firstname.lastname@example.org | 855-628-6333
PO Box 4108, Flagstaff, AZ 86011
Scholarship Reinstatement Request
Deadline: Fall: November 15 Spring: April 15
Priority Dates: Fall: August 1 Spring: November 1
Note: Priority date will ensure you will receive a response by disbursement date.
All requests must include a completed Reinstatement Request and supporting documentation.
Complete reinstatement requests will be reviewed by the committee within 25 business days of receipt.
Incomplete reinstatement requests will not be reviewed and/or may be denied.
Students awaiting a decision are responsible for all tuition, fees, and other university charges by
assigned due dates. Late fees will not be waived for non-payment while awaiting a decision.
Submission of this request does not guarantee approval of a scholarship reinstatement.
You may only submit one reinstatement during your undergraduate career.
The Reinstatement Committee reserves the right to award a merit scholarship of a lesser amount. No
appeals for a higher merit award will be allowed.
You must be enrolled for the term you are trying to reinstate in order for you request to be reviewed.
B. Reason for Reinstatement Request
Check all reinstatement circumstances that apply and submit required supporting documents.
Major Life Event: You underwent a major life change that
negatively impacted your ability to meet your scholarship
requirements. Examples of this are a divorce or the birth of a
Separation agreement or divorce
Record of your child’s birth
Any other documentation recording
Mental or Physical Illness or Injury: You, or a member of
your family, suffered from a condition or incident that negatively
affected your ability to participate in your studies.
Signed letter from physician,
therapist, or health professional
outlining illness or injury
Death of a Family Member or Significant Person: A
member of your immediate family or an emotionally significant
person in your life passed away.
Signed letter from a mental health
professional assisting you with grief
Copy of a death certificate
Attended another institution: You attended another
institution for a full semester. (Must have attended NAU for a
minimum of 1 semester.)
Official or unofficial transcript
showing grades earned
Work schedule: Your previous work schedule hindered your
ability to meet your scholarship requirements.
Documentation from a supervisor
regarding workload adjustments
Religious Mission: You completed a religious mission that
required you to be absent from school.