Do not print the form and fill it out by hand.  
 

Enter all the required information online, use the "Print and Sign" button at the bottom of the form to generate the official PDF copy.
 Adobe Reader required. Click here Download Adobe Reader to install.
 
The official copy will have a barcode in the lower left corner and a signature line at the end of the form.
 

After you print and sign the form, bring the form to the Enrollment Services Office on the first floor of Lynnwood Hall, OR fax the form to 425-640-1159, OR mail the form to: 
 
Enrollment Services 
Edmonds Community College 
20000 68th Ave W 
Lynnwood, WA 98036 

Admission Fee Delay of Payment Request 
 Student Name     Last: (Surname):      First:      M.I.: 
 Student ID Number:    -- Help  Birthdate:  //   MM/DD/YYYY
 Year/Quarter:    Help  Social Security Number: -- Optional
 Email:       
 
 Students who are unable to pay the Admission Fee due to financial hardship may ask for a delay of payment at the time they apply to the college. To request a delay of payment on the Admission Fee, please complete this form and submit to the Enrollment Services Office.
 ALERT: The following programs may be able to waive the admission fee for eligible students, meaning you would not be required to pay the fee at a later date. If you participate in one of these programs, please ask your program contact if you qualify for the waiver:
Adult High School BFET C.A.T.C.H. Grant
EdCAP Early Achievers Opportunity Grant L & I (contact Cashier Office)
Opportunity Grant Workfirst
 State the reason you are unable to pay your admission fee at this time:
    
characters left
 I understand I am responsible for paying the admission fee and if this request is approved the fee must be paid by the end of the quarter in which I am asking for admission. This is a debt owed to the college and if not paid I understand my records will be placed on hold and I will be unable to register for an upcoming quarter, change my schedule, receive financial aid funds, or request a copy of my transcript. Additionally, I understand the college may start collection procedures, which may include assignment of this debt to a collection agency.
 
 If you have applied for financial aid and expect to be awarded prior to or during your first quarter of enrollment, you may ask to have financial aid pay the admission fee by checking the box and signing below. Please note that if you are not eligible for financial aid, or you are not awarded by the end of your first quarter, you are still responsible for paying the fee by the due date.

   I authorize my financial aid, which may include the Pell grant and student loans, to pay my admission fee.
 Student Signature:_________________________________________
 
 Date:____________
 
 
   This button will generate a pdf form.
 Please print the PDF and sign

 
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