Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Fee Waiver Application

  1. Fee Waiver Application

    Maricopa County Environmental Services Department
    Phone: (602) 372-1778
    feewaiver@mail.maricopa.gov

  2. Please be aware of the following:

    1. All documents must be submitted to the Department before the Board of Health can consider granting a fee waiver.
    2. Fee waiver applications submitted to the Department less than 3 weeks before the Board of Health meeting will be held over until the next scheduled meeting.
    3. The Board of Health is scheduled to meet on the 4th Monday in January, April, July and October.

  3. A school district or school with students enrolled in a K – 12 culinary arts program, or similar program, seeking a waiver of fees associated with the issuance of a limited food employee certificate must meet all of the following criteria as outlined in {Maricopa County Environmental Health Code, Ch. 1 Reg. 5a (2)}. *

    Please read and acknowledge both statements by checking boxes.

    Note: Fee Waived Food Employee Training certificates are valid for three (3) years and only when students are handling food during their Culinary Arts class or at a Culinary Arts event.

  4. A person or entity seeking a waiver of fees associated with the administering and issuance of a limited food employee certificates must meet all of the following criteria as outlined in {Maricopa County Environmental Health Code, Ch. 1, Reg. 5a (1)}*

    Please read and acknowledge both statements by checking boxes.

    Note: Fee Waived Food Employee Training certificates are valid for three (3) years and only when volunteering at the Charitable Non-Profit Establishment.

  5. A person or entity seeking a permit fee waiver must meet all of the following criteria as outlined in (Maricopa County Health Code Ch. 1, Reg. 5a) :*

    Please read and acknowledge statements by checking boxes.

  6. DOES THE SCHOOL DISTRICT OR SCHOOL HAVE CURRENT STUDENTS ENROLLED IN A CULINARY ARTS PROGRAM OR SIMILAR PROGRAM? *

  7. 1. Determine how many students need food employee training within a year.
    2. Determine the total number of training classes needed within said year.
    HINT: Training class size should be at least seven (7) students to a maximum of forty-five (45) students.
    3. Enter the number of training classes needed within said year in the field above.

  8. IS THIS FEE WAIVER APPLICATION FOR TEMPORARY PERMITS AT SPECIAL EVENT?*

  9. Please upload letter from Department of the Treasury, Internal Revenue Service.

  10. Please upload Invoice(s) or Receipt(s).

  11. Application Acknowledgement*

    As the responsible agent for the above-mentioned organization, I certify the information on this application and the attached document(s) is true and correct.

  12. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  13. Disclaimer

    Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.

  14. Leave This Blank:

  15. This field is not part of the form submission.