McNair Alumni Fee Waiver Request Form

This form is for Delta State University McNair Research Scholar Alumni only.

Please complete the information below. It will be submitted to the McNair Research Scholars Program staff for certification. Your fee waiver form will be returned to you electronically for you to turn in to your graduate school of choice.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone Number(Required)

900#(Required)

Undergraduate Major(Required)

Date of entry to the program(Required)

Month and year only

Date of exit from the program(Required)

Month and year only

McNair Research Title or Topic(Required)

Faculty Mentor's Name(Required)

First Last

Name of University to Receive this Waiver(Required)

Date Fee Waiver is Needed

McNair Alumni Fee Waiver Request Form

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