2019-2020

Noncustodial Parent Waiver Request

For need-based institutional grants and scholarships, Baylor University requires all new undergraduate students to provide both of their
biological/adoptive parents’ information on the CSS Profile, regardless of their current marital status. In unusual circumstances, we may consider an
exception to this requirement. Examples of such circumstances include:

 Physical and/or mental abuse from non-custodial parent

 Abandonment or neglect from non-custodial parent
 Legal order(s) that preclude contact with non-custodial parent

Note: The financial aid committee’s decision is final and cannot be appealed.

Student Information

Name: ___________________________________________________ Baylor ID #: _________________________________

Permanent street address: _________________________________ City: ____________________ State: _________ ZIP: _________

Email: ______________________________________________________ Phone #: ________________________________________

Noncustodial Parent Information

Name: ___________________________________________________ Phone #: ___________________________________

Permanent street address: _________________________________ City: ____________________ State: _________ ZIP: _________

Occupation: ________________________________________________ Employer: ________________________________________

Marital Status Information

Status of student’s biological/adoptive parents:

o Divorced _______________________
Date (month & year)

o Separated______________________
Date (month & year)

o Never married & do not share household

If noncustodial parent remarried, please indicate month & year: _________________________

If noncustodial parent has other children, please indicate how many and their ages: _____________________________________________

Frequency of Contact Information

Provide date of last contact with noncustodial parent: _______________________________

Please explain the nature and duration (e.g., letter, short visit) of any contact with the noncustodial parent in the past 12 months. Include information
regarding any legal restrictions (e.g., restraining order) to contact.
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Child Support Information

Provide the amount of child support your noncustodial parent paid on your behalf in 2018. __________________
If none, please indicate the most recent year and amount paid. ____________________
Please indicate if the support was (check all that apply):

o Voluntary
o Court ordered
o Paid by wage garnishment
Other Information

Please detail the basis for your request and provide as much information as needed to make a fair decision. Include additional sheets if needed. Also,
attach pertinent documentation to substantiate your circumstances.

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Signatures

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Student’s signature Date

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Custodial parent’s signature Date

Office use only:

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Reviewer’s signature Date