2020-2021 Authorization to Decline Pell Grant Form
Student Na
me: ________________________ GCU Student Number: ________________
I, ________________________, (name of student), would like to decline the Pell Grant funds
for which I am eligible to receive. I understand that these funds may not be available once
the 2020-2021 award year is over. I understand that the maximum eligibility for the
2020-2021 Award Year is 150% of the Pell Grant amount.
Student Si
gnature: ________________________ Date: ________________
HANDWRITTEN SIGNATURES REQUIRED TYPED/ELECTRONIC SIGNATURES NOT ACCEPTED
P0108292019