Student Representation Fee and ASB Student Card Waiver Form

Information and Waiver Request for the Associated
Student Body and Student Representation Fees

The ASB Viking Card will provide you with student discounts and privileges that are not available to students without an ASB Sticker. Funds raised by the sale of these cards are used to provide student representation on issues affecting community college students. Funds support various activities and programs on campus.

YOUR SUPPORT OF $6 PER SEMESTER ENTITLES
YOU TO THE FOLLOWING:

Free admission to BCC College basketball games
10% discount on textbooks/supplies at the Viking Shop
Complimentary back-to-school refreshments at the beginning of each semester
Discounted admission to college musical, dance and theatrical programs
Unlimited use of BCC computer labs
10% discount at Fosters Freeze
10% discount at The Furniture Outlet
10% discount at Ava’s Hair Studio & Spa
10% discount at R Tux Shop
10% discount at Mariani Jewelers
10% discount at Barstow Motorcycle Center
10% discount at Phantom Sports
10% discount at Haver Glass Company
10% discount at Red Baron Pizza
10% discount at Michael’s Flowers
10% discount at Tattle Tails Grooming By Brenda
10% discount at Deluxe Cleaners Number 1 & 2
10% discount at Talk’N Trash Clothing
10% discount at The Lunch Box (upon ordering 3 items or more)
10% discount at High Desert Appliance (All parts)
10% discount at Carpets-N-More (Off Installation of 100 sq. /yds or More)
10% discount at Adorable Pets (Excluding dog & cat food and grooming)
15% discount at Badd Fingers Guitar Studio
15% discount at Xotic Tanz
20% discount at Straw Hat Pizza (Regular menu prices, not valued on discounts)
20% discount at Karl Brown Tax Service (For Personal Income Tax preparation only)
25% discount at Main St. Fitness & Tanning
$5 off at Nail House Rock-n-Hair
$5 off at A Touch of Softness (Any Facial or Pedicure by Rita)
Philly’s Cheese Steak & Sandwich Shop (Buy Any 2 Small Combos Get the 3rd on FREE; Sunday- Buy Any 2 Sandwiches Get the 3rd on FREE)
Buy one #18 get one free at Lola’s Kitchen
Free tire dressing with of Full Service Car Wash From Sparkle Car Wash
Free Nutritional Boost with Smoothie or Ice Coffee From the Cake Shop

Purchase of an ASB Card is validated by a sticker placed on the Student ID Card. ASB Cards are purchased at the time of registration or at Admission and Records throughout the semester. Validation stickers may be obtained from the Campus Events Office during their advertised hours.

The above stated programs and discounts are provided only to
purchasers of the Barstow Community College Associated Student Body Card.

What is your name?

What is your email address?

Purchase of an ASB Card is validated by a sticker placed on the Student ID Card. ASB Cards are purchased at the time of registration, or at Admission and Records throughout the semester. Validation stickers may be obtained from the Campus Events Office during their advertised hours.

I have read and understand the material above, but request to be exempted from the purchase of an Associated Student Body Card at the price of $5 per semester for thesemester of the school year.

I understand that I will not have of the privileges and rights of active membership of the Associated Student Body of Barstow Community College as stated above.

First Name	Last Name
Last four of Student ID	Telephone #
Date	College Official

The Student Representation Fee is used to support students who lobby for legislative issues that benefit community colleges and community college students. These funds are utilized by student representatives for travel to Sacramento to lobby legislators and for participation in CalSACC (California Student Association of Community Colleges) related activities. You may elect to waive the $1 fee for religious, political, financial, or moral reasons.

By signing your name below, you are choosing NOT to support legislative efforts of the students of Barstow Community College.

First Name	Last Name
Last four of Student ID	Telephone #
Date	College Official