Fillable Printable ACT Fee Waiver Form - Michigan
Fillable Printable ACT Fee Waiver Form - Michigan
ACT Fee Waiver Form - Michigan
Office of Undergraduate Admissions
P.O. Box 02759
Detroit, MI 48202
Phone: 313-577-2100
Fax: 313-577-7536
FEE WAIVER FORM
Applicant’s name
Last First Middle
Date of birth
Address
City State ZIP Code
Applicant must meet at least one of the following reasons showing economic need. Do not submit this form unless
at least one reason is checked.
o Applicant has received or is eligible to receive an ACT or SAT testing fee waiver.
o Applicant is enrolled in or eligible to participate in the Federal Free or Reduced Price Lunch program (FRPL).
o Applicant’s annual family income falls within the Income Eligibility Guidelines set by the USDA Food and Nutrition
Service.
o Applicant is enrolled in a federal, state or local program that aids students from low-income families (e.g. TRIO
programs such as Upward Bound).
o Applicant is in foster care or homeless.
o Applicant is a ward of the state or an orphan.
o Other. Please state the specific reason why applicant should be eligible for waiver if the reasons above are not
applicable.
High school counselor/school official
Please enter your name and contact information in case we need to follow up with you concerning the waiver request.
Name
Last First Middle
Title Email
Phone
School name
Signature
Mail or fax
Mail: Office of Undergraduate Admissions, P.O. Box 02759, Detroit, MI 48202
Fax: 313-577-7536
