Student Fee Declaration Form (SFDF) |

Dublin City University

Student Fee Declaration Form

(Higher Education Free Tuition Fee Scheme)

On the basis of information available, it would appear that you have previously attended/applied to a third level institution. This may mean that you do not qualify for the Free Fees Initiative. If you completed a Level 6 or 7 award and are progressing to a level 8, this must be in the same field to qualify for Free Fees.

To enable a decision to be made as to your eligibility for the Free Fees Initiative, please complete the form below. In the absence of this form being completed and returned, you will remain liable for full tuition fees at this University. If you have attended more than one Institution, please complete separate forms for each institution attended/applied to. Please submit this form within 5 working days of receiving our email.

During Semester One the University will validate the data provided by you. You may be contacted as part of this process and asked to complete a form which must also be validated by your previous institution. Failure to complete or obtain a validation from your previous institution will result in your record being amended and you will then be required to pay full tuition fees.

First Name

Surname

Date of Birth

Selection Category

Previous Student No: (If applicable)

Current CAO No:

Data Protection NoticePersonal information that you submit to DCU Fees Office in connection with any service provision will be dealt with in accordance with the DCU Data Protection Policy, which can be viewed at the following website address: Data Privacy Policy V3.6

Please do not register online until you have received confirmation of the outcome of this assessment

Period of Attendance:

Name of Previous Institution:

Title & Level of Programme:

Reason for Leaving

Attended From: (Exact Date)

Attended to: (Exact Date)

Level of Programme:

Year of programme at exit:

Percentage of fees claimed: (If you do not have/know this information please confirm with your previous Institute)

I hereby declare that the above information I have provided is true and accurate and understand that if found otherwise, my record will be amended and I will be liable for full fees.

I agree to the Terms & Conditions.

I hereby declare that the above details are correct and understand that I will be liable for fees if found otherwise

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