REQUEST FOR FINANCIAL AID AWARD REVIEW
2019-20
Student’s Name Student’s ID
Student’s Address
Student’s Email Student’s Phone
Parent’s Name Parent’s Day Phone
Parent’s Email
Situations may occur that affect your eligibility for federal funds. Please complete this form to document
those situations. A committee within the Office of Student Financial Assistance will review your request.
Decisions are based on the documentation provided and the guidelines established by Jacksonville
University and federal regulations. All decisions of the committee are final. Your request for re-evaluation
will not be reviewed until we receive all of the required documentation. Please allow 2-6 weeks after
receipt for review and evaluation.
Award reviews may be requested at any time resulting from a change in family circumstance(s). Check only
those that are applicable to your family’s specific situation and submit supporting documentation with this
form.
Involuntary loss/reduction of work income
Loss of unemployment or some untaxed income or benefit.
Household’s unusually high unreimbursed medical or dental expenses (must exceed 10% of AGI)
Legal separation/divorce
Death of a parent/spouse
Any other information or changes affecting your family’s financial situation
Please use this section to provide additional information describing the basis for your request. You may attach
additional letters or documents that you think will support your request.
CERTIFICATION
By signing below, I certify that the information contained on this form is true and complete to the best of my
knowledge. Upon request, I will provide any additional documentation to substantiate the information provided.
Student Date
Parent Date
