Colleges, Vocational Schools, and other Postsecondary Institutions
Please list all institutions, including CCC&TI, attended during the academic periods that include 2016-2017,
2017-2018, 2018-2019, and 2019-2020. Please attach or have each of your prior schools, excluding CCC&TI,
send an academic transcript to Student Records.
Full review cannot be completed until your transcripts have been received.
Institutions,
received (Pell
Credits Earned
Required Documentation and Reasons for the Appeal
For each school listed above attach a detailed statement explaining the reason for your failure to earn
academic credit at that institution while receiving Federal Pell Grant funds during the review period. Please
refer to a situation that occurred during those academic terms in which you failed to earn credit. Please
indicate what you have done to address and correct the issues associated with the unusual enrollment history.
Within your statement, please include the name of the school and academic period. You may include any third
party documentation which would support your statement. Attach relevant documentation to this appeal
worksheet.
Please initial each item indicating that you have read and understand the information below:
____ I understand that decisions on Unusual Enrollment History are processed on a case by case basis.
____ I understand that I must maintain enrollment and satisfactory academic progress to maintain eligibility in the
future.
____ I understand that appeals submitted without supporting documentation will be denied.
Certification and Signatures:
I understand if I purposely give false or misleading information I may be fined, sentenced to jail, or both.
Student Signature Date
Return completed worksheet(s) to:
Caldwell Community College and Technical Institute
Office of Financial Aid
E-mail – finaid@cccti.edu
Caldwell Campus – 2855 Hickory Blvd., Hudson, NC 28638 Watauga Campus – PO Box 3318, Boone, NC 28607
Fax: 828.726.2709 Fax: 828.297.1729
click to sign
signature
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