Dr. H.A. Miller Student Services Center Enrollment History Review
417 Schepps Blvd., Clovis, NM 88101
2019-2020
Ph. (575) 769-4060 * Fax (575) 769-4027
CCC ID: Name:
Your 20182019 Free Application for Federal Student Aid (FAFSA) has been flagged for “Unusual Enrollment History Review” by the U.S.
Department of Education because you received Federal Pell Grant and/or Federal Direct Loan funds at multiple education institutions
during the review period: 2014-2015, 2015-2016, 2016-2017, 2017-2018, and 2018-2019. This flag requires our institution to review your
enrollment history and determine whether or not you are enrolling only long enough to receive cash refunds of federal student aid.
INSTRUCTIONS
1. Contact CCC Admissions Office at (575) 7694025 to determine if all your post-secondary transcripts have been received.
2. If all of your post-secondary transcripts have not been received by Clovis Community College, you will need to request academic
transcripts from the missing post-secondary institutions and have them sent to Office of Admissions and Records. It is your
responsibility to ensure that all post-secondary institution transcripts are received by Clovis Community College. Your eligibility for
financial aid cannot be determined until all transcripts have been received.
3. List all post-secondary institutions you have attended during the review period below:
Name of College or University
Dates Attended
Aid Type
Credits Earned
2014-2015
2015-2016
2016-2017
2017-2018
2018-2019
4. For each school listed above where you did not earn any credits, attach a signed and detailed explanation of why you failed to earn any
academic credit at that institution while receiving Federal Pell Grant and/or Federal Direct Loan funds during the review period. Along
with the explanation, you must submit date-specific supporting documentation from a disinterested third party. Letters from family
and friends are generally not accepted.
Valid reasons for failure to complete academic credit include, but are not limited to:
Documented medical condition or serious illness
Documented family emergency
Death of immediate family member
Documented change in where student is living
Only a move to a different city or state will be considered
Documented military obligations
Other extraordinary/emergency circumstances
SIGNATURE REQUIRED
By signing this worksheet you certify that all of the information reported on it, is complete and correct. Warning: If you purposely give false or
misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
Student Signature: Date:
Financial Aid Office Use Only
Federal Pell Grant funds received at CCC during review period: Yes No Flag 2 Flag 3
Comments:
Revised 9-26-2017
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