Instructions: fill out form, choose ‘print’ icon then ‘save as pdf’ and email form from your device to firstname.lastname@example.org
2020-2021 UNUSUAL ENROLLMENT HISTORY APPEAL FORM
Based on the submission of your recent FAFSA it has been determined that you have an unusual enrollment history while receiving Federal Student
Aid. An unusual enrollment history is defined as having attended multiple institutions in the past four aid/award years. If, upon review of your
academic records, it is determined that you did not earn academic credit at one or more of your previously attended institutions, you will need to
complete part C of this form. In this circumstance, our office is unable to award federal Title IV funding until the appeal is received documenting the
reason for your failure to earn academic credit.
If you wish to appeal, please complete this appeal form providing an explanation of your circumstances during the semester(s) in which you did not
earn credit. Attach any supporting documentation to this form.
A. STUDENT INFORMATION
Name: __________________________________________ Student ID #: _______________________________________
Mailing Address: __________________________________________ Telephone Number: _________________________
Email Address: ______________________________________________________________________________________
B. List all schools at which you attended in the last 4 years
Name of Schools and terms attended: Did you submit Did you
transcripts? earn credit?
Yes No Yes No
If you answered “yes” to having earned credit at all of the schools listed above, and have submitted transcripts showing your grades from all of
these semesters, you may sign here and submit this form to request that we review your transcripts and Federal Student Aid history. If we can
confirm that you earned credit at every school each year you received Federal Aid, you will not need to provide explanation or documentation:
I earned credit at every school each year I received Federal Aid. Please review my records.
Student Signature: _____________________________________________ Date: _____________________________
Office of Financial Aid & Scholarships