2021-2022 PARENT FAFSA REFUSAL FORM
Student Name: GCU Student Number: __________________
Federal regulations give schools the authority to allow a student to borrow a Federal Direct Unsubsidized Loan
when the student’s parent(s) have ended all financial support and have refused to complete and sign a
Free Application for Federal Student Aid (FAFSA). Students who request consideration for the loan should read
the rest of this form and have one parent complete and sign the form. Note that this form does not allow a student
to apply for financial aid as an independent student. Students must understand that they are requesting
only Federal Direct Unsubsidized Loans subject to the limits for dependent students. No other federal aid will be
available, including the Federal Direct Parent PLUS Loan, the Federal Direct Subsidized Loan, and Pell Grant.
Although the Off
ice of Financial Aid may waive the requirement for parent income and asset information on the
FAFSA, the student must complete and submit a FAFSA that includes all of the required student information and
certifications.
A dependent student whose parent(s) has ended financial support and refuses to file the FAFSA may be eligible
to receive Federal Direct Unsubsidized Loans to assist in funding his education. The Office of Financial Aid will
make this determination based on the documentation submitted, and this request will be approved only in
certain circumstances. The decision of the Office of Financial Aid is final and may not be appealed to the U.S.
Department of Education.
Student: Please have your parent complete this form and send it to your GCU Student Services Counselor. If
you meet the conditions shown in the Parent Section below but your parent will not sign this form, you may
submit a letter from a third party (e.g. teacher, counselor, clergy, or court) who is familiar with your situation
and can describe your relationship with your parent(s). The letter must be signed and dated on appropriate
letterhead, if applicable.
PARENT SECTION:
I attest that all
of the following statements are true:
1.
I have stopped providing financial support to the student (including payment of educational costs as well
as all other cash and non-cash support to the student such as room and/or board, use of my vehicle,
healt
h and car insurance, groceries, rent, utilities, tuition, cell phone, etc., and the student is not included
in my tax exemptions) as of the following date:
______________________________ (MM/DD/YYYY), AND
2. I will not provide financial support to the student in the future, AND
3.
I refuse to complete the parental section of the Free Application for Federal Student Aid (FAFSA).
Parent Name (print): ___________________________________________________________
Parent Address: ______________________________________________________________
Parent Signature: Date:
HANDWRITTEN SIGNATURES REQUIRED – TYPED/ELECTRONIC SIGNATURES NOT ACCEPTED
P0109102020
