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2018-2019 Unusual Enrollment History - Unusual Enrollment History underlined

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2018-19
Unusual Enrollment History
KCTCS ID: ________________________________
Name:_____________________________________________________________
Address: __________________________________________________________
City, State & Zip: ____________________________________________________
Federal
Financial Aid Regulations require certain actions be taken when a student has an unusual enrollment
history with regard to the receipt of Title IV funds (Pell Grant and/or Direct Loans). These actions are intended to
address possible fraud and abuse of these financial aid programs. Your 2018-19 FAFSA was flagged by the
Department of Education for an Unusual Enrollment History review, or it was the result of an institutional review.
Review the Attendance and Title I
V History chart, checkboxes and comments to take appropriate action.
Attendance and Title IV History
Attendance History
Award
Year
Pell Grant
Received
Direct Loans
Borrowed
Academic
Transcript
Received
Academic
Credit
Earned
Fall: ____________________
Spring: ____________________
2017-18
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
Fall: ____________________
Spring: ____________________
2016-17
☐ Yes ☐ No
☐ Yes ☐ No
☐
Yes ☐ No
☐ Yes ☐ No
☐
Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
Fall: ____________________
Spring: ____________________
2015-16
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
Fall: ____________________
Spring: ____________________
2014-15
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
Academic Review: Code 359 (Flag 2) - ☐ Yes
☐
No
In the last four Award Years, was academic credit earned at our institution?
☐ Yes:
☐ No further action is required, this review is complete.
☐ There is reason to believe the student enrolled just to receive a credit balance.
Complete the “Academic Review: Code 360 (Flag 3)” on the reverse side of this form;
supporting documentation may be required.
☐ No:
☐ To verify the student did not enroll just to receive a credit balance, complete the “Academic
Review: Code 360 (Flag 3)” on the reverse side of this form; supporting documentation may
be required.
2018-19
Unusual Enrollment History
Continued on back of page
Academic Review: Code 360 (Flag 3) - ☐ Yes ☐ No
1. Have we obtained copies of all Academic Transcripts according to the Attendance and Title IV
History?
☐ Yes: Proceed with Step 2.
☐ No: Use the “Academic Transcript Received” column of the Attendance and Title IV History chart to
find which transcript(s) is needed. The student must submit the Academic Transcript to the
financial aid office for review, even if academic credit was not earned.
NOTE: Submission of transcripts is not an offer to accept the credit at our institution;
However, we must determine whether or not you earned credit at the institution.
2. Was academic credit earned at each institution during the last four Award Years?
☐ Yes: No further action is required, this review is complete.
☐ No: The following documents must be submitted by the student, to the Office of Financial Aid:
1. Signature required on this document,
2. Typed letter explaining why academic credit was not earned at each institution, and
3. Supporting documentation
I wish to appeal the unusual enrollment history review decision. I understand that by signing this I am agreeing
that all information reported is complete and correct. I understand that the institutional determination is final
and cannot be appealed to the Department of Education. If the appeal is denied, I am responsible for all charges
pertaining to enrollment in future terms.
Student Signature Date
FOR OFFICE USE ONLY
☐Approved/UEH Flag Cleared ☐Denied
Reason for Denial:
Reviewer: Date
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Completed 1 November 2019

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