Central Alabama Community College
Student’s Name: __________________________ Student Number: _________________________
Address: __________________________________ Phone Number: ___________ Date of Birth: _________
A Professional Judgement appeal may be submitted for consideration based on your circumstances. Please indicate the
reason for requesting a professional judgment consideration and submit supporting documentation (non-returnable
copies) to the Financial Aid Office. Requests submitted without documentation will not be considered.
Please complete, sign, and submit this form with a letter of explanation and the required documentation to the
Financial Aid Office. See Required Documentation Below:
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
signed copies of 2018 Federal tax return including schedule(s) and W-2 information. Additional documentation may be
Reason for Request
Please check your reason below and submit documentation that supports your appeal request. See below for required
_____Loss of income or change in source of income (Please check all that apply.):
_____Parent(s) _____Student _____Student’s Spouse
Loss or significant change in income: Parent/Student/Student’s Spouse: Submit proof of prior-year income and
current-year expected income. If there is a loss of income, submit proof of reason for and date of income loss
such as unemployment form. Include most recent paystub(s) and letter from employer(s).
_____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
_____Death of parent/spouse: Submit a copy of the death certificate of the parent/spouse and surviving
parent’s/spouse’s expected current-year income.
_____Divorce or separation (Please check one.): _____Parent _____Student Submit a copy of the divorce decree or
a letter of separation from court or lawyer. Include the current-year expected income of the student, if
independent, and/or the custodial parent for dependent students.
_____Other extenuating circumstances (Please check one): _____Parent _____Student Submit a letter explaining
your special circumstances. Submit as much documentation as possible to support your reason for requesting
I/We 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
Please return the completed form to:
Central Alabama Community College Financial Aid Office
Alexander City Campus: 1675 Cherokee Road, Alexander City, AL 35010 OR Childersburg Campus: 34091 US Highway 280, Childersburg, AL 35044
FAA Name: ________________________________ Signature: ____________________________ Date: ____________
WARNING: If you purposely give false
or misleading information, you may
be fined, sent to prison, or both.