived?
*