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ROZ Student Loan Repayment Application

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If you are interested in applying for the ROZ program, please fill out the following form. Your information will be reviewed and you will be contacted within 120 days.

Residence Information









We have had an overwhelming demand for the ROZ tuition reimbursement program. A few counties have had a particularly high number of applications, and as a result may have a waiting list. While many applicants will not have to be placed on a waiting list, there is a chance that the county for which you are applying may have a waiting list. If you indicate that you do not understand this process in the box below, we will provide you with more information.




Please provide the following details on each of your primary residences within the 5 years immediately prior to establishing your primary residence within a ROZ county, starting with your most recent residence in the section labeled "Address 1."


Please enter the dates you established prior residences in MMDDYYYY format.







Income Information





Education Information







Student Loan Information







Note: Kansas Dept. of Commerce may request additional information if deemed necessary to verify eligible loan balances and establish a payment process. This information may include but not be limited to transcripts.

Please Note: If you choose the Submit and Print option below, you must be sure to click the Continue button at the bottom of the form once you've printed your copy in order for your nomination to be submitted.
 
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Kansas Department of Commerce, 1000 S.W. Jackson St., Suite 100, Topeka, KS 66612-1354
(785) 296-3481      TTY - 711      Fax (785) 296-5055