Student Representation Fee and ASB Student Card Waiver Form

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

Before you deny and sign the ASB Discount Waiver Card, did you know that it makes good "cents" to receive more for your buck!

This voluntary membership fee supports a wide range of student services, activities and programs. All students enrolled are automatically assessed a membership fee of $6 per semester. Should a student choose not to be a member, the fee can be waived by completing the "Information and Waiver of ASB and student Representation Fees." The ASB Viking Card will provide you with student discounts and privileges that are not available to students without and ASB sticker. Students may stop by the Student Government office to pick a list of businesses around town that also honor the Barstow Community College Discount Card. This is a listing of the benefits of ASB membership:

Benefits with your ASB Sticker:

Automatic 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
15% discount at Mega Tom’s Burgers. (Not on Specials.)
20% discount at Adorable Pets. (Excludes dog and cat food and grooming.)
10% discount at Los Domingos. (On food purchases only)
15% discount at Panda Express. (Barstow Station only.)
10% discount at iNVE Beauty Supply & Salon. (On product only.)
Buy one get one free on a #18 at Lola’s Kitchen. (One per person no other offers combined.)
10% discount at Deluxe Cleaners.
15% discount at Xotic Tanz. (Not valid with current sales/promotions)
10% discount at Rock Body Sport Nutrition
10% discount at DiNapolis Firehouse. (One meal students only.)
10% discount at Route 66 Pizza Palace. (Off menu price.)
10% discount at Red Baron Pizza. (Off menu price.)
$5 off one hair cut only at Lydia’s Hair Salon. (Only by Georgia Mitchell)
10% discount at Game World. (Only on pre-owned products, trades do not apply.)
10% discount at Shot Caller.
10% discount at Shot Callers. (Only by Sunshin Braiders.)
$10 per Haircut at Shot Callers. (Only by Jason Barber. Excludes designs or facial hair.)
20% discount at Straw Hat Pizza. (Off any regular priced menu item.)
10% discount at Family Fashionz. (With the purchase of $50 you will receive a single hand dipped cone at Daily Stop.)
10% discount at Revolutions Entertainment Center. (Excludes alcoholic beverages and play cards)
20% discount at Cutting Edge Hair and Nail Salon for all services. (Not good on products.)
10% discount at Jenny’s Grill Steak and Mariscos.
10% discount at Laplacita Mexican Restaurant.
$5 off at A Therapeutic Pain and Stress Center. (Only from massage therapist Reanna Walker.)
79.99 +tax rate at Country Inn and Suites. (Must be over 18yrs old, must have ID and credit card.)
10% discount at Sizzlers. (Except on specials and already discounted items.)
$1 off at Just Grill It Teriyaki House. Any bowl or plate. (Can only buy 1 bowl or plate per day no exceptions.)
10% discount at Phantom Sports. Must have card present.
10% discount at Mirage Motorsports. (Does not apply to purchase of used vehicles.)
10% discount at Platas Mexican Food Lenwood location only. (Not on special offers or sales.)
$50 discount at Image Collision.
5% discount at Pro Dirt Motorsports LLC.
10% discount at Rainbow Florist. (Not valid on major holiday items i.e. Christmas, Mother’s Day and Valentine’s Day.)
10% discount at The Furniture Outlet.
Buy one combo, get another combo free with purchase of two sodas at Costa Azul

10% discount at American Tire Depot (Winston Tires). Oil changes $24.95 +tax & disposal.
15% discount at Quigley’s Food & Spirits. (Not good with specials or other discounts)
15% discount at Foster Freeze. (Not good with specials or other discounts)
10 % discounts at Idle Spurs Steakhouse
5% discount at B&D Automotive
5 dollars of ladies haircut and 1.50 dollars off men’s haircut at Split Endz

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. I also understand the ASB fee cannot be waived once paid.

First Name	Last Name
Student B Number	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
Student B Number	Telephone #
Date	College Official