Home / Employee Dependent Waiver Application
Date of Birth(Required)
Are you applying as a West Virginia Resident?
Are you applying as a Border County Resident?


  • Dependents of full-time, permanent faculty, classified, and non-classified staff.
  • Student must remain in Academic Good Standing for renewal.
The information provided on this application form is true and correct, to the best of my knowledge. I authorize Bluefield State University to access my student records. In addition, if awarded, I grant permission to BSU personnel to release information on my academic progress to donors