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2020-2021
Unusual Enrollment History Review Form (UEH)
STUDENT NAME: ____________________________________________________________ WCC ID: _________________________
ADDRESS: _____________________________________________ ________________________________ _______________ __________________
STREET OR PO BOX CITY STATE ZIP
Your 2020-2021 Free Application for Federal Student Aid (FAFSA) has been flagged for an “Unusual Enrollment History"
review because you received Federal Pell Grant funds and/or Federal Direct Loans at multiple schools in recent years.
Wayne Community College (WCC) is responsible for conducting this review to ensure that federal educational funds are
being used for educational purposes, and that you are making progress toward completing your degree program. The law
requires that the College obtain this information before awarding federal aid. PLEASE NOTE - Your eligibility for
financial aid cannot be determined until this review process is complete.
INSTRUCTIONS: Complete this form using blue or black ink, sign, and submit to the WCC Financial Aid Office with the
following items:
A copy of your Pell Grant history AND Direct Loan history (available through studentaid.gov)
Additional information as required. (see note below)
A. COLLEGES ATTENDED
enter all colleges attended during the years listed below
~If you need additional space, attach a separate sheet that includes your name and WCC ID.
COLLEGE OR UNIVERSITY ATTENDED*
ACADEMIC
YEAR
DID YOU RECEIVE
FINANCIAL AID?
DID YOU EARN
ACADEMIC CREDIT?
TOTAL
CREDITS
EARNED
2016 - 2017
Yes
No
Yes
2017 - 2018
Yes
No
Yes
2018 - 2019
Yes
No
Yes
2019- 2020
Yes
No
Yes
* Submit official transcripts from each college/university listed on your NSLDS record to the Office of Admissions and Records.
NOTE: If you did not earn academic credits at one or more of the institutions listed above, you are required to
attach a typed statement explaining why you failed to earn credit during that academic year.
The statement must include specific details related to any extenuating circumstances that prevented you from
successfully completing your coursework. Attach relevant third-party documentation to support your statement.
(Acceptable documentation may include, but is not limited to, medical or legal documents, accident reports, a death
certificate, or letters from medical doctors or mental health professionals).
RETURN THIS COMPLETED FORM WITH REQUIRED DOCUMENTATION TO:
Wayne Community College - Financial Aid Office - PO Box 8002 - Goldsboro, NC 27533-8002
FAX: 919-736-9425
Wayne Community College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate degrees. Contact the
Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Wayne Community College.
The Commission on Colleges may be contacted only if there is evidence that Wayne Community College is significantly non-compliant with a requirement or standard.
Accreditation standards are located at: http://www.sacscoc.org/principles.asp. Inquiries about Wayne Community College, such as admission requirements, financial aid,
educational programs, etc. should be addressed directly to Wayne Community College and not the Commission’s office.
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B. CERTIFICATION AND SIGNATURE
Review each item below and INITIAL to confirm that you understand the information:
I understand that forms submitted without required information and/or applicable documentation will be denied.
I understand that if I owe any debt to Wayne Community College, or if I am flagged for a debt to another
institution, my Unusual Enrollment History Review form will not be processed until the debt is paid in full or
satisfactory payment arrangements have been made.
I understand that decisions regarding Unusual Enrollment History Review are made on a case-by-case basis.
I understand that submission of an explanation of why no credit was earned and any supporting documentation
does not guarantee that my financial aid eligibility will be reinstated.
I understand that if my Unusual Enrollment History Review is approved, I am required to maintain enrollment
and make satisfactory academic progress to remain eligible in the future.
I understand that the decision made by the WCC Financial Aid Office for Unusual Enrollment History Review is
final.
I, ____________________________________________, understand that my FAFSA has been flagged for a review of
Unusual Enrollment History by the Department of Education. I certify that the information reported on this form, my
accompanying statement, and all documentation provided in support of my statement is true and accurate.
_________________________________________________ ____________________
STUDENT’S SIGNATURE (REQUIRED)
DATE
DOCUMENT SUBMISSION CHECKLIST:
Your name and WCC student ID is included on each document you are submitting.
Grant and loan history are attached.
Official, sealed academic transcripts from each college/university attended have been submitted to the Office of
Admissions and Records.
A typed statement in support of reasons no credit was earned is attached.
Additional, third party documentation in support of reasons no credit was earned is attached.
Note: The dates on any supporting documentation must coincide with the dates you received the federal Pell Grant
and/or student loans and did not earn academic credit.
WARNING: If you purposely provide false or misleading information
to obtain financial aid, you may be fined, sentenced to jail, or both.
click to sign
signature
click to edit
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