Online Classes ONLY Immunization Waiver

Students who are enrolled in online classes ONLY (including ETSU online and RODP) are exempt from immunization requirements related to full-time enrollment. To request this exemption, such students must complete this form, sign and either fax or bring it to the Registration Office, Burgin Dossett Hall Room 102. This form is for one term only and must be updated each semester for which the exemption is being requested.

In submitting this form, I affirm that I am registering for ONLY online classes for    
I understand, for each semester for which I am requesting the exemption, I must complete a new form, sign and either submit online, fax, or bring it to the Registration Office in order to continue to be exempt from the immunization requirements related to full-time enrollment.

Check immunization status in GoldLink to verify that proof has been received.

If necessary requirements are not met, the one semester waiver will not be approved.

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8/1/2014 5:51:30 AM

I certify that the information is correct and my E Number acts as my electronic signature.

Questions regarding immunization requirements : contact Student Health Clinic (423) 439-4225.
Questions regarding completing this wavier: contact Registration Help Desk (423) 439-5584.