For Benefits Services Use Only
PERSONNEL REQUEST FOR CLASS ATTENDANCE
BYU Benefits Services D240 ASB ext. 2-4496 fax. 2-0306 amber_mcwhorter@byu.edu
1. Prior to submitting your request to Benefits Services, read the tuition benefit information found on the reverse
side (or accompanying page) of this form. This information reviews University policy regarding BYU class
work. Requests for tuition benefits that do not conform to policy will not be approved.
_______ Í Initial here to indicate that you understand the tuition benefit guidelines and instructions.
2. Completion of this form does not grant acceptance for admission or guarantee registration of classes.
For Admissions and Registration information, please contact the following offices.
Admissions contact: Student Services, D-155 ASB (2-2507) or Evening Classes, 122 HCEB (2-2872)
Registration contact: Registration, B-130 ASB (2-2824) or Evening Classes, 122 HCEB (2-2872)
3. You need to submit this form to Benefits Services no later than the add/drop deadline of the given semester
only if your class schedule includes any class between the hours of 7:00 A.M. to 5:00 P.M., TBA, thesis hours
or dissertation hours. Note: Benefit Services cannot post the tuition to your financial account until this
form is received.
4. Please complete the following:
Full-time employment status:
_______________________________________
F Faculty F Administrative F Staff
Name (Last, First, Middle)
Semester or term:
_______________________________________
F Fall F Winter F Spring F Summer
BYU ID Number
Year:
_______________________________________
F 2009 F 2010 F 2011 F 2012
Department
______________________ _______________
_____________________________________
Campus Address Campus Phone
Adjusted working hours approved by Supervisor
List below all