This form may be completed online but must be printed for signatures.  Submit original and one (1) copy.      
   
CONTRACT AND GRANT TUITION AND FEES
   
   
Contract/Grant Number For which Term? Interim Term
Assigned by Awarding Agency  
20     First Term Summer
    Second Term Summer
Project Director (Name)     Both Term Summer
    Fall Semester
University Account Number     Spring Semister
   
Grant/Contract will pay (check only ONE):  
 
 
  In-State Only  
   
  In and Out of State  
   
Type in the information below in the unshaded areas only.  
Social Security Number Name (Last, First, M.I.) Charges  
     
       
     
       
     
       
     
       
     
       
     
       
     
       
     
    APPROVED:        
Project Director/Project Investigator Contract & Grant Accounting  
   
         
  Date  
Note:  If grant allows for both in and out of state tuition, please mark it on this form and do not fill out the "Schedule 9 -- Special Request  
for Out-of-State Tuition Award for Graduate Assistants".