Central Alabama Community College
Student’s Name: __________________________ Student Number: _________________________
Address: __________________________________ Phone Number: ___________ Date of Birth: _________
A Professional Judgement appeal may be submitted for consideration for Cost of Attendance increases for unusual
expenses incurred for educational purposes. Adjustments in Cost of Attendance are generally limited to the following
costs associated with a student’s disability
child care expenses for a dependent child or
one-time purchase of a computer for
educational expenses
one-time costs of professional licenserure
required for a student’s major
additional credit hour enrollment by semester
residency/housing change
health Insurance Fees
other extenuating circumstance(s)
Please complete, sign, and submit this form with a letter of explanation and the required documentation to the
Financial Aid Office.
Please allow 1-2 weeks for our response. Please note that all decisions are final. All Professional Judgment requests
must complete the FAFSA, and verification process, if selected, by submitting all required verification papers along
with copies of 2018 Federal tax return and W-2 information. Additional documentation may be requested.
Reason for Request
Please check your reason below and submit documentation that supports your appeal request. See below for required
documentation. Professional Judgment appeals are reviewed on a case-by-case basis, and require a letter of
explanation and supporting documentation.
____Disability: Documentation of disability diagnosis, costs related to student’s disability (ex: personal
assistance, transportation, equipment or supplies.)
____Child Care Expenses: Proof of dependent care expenses paid for the current academic year and signed
and dated statement of what changed.
____Unusual Medical and Dental Expenses not Covered by Insurance: Excessive medical and dental expenses:
Submit proof of actual medical and dental payments made in the prior year and the current year that
were not reimbursed by insurance. Submit a signed copy of Schedule A from your tax form.)
____Computer Purchase: Proof of cost of computer required for educational purposes or proof of purchase.
This is a one-time adjustment during your enrollment at CACC and requires receipt of purchase.
____Additional Credit Hours Enrollment: Proof of enrollment greater than 15 hours for the semester.
____Change in Housing Status from With Parent to Off Campus: Proof of off campus rental/lease/purchase
agreement with your name on the document and the address of the new residence.
____Other extenuating circumstances: Submit a signed and dated letter explaining your special circumstances.
Submit as much documentation as possible to support your reason for requesting consideration.
I confirm that the statement above and information provided is true
and accurate to the best of my knowledge as of this date.
____________________ _________________________________________
Student Signature Date
_________________________________________ _________________________________________
Parent’s Signature (if applicable) Date
FAA Name: ________________________________ Signature: ____________________________ Date: ____________
WARNING: If you purposely give false
or misleading information, you may
be fined, sent to prison, or both.