Fillable 2020 - 2021 Budget (Cost of Attendance) Appeal (University of North Dakota)

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2020 - 2021 Budget (Cost of Attendance) Appeal (University of North Dakota)

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File type: PDF

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UND One-Stop Student Services
Email: onestop@UND.edu
Mail:
One-Stop Student Services
264 Centennial Dr Stop 7155
Grand Forks, ND 58202-7155
Student’s Name
Student ID:
Undergraduate
Graduate
Law
UND Email
Phone #:
Number of Dependent Children:
Marital Status:
Single
Married Is spouse enrolled?
Y
N
Spouse’s Name
Is spouse employed?
Y
N
Full-Time Part-Time
All Budget Appeal forms must include the following:
• A l
etter explaining your need for a budget appeal and additional funding.
• This form completed and signed.
• Documentation of expenses listed.
You will receive notification to your UND email account after your budget appeal has been reviewed. The
Budget Appeal review process may take up to 14 business days.
Deadlines:
Fall Only: Oct. 15, 2020
Spring Only: Mar. 30, 2021
Fall & Spring: Mar. 30, 2021
Budget appeals for the summer session are separate will only be reviewed after registration for summer is completed.
PLEASE READ AND COMPLETE THE FOLLOWING
2020 - 2021 Budget (Cost of Attendance) Appeal Form
UND One-Stop Student Services
Email: onestop@UND.edu
Mail:
One-Stop Student Services
264 Centennial Dr Stop 7155
Grand Forks, ND 58202-7155
D
D
Monthly Expenses
Expenses
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Total
-EXAMPLE-
150 0 0 0 0 150 150 150 150 150
900
*Educational Expenses
(Not tuition/fees)
*Rent/House Payment
*Utilities
Food (special diet
documentation)
*Renter’s/Homeowners
Insurance
*Auto Insurance
*Gas/General Car
Maintenance
*Medical Insurance
*Dental/Optical
*Toiletries/Personal Expenses
*Computer Purchase
*Other:
Expenses Total Per Month
$
*Proof of payment required for expenses listed (e.g. bank statements, cancelled checks, copy of checks, copy of lease agreement,
child care contract) Any expenses without documentation will not be considered.
Child care/adult care expenses will only be considered for the time period you are participating in an education
related activity (clinicals, class, research, group meetings, etc.).
Are you (or will you be) receiving child or adult care assistance from any other source? Yes No
If yes, which source? Amount received each month: $
Expenses
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Total
*Child/Adult Care
Dependent’s Name Age Avg. Hours/ Day Hourly Care Fee Avg. Monthly Expenses
Child or Adult Care Expenses
UND One-Stop Student Services
Email: onestop@UND.edu
Mail:
One-Stop Student Services
264 Centennial Dr Stop 7155
Grand Forks, ND 58202-7155
Commuting Expenses
If you commute more than 40 miles (round trip) per day to attend classes at UND, complete the following:
Commuting From: Commuting To:
Number of miles per day: Number of days per week:
Number of expected days per semester:
Reason(s) for commuting:
If you have acquired additional medical and/or relocation expenses related to COVID-19, please specify here or attach
further explanation if more room is needed.
Explanation of financial impact or expense(s):
Date(s) expense(s) incurred:
Warning: If you purposely give false or misleading information on this form to help establish eligibility for
Federal Student Aid, you may be subject to a $20,000 fine, a prison sentence, or both.
*Please note that this request for a budget adjustment does not guarantee additional funding.
Student’s Signature Date Spouse’s Signature (if applicable) Date
FOR OFFICE USE ONLY
Eligible Ineligible
Additional aid requested:
Financial Aid Advisor Signature: Date:
COVID-19 Related Relocation or Medical Expenses
Signature(s)
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2020 - 2021 Budget (Cost of Attendance) Appeal (University of North Dakota)

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Completed 2 February 2021

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