Roanoke College
Tuition Exchange Request Form

Employee Name:
Your E-mail:
"yourname@roanoke.edu"
Date:
Years you have been employed  by Roanoke College:
Academic year:
   
Student Information:

Name:  
 

Student's SSN:  
xxx-xx-xxxx
 

Student's Email:  
"name@roanoke.edu"
 

Home Address:  


 

City/State/Zip:  
 

Telephone:  
 

Parent Name:  
(If applicable)  

   
College 1:

College Name:
 

Location:
 

Student:

 as a
     
College 2:

College Name:
 

Location:
 

Student:

 as a
     
College 3:

College Name:
 

Location:
 

Student:

 as a
     

Note:

 Requests are valid for Summer through the following Spring semesters and must be submitted to the Human Resources Department by December 31st of the year prior to the academic year being requested.
Please refer to the Educational Assistance/Scholarship Policy in Handbook.