T: +1 671.735.2940/2945 F: +1 671.734.2907 W: www.uog.edu
Mailing Address: 303 University Drive UOG Station Mangilao, Guam 96923
The University of Guam is a U.S. Land Grant Institution accredited by the Western Association of Schools and Colleges
Senior College and University Commission and is an equal opportunity provider and employer.
ADMINISTRATION & FINANCE
Bursar Office
Student Name: _______________________________________________ Social Security #: _______________________
Student ID#: ________________________________ SFAP Program(s): _______________________________________
Email: ____________________________________________________________ Contact #: ____________________________
Explain, in detail, the reason(s) for your special request
Documents must be legible.
Incomplete forms will not be reviewed
SPECIAL REQUEST (Example: To change graduation date from May 2019 to May 2020.)
Student Signature Date
FOR BURSAR OFFICE USE ONLY
Approved Denied
Comments:
Bursar Signature Date