Anoka Technical College and Anoka-Ramsey Community College are affirmative action, equal opportunity educator/employers. To receive this information in an alternative format, 763-576-4069. Rev. 10/18
1355 West Highway 10
Anoka, MN 55303
Fax: 763-576-7721
2019-2020 Petition for Pell Grant Census Date Override
Name ________________________________________ Stu.ID _______________________ ATC Email _______________________@my.anokatech.edu
I am petitioning the Financial Aid Office to consider my course(s) for Pell Grant eligibility after the Grant Census Date.
The Pell Grant Census Date APPEAL:
• Your Pell Grant awards are calculated based on your registration as of the Grant Census Date for the term. The Pell Grant will not be
automatically adjusted for course registrations taking place after this date. If you register or modify your course schedule after the Grant
Census Date, you may appeal to have your grant eligibility reviewed. Examples of Valid Circumstances for an appeal include, but are not
limited to, course section changes, college initiated registration error, submission of paperwork submitted before the census date, but not
processed until after the add/drop date.
THE STUDENT MUST COMPLETE AND SUBMIT this signed document, along with the Requested Documentation as detailed below:
Explanation of Valid Circumstances for Registration After the Grant Census Date. Provide separate statement if needed.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
List Courses Requested for Grant Eligibility. Only courses added after the Grant Census Date should be included.
Course Number: ___________ Course Section: _______ Comments: ________________________________________________
Course Number: ___________ Course Section: _______ Comments: ________________________________________________
Course Number: ___________ Course Section: _______ Comments: ________________________________________________
Course Number: ___________ Course Section: _______ Comments: ________________________________________________
Course Number: ___________ Course Section: _______ Comments: ________________________________________________
Course Number: ___________ Course Section: _______ Comments: ________________________________________________
Attach Supporting Documentation. Such as 3
rd
party statements, registration history, email, or written documents.
***I certify that all of the information stated in the letters attached concerning my request for a status change from dependent to independent is true and complete.***
__________________________________________ ____________________
Student Signature Date
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OFFICE USE ONLY
Approved __________________________________________________________________________________________________________
Pending/Denied _____________________________________________________________________________________________________
__________________________________________ ____________________
Financial Aid Administrator Date
